Glaucoma

 

What is glaucoma?

Glaucoma is a leading cause of blindness in the US, especially for older people.  But loss of sight from glaucoma is preventable if you get treatment early enough. 

Glaucoma is a disease of the optic nerve.  The optic nerve carries the images we see to the brain.  The risk for glaucoma is greater with higher pressures in the eye.  A high pressure in the eye can cause damage to the optic nerve.  When the damage occurs, blind spots will develop.  Often people do not notice these blind areas until much optic nerve damage has already occurred.  If the entire nerve is destroyed, blindness results. Early detection and treatment by your eye M.D. are the keys to preventing optic nerve damage and blindness from glaucoma.

 

What causes glaucoma?

A clear liquid, called aqueous humor, is constantly flowing within the eye.  If the drainage of the fluid out of the eye is blocked, the fluid pressure in the eye will build up without any symptoms.  This pressure build up of fluid can damage the optic nerve.

The most common type of glaucoma is chronic open angle glaucoma.  It occurs as a result of aging.  The drainage of fluid out of the eye becomes less efficient with time and pressure within the eye gradually increases.  Over time, this pressure may cause damage to the optic nerve.

A less common type of glaucoma is acute angle closure glaucoma.  In this disease, the iris suddenly blocks off the drainage of fluid out of the eye and the pressure rises suddenly.  Symptoms of acute angle closure glaucoma include blurred vision, severe eye pain, headaches, haloes, nausea, and vomiting.  If you have any of these symptoms, seek help immediately to prevent blindness. 

 

How is glaucoma detected?

Regular eye exams by your eye M.D. are the best way to detect glaucoma.  Your eye M.D. will likely measure the intraocular pressure, inspect the drainage angle of your eye, evaluate the optic nerve, and test the visual field of each eye. 

 

Who is at risk for glaucoma?

The most important risk factor for glaucoma is a high pressure in the eye.   Glaucoma is more common in the elderly.  Other risk factors include near-sightedness, a family history of glaucoma, prior eye injuries, a history of anemia or shock, and race.

 

How is glaucoma treated?

It is very important to treat glaucoma because the damage is irreversible.  Glaucoma is usually controlled with eye drops to lower the eye pressures.  These drops need to be taken regularly and continuously as directed.  Please notify your eye M.D. if you are experiencing any side effects of the drops.  It is very important for you and your eye M.D. to work together to help preserve your vision.

Sometimes laser surgery can be used to treat glaucoma.  Chronic open angle glaucoma is sometimes treated with trabeculoplasty laser to increase the outflow of fluid from the eye.  Acute angle closure glaucoma is treated with a different type of laser to create a tiny hole in the iris to relieve the pressure problem. 

When the pressure cannot be controlled with drops or laser, surgery may be indicated to lower the eye pressures.

 

What can you do to prevent vision loss?

Regular medical eye exams may help prevent unnecessary vision loss.  You should have an eye exam approximately every 2-3 years if you are age 40 or over.  More frequent eye exams are recommended if you have a family member who has glaucoma, if you have had an eye injury in the past, if you are taking steroids, if you are of Asian or African ancestry, or if you have serious medical problems like diabetes.

 

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