What causes secondary glaucoma?
Secondary glaucoma is less common than POAG. In POAG, we don’t yet know why the drainage channels stop working. In secondary glaucomas, there is an obvious reason for the rise in IOP.
These reasons could be:
- Rubeosis – Abnormal blood vessels grow inside the eye. This is due to diabetes, blocked veins or arteries inside the eye, poor blood supply in the carotid arteries in the neck. Rubeotic glaucoma is aggressive and requires almost always multiple surgical procedures.
- Pseudoexfoliation – Also known as PXF. PXF is seen as white powdery deposits on the lens, iris and drainage channels inside the eye. It can be associated with very high IOP and glaucoma that progresses very quickly. Early treatment and close follow-up are essential.
- Pigmentary glaucoma – This occurs when the iris rubs against the human lens that lies close behind it. This ‘rubbing’ dislodges the pigment that gives our eyes their colour. The pigment then clogs up the drainage channels leading to raised IOP and glaucoma. It particularly affects younger short -sighted people. Pigment shedding can often increase significantly during exercise.
- Previous eye surgery – Previous retinal detachment surgery involving silicone oil increases the risk of glaucoma.
- Inflammation – Patients who have chronic and repetitive inflammation in their eyes can develop glaucoma. This may be due to inflammatory related scarring of the drainage channels themselves or may be a response to the steroid drops that are necessary to treat inflammation.
In all cases of glaucoma an individualised treatment plan is necessary and is based on good clinical evidence.
More about Laura Crawley
Ms Laura Crawley is a Consultant Ophthalmologist at Clinica London. Her special expertise is in treating glaucoma patients as well as patients with glaucoma and cataracts. She has a lot of experience in treating glaucoma and has published extensively in scientific journals and on medical education. She still does a lot of emergency operations at the emergency department at the Charing Cross and Western Eye Hospitals for the NHS. At Clinica London, she is responsible for glaucoma patients and glaucoma patients with cataracts. She also sees patients with general eye problems.