Glaucoma is a disease of the optic nerve - the part of the
eye that carries the images we see to the brain. The optic nerve is made up of
many nerve fibers, like electric cable containing numerous wires. When damage
to optic nerve fibers occurs, blind sports develop. These blind spots usually
go undetected until the optic nerve is significantly damaged. If the entire
nerve is destroyed, blindness results.
detection and treatment by your ophthalmologist are the keys to preventing
optic nerve damage and blindness from glaucoma.
Glaucoma is a leading cause of blindness in the United States,
especially for older people. But loss of sight from glaucoma can often be
prevented with early treatment.
Clear liquid called aqueous humor circulates inside the
front portion of the eye. To maintain a healthy level of pressure within the
eye, a small amount of this fluid is produced constantly while an equal amount
flows out of the eye through a microscopic drainage system. (This liquid is not
part of the tears on the outer surface of the eye).
the eye is closed structure, if the drainage angle is blocked, the excess fluid
cannot flow out of the eye. Fluid pressure within the eye increases, pushing
against the optic nerve and causing damage.
- What are the different types of glaucoma?
- Chronic open-angle glaucoma - this is the most common
form of glaucoma in the United States. The risk of developing chronic
open-angle glaucoma increase with age. The drainage angle of the eye becomes
less efficient over time, and pressure within the eye gradually increases,
which can damage the optic nerve. In some patients, the optic nerve becomes
sensitive even to normal eye pressure and is at risk for damage. Treatment is
necessary to prevent further vision loss.
Typically, open-angle glaucoma has no symptoms in its early
stages, and vision remains normal. As the optic nerve becomes more damaged,
blank spots begin to appear in your field of vision. You typically won't notice
these blank sports in your day-to-day activities and these spots become large.
If all the optic nerve fibers die, blindness results.
Closed-angle glaucoma - Some eyes are formed with
the iris (the color part of the eye) too close to the drainage angle. In these
eyes, which are often small and farsighted, the iris can be sucked into the
drainage angle and block it completely. Since the fluid cannot exit the eye,
the pressure inside the eye builds rapidly and causes an acute close-angle
Symptoms may include:
Sever eye pain
Rainbow-colored halos around lights
Nausea and vomiting
This is a true eye emergency. If you have any of these
symptoms, call your ophthalmologist immediately. Unless this type if glaucoma
is treated quickly, blindness can result. Unfortunately, two-third of these
with closed-angle glaucoma develop it slowly without any symptoms prior to an
is at risk for glaucoma?
Your ophthalmologist considers many kinds of
information to determine your risk for developing the disease.
most important risk factors include:
Elevated eye pressure
history of glaucoma
African or Spanish ancestry
Past eye injuries
Thinner central corneal
Systemic health problems including diabetes, migraine headaches
and poor circulation
ophthalmologist will weigh all of these factors before deciding whether you
need treatment for glaucoma, or whether you should be monitored closely as a
glaucoma suspect. This means your risk of developing glaucoma is higher than
normal and you need to have regular examinations to detect the early signs of
damage to the optic nerve.
is glaucoma detected?
Regular eye examinations by your ophthalmologist
are the best way to detect glaucoma. A glaucoma screening that checks only the
pressure of the eye is not sufficient to determine if you have glaucoma. The
only sure way to detect glaucoma is to have a complete eye
- During your glaucoma evaluation, your ophthalmologist
- Measure your intraocular pressure (tonometry)
- Inspect the drainage angle of your eye (gonioscopy)
- Evaluate whether or not there is any optic nerve damage
the peripheral vision of each eye (visual field testing, or
Photography of the optic nerve or the other computerized imaging may be
recommended. Some of these tested may not be necessary for everyone. These
tests may need to be repeated on a regular basis to monitor any changes in your
is glaucoma treated?
As a rule, damage cause by glaucoma cannot be
reversed. Eye drops, laser surgery, and surgery in the operating room are used
to help prevent further damage. In some cases, oral medications may be
any type of glaucoma, periodic examinations are very important to prevent
vision loss. Because glaucoma can progress without your knowledge, adjustments
to your treatment may be necessary from time to time.
Laser surgery treatments may be recommended for different
types of glaucoma. In open-angle glaucoma, the drain itself is treated. The
laser is used to modify the drain (trabeculoplasty) to help control eye
pressure. In closed-angle glaucoma, the laser creates a hole in the iris
(iridotomy) to improve the flow of aqueous fluid to drain.
Surgery in the operating room
When surgery in the
operating room is needed to treat glaucoma, your ophthalmologist uses fine
microsurgical instruments to create a new drainage channel for the aqueous
fluid to leave the eye. Surgery is recommended if your ophthalmologist feels it
is necessary to prevent further damage to the optic nerve. As with laser
surgery, surgery in the operating room is typically an outpatient
What is your part in treatment?
Treatment for glaucoma requires teamwork
between you and your doctor. Your ophthalmologist can prescribe treatment for
glaucoma but only you can make sure that you follow your doctor's instructions
and use your eye drops.
you are taking medications for glaucoma, your ophthalmologist will want to see
you more frequently. Typically, you can expect to visit your ophthalmologist
every three to four months. This will vary depending on your treatment