Every year, more than 80,000 people suffer total loss of vision in both eyes, and 250,000 in one eye, due to glaucoma.
Glaucoma is a general term for a group of eye diseases that, if left untreated, will elevate pressure inside the eye causing optic nerve damage. This damage creates a loss of vision. Glaucoma is a disease of the optic nerve. The optic nerve carries the images we see to the brain. It is like an electric cable containing a huge number of wires.
Glaucoma earned its reputation as a “sneaky thief of sight” because there are no early visual symptoms alerting one to the presence of the disease. By the time someone determines their vision is changing, it is too late, and irreversible damage has already occurred. If caught early though, glaucoma can be successfully treated with medication. Regular preventative eye exams are important to help to detect this disease in its early stages.
What causes Glaucoma?
Clear liquid, called the aqueous humor, flows in and out of the eye. This liquid is not part of the tears on the outer surface of the eye. The flow of aqueous fluid would be similar to having a sink with the faucet turned on all the time. If the “drainpipe” gets clogged, water collects and pressure builds up. If the drainage area of the eye is blocked, the fluid pressure within the inner eye may increase, which can damage the optic nerve.
There are many different types of Glaucoma, but there are two major types: open angle and closed angle.
Chronic open-angle glaucoma is the most common type of glaucoma. Over 90% of adult glaucoma patients have this type. It occurs when the drainage angle of the eye becomes less efficient or “clogged” and pressure within the eye gradually increases. In open-angle glaucoma, the angle where the iris meets the cornea is as wide and open as it should be but it malfunctions.
Closed-angle glaucoma or acute glaucoma is the type of glaucoma which occurs when the drainage canals of the eye become blocked suddenly causes eye pressure to build up rapidly.
Glaucoma is a genetic disorder which frequently manifests itself only after the age of 40. There are subsets of glaucoma which appear as congenital and are seen in infancy and as juvenile glaucoma. Secondary glaucoma can result from an eye injury, inflammation or tumor, or in advanced cases of cataract or diabetes.
Low tension or normal tension glaucoma occurs when the optic nerve is genetically weak and even normal or low eye pressure is capable of causing glaucoma damage.
Who is at risk for Glaucoma? You are at risk for glaucoma if you:
- Are over the age of 40 and do not have regular eye exams
- Have a family history of glaucoma
- Have diabetes, myopia or high blood pressure
- Suffer morning headaches or migraines
- Experience recurrent blurry vision
- See haloes around lights at night
- Notice your peripheral (side) vision is decreasing
- Experience pain around your eyes after watching TV
- Have used steroid drugs (orally or inhaler) for any length of time
- Are of African-American or Asian-American descent
How is Glaucoma detected?
Regular eye examinations by your Ophthalmologist are the best way to detect glaucoma. As a medical eye doctor, your Ophthalmologist can detect and treat glaucoma.
How is Glaucoma treated?
Glaucoma is usually controlled with eye drops which are generally taken several times a day, sometimes in combination with pills. These medications decrease eye pressure, either by slowing the production of aqueous fluid within the eye or by improving the flow leaving the drainage angle. For these medications to work, you must use them regularly and continuously. As with any medication, it is important to tell all of your doctors about the eye medications you are using.
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Laser surgery may be effective for different types of glaucoma. The laser is usually used in one of two ways:
- In open-angle glaucoma, the drain itself is treated. The laser is use to enlarge the drain (trabeculoplasty) to help control eye pressure.
- In angle-closure glaucoma, the laser creates a hole in the iris (iridotomy) to improve the flow of aqueous fluid to the drain.
Operative surgery may sometimes be needed to control glaucoma. This surgery is performed using miniature instruments to create a new drainage channel for the aqueous fluid to leave the eye. The new channel helps to lower the pressure.