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Worldwide, glaucoma is the leading cause of irreversible blindness. Glaucoma refers to a group of eye conditions that lead to the damage of the optic nerve, the nerve that carries visual information from the eye to the brain.

The front part of the eye is filled with a clear fluid called aqueous humor. This fluid is always being made in the back of the eye. It leaves the eye through channels in the front of the eye in an area called the anterior chamber angle, or simply the angle. Anything that slows or blocks the flow of this fluid out of the eye will cause pressure to build up in the eye. This pressure is called intraocular pressure (IOP). In most cases of glaucoma, this pressure is high and causes damage to the major nerve in the eye, called the optic nerve.


There are many types of glaucoma, the most common of which are primary open-angle glaucoma and acute angle-closure glaucoma. Closed angle glaucoma can appear suddenly and is often painful; visual loss can progress quickly but the discomfort often leads patients to seek medical attention before permanent damage occurs. Open angle, chronic glaucoma tends to progress at a slower rate and the patient may not notice that they have lost vision until the disease has progressed significantly.

The goal of treatment is to reduce eye pressure. Depending on the type of glaucoma, this is done using medications or surgery. Surgery is the primary therapy for those with congenital glaucoma. Both laser surgeries and conventional surgeries are performed to treat glaucoma.

The most common surgical procedures for primary congenital glaucoma are goniotomy and trabeculotomy. In both procedures, the ophthalmologist makes an incision into the trabecular meshwork to allow the fluid (aqueous humor) to flow out better from the eye using the normal drainage channel. In goniotomy, the fibers of the trabecular meshwork are cut to eliminate any resistance to fluid flow imposed by an incompletely developed trabecular meshwork.

In trabeculotomy, a probe is used to tear through the trabecular meshwork to open it and allow fluid flow.

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