What is glaucoma?
More than three million Americans have glaucoma, but only half are actually aware that the “silent thief” is slowly and without warning permanently stealing away their vision, sometimes without symptoms.
The eye has about one million tiny nerve fibers that carry visual information from the back of the eye to the brain. Glaucoma irreversibly destroys these nerve fibers, and though it was once thought that the destruction of these fibers was due to high pressure within the eye, we now know that even patients with normal eye pressure can have glaucoma and experience loss of this important nerve function.
The eye is filled with fluid; this is what helps it maintain its shape. The eye is constantly creating fluid. It must drain this fluid out of the eye at the same rate it is being created or else the internal eye pressure goes up. Treatments for glaucoma are focused on lowering the pressure inside the eye, either by decreasing the rate of fluid production or by increasing the rate at which it is drained from the eye.
What are the symptoms of glaucoma?
Glaucoma often goes unnoticed in its early stages because it usually does not cause pain or immediate changes in vision. If you have glaucoma, you probably won't notice any warning signs or symptoms until your vision has suffered irreversible damage. Regular eye exams are necessary to detect and diagnose glaucoma.
Is there more than one type of glaucoma?
Yes. The two most frequently occurring types are primary open-angle glaucoma and angle-closure glaucoma.
With primary open-angle glaucoma, the most common form, the eye's drainage canals are open but have become less efficient in draining fluid. Fluid build-up causes pressure within the eye to increase, which eventually damages the optic nerve. In some patients, the optic nerve is at risk of damage because it has become sensitive to even normal pressure. Primary open angle glaucoma generally does not cause symptoms and leads to gradual vision loss.
In angle-closure glaucoma, the iris, or the colored part of the eye, blocks the entrance to the drainage canal, sometimes causing the pressure within the eye to build up suddenly. Symptoms of an acute angle-closure glaucoma attack include severe eye pain, blurred vision, headache, nausea, and vomiting. This is a true emergency that can lead to blindness if not treated promptly. Commonly, however, the iris blocks the entrance to the drainage canal more slowly and causes chronic angle-closure glaucoma. A thorough eye exam can detect narrow angles that are at risk of closure. Laser treatment to the iris or cataract surgery can usually prevent angle-closure glaucoma.
How is glaucoma diagnosed?
Because early detection is so important to limiting the vision loss associated with glaucoma, regular eye examinations are recommended. Elevated pressure within the eye and other indicators of glaucoma, such as optic nerve damage, can be detected only by a thorough examination and testing. Hollingshead Eye Center employs advanced state-of-the-art computerized evaluation techniques to detect early signs of optic nerve damage and peripheral vision loss associated with glaucoma.
How is glaucoma treated?
Glaucoma can be treated in a variety of ways, including with eye drops, pills, laser surgery, traditional surgery, Micro-Invasive Glaucoma Surgery, or a combination of these methods.
Micro-Invasive Glaucoma Surgery, or MIGS, are procedures designed to provide better intraocular pressure control and to decrease your reliance on glaucoma medication. While MIGS will not replace or eliminate traditional glaucoma surgery, it has greatly decreased the number of patients who require more invasive surgeries to control their intraocular pressure.
Some types of MIGS procedures are FDA approved to be performed at the same time as cataract surgery (Ex. iStent, the world’s smallest FDA approved medical device implanted during cataract surgery to lower eye pressure by improving the eye’s natural fluid outflow), while other MIGS procedures are approved to be performed independent of cataract surgery.
Talk to your eye doctor to find out which treatment option is best for you.
Am I at risk for glaucoma?
Glaucoma typically affects people over the age of 40, but it can occur at any age. Everyone is at risk for glaucoma, but some groups are at higher risk than others. People age 65 or older, family members of those already diagnosed with glaucoma, African-Americans, Asian-Americans, diabetics, and those who are nearsighted or who have suffered severe injury to the eye are all at elevated risk. High blood pressure is another risk factor. If you fit into any of these categories, a thorough eye examination to evaluate for glaucoma is recommended.