Low Tension Glaucoma

in StemSocial2 months ago

Greetings to all and sundry,

It is a beautiful day today and the week has started on a great note, I do hope we are all having good times at our workplaces and that things are going great for all of us. Finally, January is about ending and I am certain we are all truly excited about that, next comes the month of love.


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But before we move on to the month of love, let's learn again today, as usual, I come to your blogging space with discussions on ocular health and ocular conditions that disturb our lives and we get to look at things that will help us live healthily and prevent the preventable. Let's see what we get to learn today.


Sometimes as health practitioners, it is a bit difficult to explain the technicalities of some pathologies or conditions to patients because then if you decided to go too deep you get them confused about everything and the purpose of education becomes useless. And so a lot of times we use what we call the layman's approach.

We give the most important and basic points to our patients, letting them understand how and why and the need to perhaps take their medication seriously, what the medication seems to do, and such basic stuff. When it comes to glaucoma you will find out from research that a lot is still been learned on a daily and a lot of things have yet to be ascertained.


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But then over the years, we notice one thing which always stands out among glaucoma patients and this is the rise in intraocular pressure. We have come to understand that the rise in IOP is directly linked to the apoptosis or death of cells that occurs during the glaucoma condition which inevitably leads to blindness starting from the periphery to the center of one's vision.

But then there are these special instances where IOP can be low and still one would have the glaucoma condition and then there are instances where the pressure can be high and the patient wouldn't necessarily have glaucoma. And so for our lesson today we would be looking at the first instance and then we could tackle the latter in the days ahead.

Low Tension Glaucoma

And so in low-tension glaucoma what exactly happens? Now for glaucoma to be diagnosed series of tests would have to be conducted and they ought to follow a particular pattern before a confirmed diagnosis can be made. If you follow the definition of glaucoma you come to realize that the most important thing that eye care practitioners are on the lookout for is glaucomatous damage on the retina.

This damage follows a particular pattern that also shows up during the visual field test as well as the ocular coherence tomography test. When you look into the eye of an individual with glaucoma with the aid of an ophthalmoscope or indirect ophthalmoscopy with a slit lamp and a volks lense, you see that the disc has some particular properties that go off from the normal.


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These include lamina dots being visible which is a sign of cupping beginning or the disc atrophying, the cup-to-disc ratio being big or having a difference of at least 0.2 between the two eyes as well as a rule referred to as the ISNT rule getting disobeyed in the eye. When these are noticed, the IOP is checked to confirm a high pressure, visual field test may be done to confirm damage to vision or OCT to confirm structural damage to the retinal nerve fiber layer.

But then low tension glaucoma the pressure may be within a good range or recommended range even though all other parameters may suggest glaucoma. To someone relatively new to the field, this could easily be confusing or get misdiagnosed or overlooked as the high IOP is a guide for a lot of people when it comes to glaucoma diagnosis. But I want us to know today that your pressure could still be normal and you would still have the glaucoma condition.

The cause of the death of cells, in this case, cannot be attributed to the pressure and so we consider it to be idiopathic, the management becomes a bit confusing too for us because glaucoma management focuses on bringing the pressure down so the cells may survive but in this case, the pressure is already down and the cells are still dying at the rate of high tension glaucoma.


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And so what we do is set target pressures below the measured one on the day of the visit and monitor over time to observe whiles using the same management protocol. Now when it comes to explaining to patients in this instance we cannot use a common explanation of there being pressure on the eye and so we would have to let you know you have glaucoma.

If you happen to fall within this diagnosis which is not so common, please do not refer to your condition as pressure on the eye, instead, use the term glaucoma. Also, do well to check your eyes as often as possible and do not miss appointments, take your medication seriously, and do not keep any information about your health from your Optometrist as it may prove useful in your care or treatment.


Do not panic if your doctor tells you that you have glaucoma, because whiles glaucoma is a possible blinding condition it is quite manageable and when things are done right on both the end of the healthcare provider and the patient keen instructions, you could have a good amount of your vision throughout your entire lifespan.

Be sure to have your entire family screened if you are diagnosed with glaucoma because it is known to have a possible genetic implication, do not miss your drugs, and do not let them run out. Do not just use your medication without going for reviews because your pressure could drop below the limit which could also be deadly to your eyes.


by @nattybongo

Before you try out any new things relating to your condition please speak to your Optometrist, when in doubt always ask because we are there to serve you, and avoid over-the-counter medication without proper examination. Remember that your ocular health is a priority and that vision loss on a lot of occasions ain't reversible.

It is a pleasure to yet again share my knowledge with you today, in our lesson discussion we would talk about ocular hypertension which is also directly linked to glaucoma and a possible misdiagnosis for glaucoma sometimes. Until then, I wish you a happy week and a blessed time. Stay safe.

Further Reading

Esporcatte, B. L., & Tavares, I. M. (2016). Normal-tension glaucoma: an update. Arquivos brasileiros de oftalmologia, 79(4), 270–276. https://doi.org/10.5935/0004-2749.20160077.

Killer, H. E., & Pircher, A. (2018). Normal tension glaucoma: review of current understanding and mechanisms of the pathogenesis. Eye (London, England), 32(5), 924–930. https://doi.org/10.1038/s41433-018-0042-2.

Leung, D. Y. L., & Tham, C. C. (2022). Normal-tension glaucoma: Current concepts and approaches-A review. Clinical & experimental ophthalmology, 50(2), 247–259. https://doi.org/10.1111/ceo.14043.

Funk, R. O., Hodge, D. O., Kohli, D., & Roddy, G. W. (2022). Multiple Systemic Vascular Risk Factors Are Associated With Low-Tension Glaucoma. Journal of glaucoma, 31(1), 15–22. https://doi.org/10.1097/IJG.0000000000001964


I didn't know about all these different types of glaucoma


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The layman's approach is an excellent way to efficiently teach patients and ensure they grasp the fundamentals of their disease. It is critical to find a balance between providing enough information to be useful and not confusing people. Your focus on the ever-changing nature of glaucoma knowledge emphasizes the necessity of being current in one's area and continuing to learn. Excellent work! We are proud to work with you to change lives with hive @nattybongo

It is a pleasure to be a part of the team Sir, i look forward to using my area of expertise and skill to impact lives through the hive blockchain both on and offline. It has and will always be my pleasure