What is glaucoma?
Glaucoma is a group of eye disorders that damage the eye’s optic nerve. This usually happens when fluid builds up in the front part of the eye. This fluid, which normally exits the eye in a continuing stream, builds pressure increases within the eye. Eventually this damages the optic nerve.
Glaucoma is the second leading cause of blindness in the U.S. for all ages, following only macular degeneration. Glaucoma can occur at any age, but it is much more prevalent in older adults.
If left untreated, glaucoma will eventually cause blindness. Even with treatment, about 15 percent of people with glaucoma become blind in at least one eye within 20 years.
What causes glaucoma?
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Is There a Cure for Glaucoma?
There is currently no cure for glaucoma. However, with prompt care to lower intraocular pressure, treatment can help slow or stop the progression of vision loss. Treatment, which may involve prescription medication or surgery, is planned around many factors, including your age and the type and severity of your glaucoma.
What are the Symptoms of Glaucoma?
There are different forms of glaucoma, but the most common forms are known as open-angle glaucoma and acute angle-closure glaucoma. These are the symptoms for these forms:
PRIMARY OPEN-ANGLE GLAUCOMA SYMPTOMS:
- Patchy blind spots in your peripheral or central vision, frequently in both eyes
- Tunnel vision with advanced glaucoma
ACUTE ANGLE-CLOSURE GLAUCOMA SYMPTOMS:
- Severe headaches
- Eye pain
- Nausea and vomiting
- Blurred vision
- Halos around lights
- Eye redness
WHAT ARE THE RISK FACTORS FOR GLAUCOMA?
Anyone can develop glaucoma, but certain factors increase a person’s risk:
- Having high intraocular pressure
- Being over age 60
- Being black, Asian, or Hispanic
- Having a family history of glaucoma
- Having other medical conditions, such as diabetes, high blood pressure, heart disease, or sickle cell anemia
- Having corneas that are thin in the center
- Being extremely nearsighted or farsighted
- Having had an eye injury
- Having had certain types of eye surgery
- Long-time use of corticosteroid medications, particularly eyedrops
How is Glaucoma Diagnosed?
At our practice, during every routine eye exam we test for glaucoma because early diagnosis and treatment is key to success against the disease. We test your visual acuity and visual field. The intraocular pressure inside your eye is tested. We also measure the thickness of your cornea, and we inspect the drainage angle. We’re proud to offer the latest tests for glaucoma, including Cirrus HD-OCT and the Humphrey® Field Analyzer/HFA. This is the gold standard for perimetry testing.
How Glaucoma is Treated
Treatment for glaucoma is developed around the severity of the condition, medical history, risk factors, and other data obtained during a comprehensive consultation and eye exam. The objective of treatment is to lower intraocular pressure. To do so, the doctor may prescribe medicated eye drops and/or oral medication. Surgery may also be considered, especially for acute angle-closure glaucoma, which is considered a medical emergency.
Available Treatment Options for Glaucoma:
Once glaucoma has damaged a person’s vision, this is irreversible. Treatment can help slow or prevent vision loss, if the disease is caught early. The goal with treatment is to lower the intraocular pressure.
The first line of treatment is usually prescription eyedrops. These can reduce the internal eye pressure by either improving how the fluid drains from your eye or by decreasing the amount of fluid your eye is making. There are now a variety of different eyedrop options, depending on how your eyes respond. Many people don’t comply with their dosages and the need for consistent application of their eyedrops, however, and this is a leading cause of continued damage because the patient isn’t experiencing any pain or symptoms.
The goal here is to improve fluid drainage within the eye.
- Laser therapy: Laser trabeculoplasty opens clogged channels in the trabecular meshwork.
- Filtering: In a trabeculectomy, part of the trabecular meshwork is removed to enhance drainage.
- Drainage tubes: Small tubes are inserted, usually through the trabecular meshwork, to open flow.
