Glaucoma traumático

Glaucoma traumático es cualquier glaucoma provocado por una lesión en el ojo. Este tipo de glaucoma puede ocurrir tanto inmediatamente después de una lesión en el ojo como años después.

It can be caused by injuries that hurt the eye (called blunt trauma) or by injuries that penetrate the eye.

Conditions such as severe nearsightedness, previous injury, infection, or previous surgery can also make the eye more vulnerable to serious eye injury.

Blunt trauma

As a result of an immediate injury, traumatic glaucoma is most often caused by blunt force trauma, which is an injury that does not penetrate the eye, such as a blow to the head or an injury directly to the eye.

The most common cause is sports-related injuries, such as baseball or boxing. Normally, eye fluid flows from the front of the eye through the pupil and is then absorbed into the bloodstream through a network of drainage channels around the outer edge of the iris.

When blunt trauma occurs, damage can occur to this system. The most common cause is the ciliary body, the part of the eye that produces ocular fluid, inside the eye tear. This can cause bleeding inside the eye.

Excessive blood, plasma, and waste can build up and clog the drainage system. This can cause increased eye pressure, which can damage the optic nerve.

Elevated eye pressure due to blunt force trauma is treated by keeping eye pressure at safe levels while the eye drains excess blood. Glaucoma medications are usually tried first to control eye pressure. If this is not enough to control eye pressure, surgery may be necessary.

Elevated eye pressure after blunt force trauma is temporary in most cases. However, it is important to make sure you have regular follow-up eye exams.

In some cases, damaged drainage channels in the eye can accumulate excess scarring. This scarring blocks the flow of fluid and can lead to glaucoma. This type of glaucoma, called angular recession glaucoma, can occur many years after the initial injury.

Angular recession is seen on examination as a tear at the base of the iris where the drainage canals are. Angular recession glaucoma can be difficult to treat. Treatments may include medications that reduce fluid production in the eye, laser surgery, or filtration surgery.

PENETRATING EYE INJURY

Traumatic glaucoma can also be caused by penetrating injuries to the eye, such as those caused by a sharp instrument or flying debris. Eye pressure is usually lower right after the injury occurs. Once the wound closes, the tissue inside the eye may swell and become irritated, and bleeding may occur, causing eye pressure to increase.

Short-term increases in eye pressure are managed similarly to cases of blunt trauma. However, damaged tissue and scarring from a penetrating eye injury can cause obstruction of the drainage channels.

Glaucoma due to penetrating eye injury is best treated with preventative measures when the initial injury occurs. Corticosteroid therapy to help prevent tissue damage and scarring, and antibiotics are an important component of initial treatment. Initial treatment may also include surgery to remove excess eye fluid or reduce swollen tissue.

If glaucoma develops long-term, medications that reduce ocular fluid production are usually the first method of treatment, followed by filtration surgery.

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Article by Dr. Ruth D. Williams , a glaucoma specialist at Wheaton Eye Clinic in Wheaton, Illinois, and former president of the American Academy of Ophthalmology.