- Minimally invasive glaucoma surgery: These various techniques are used to lower eye pressure, generally with lower risk and easier recovery.
Glaucoma prevention steps you can take to preserve your eyesight
Two of the very best ways to address the risk of glaucoma include knowing your family history for this condition and seeing your ophthalmologist regularly. It isn’t enough to see an optometrist for “vision checkups;” you need a qualified eye doctor to also examine the parts of your eye that are not visible upon normal observation. A comprehensive eye exam includes the dilation of your pupil so the ophthalmologist can look at your retina and optic nerve. With these two steps alone, you are much better equipped to handle the risk of glaucoma.
Additional tips for managing glaucoma include regular exercise, using prescribed glaucoma medication as directed, and always wearing appropriate eye protection when playing sports.
“I have gone to Dr. Stephano at least 15 years and feel he provides excellent care and is extremely knowledgeable. A busy practice, you will wait…but well worth it.”
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At Shenandoah LASIK & Cataract Center, we can spot the early signs of glaucoma and successfully treat the condition before it causes permanent damage.
PRIMARY OPEN-ANGLE GLAUCOMA
This is the most common form of the disease. It happens gradually, where the eye simply doesn’t drain fluid efficiently. The term “angle” refers to the drainage angle inside the eye that controls the outflow of the fluid that is continually produced inside the eye. If the angle is “open” and still functioning, then the trabecular meshwork is partially blocked.
Primary open-angle glaucoma gradually reduces the person’s peripheral vision without other symptoms. By the time the person realizes there is a problem, the damage is permanent. If the pressure inside the eye remains high, destruction will eventually lead to tunnel vision, where the person can only see objects that are straight ahead. Ultimately, blindness will occur.
ACUTE ANGLE-CLOSURE GLAUCOMA
In this form, also called narrow-angle glaucoma, the iris bulges forward to narrow or block the drainage angle formed by the cornea and the iris. Fluids can’t exit the eye and pressure builds, damaging the optic nerve. Some people are born with a “narrow” drainage angle; they are at higher risk for developing acute angle-closure glaucoma.
Acute angle-closure glaucoma may occur suddenly with symptoms such as eye pain, headaches, halos around lights, and nausea and vomiting. This is an emergency situation. Each attack causes progressively more vision loss.
The risks with not having your eyes regularly checked, or not using your glaucoma pressure-reducing eyedrops once diagnosed, are pretty straightforward. You will first lose your peripheral vision. Eventually, this will leave you with only tunnel vision, where you can only see objects directly in front of you. Continued untreated glaucoma will then lead to blindness in one or both eyes.
Glaucoma develops unbeknownst to the patient in almost all cases. That’s why maintaining a regular schedule of eye exams is important, particularly after your 40th birthday.
Open-angle glaucoma is the most common form of glaucoma. It accounts for at least 90% of all cases. The next most common form is angle-closure glaucoma, which Is caused by blocked drainage canals and characterized by a sudden rise in intraocular pressure.
Additional forms of glaucoma, according to the Glaucoma Research Foundation, include normal-tension glaucoma and congenital glaucoma.
Variants of open-angle and angle-closure glaucoma include:
- Secondary Glaucoma
- Pigmentary Glaucoma
- Pseudoexfoliative Glaucoma
- Traumatic Glaucoma
- Neovascular Glaucoma
- Irido Corneal Endothelial Syndrome (ICE)
- Uveitic Glaucoma
Eye pressure measuring from 12-22 mm Hg is considered normal. Anything over 22 mm Hg is considered high. However, increased pressure may be referred to as ocular hypertension, not glaucoma, in some patients.
Elevated intraocular pressure occurs when the aqueous humor (fluid) that fills the central part of the eye does not drain normally through the trabecular meshwork at the junction of the cornea and the iris. The eye relies on a specific amount of pressure to stabilize structures without compressing the optic nerve. Too much pressure for too long damages this nerve and can degrade vision to the point of blindness.