What is it?

Glaucoma causes damage to the optic nerve of your eye and will only proceed to worsen over time if not treated. As such, early diagnosis and management are vital to preserving your eyesight. People have lost their sight completely from glaucoma a year after being diagnosed.

Who can contract it?

Most commonly, the condition is inherited and does not begin to show signs until later in life. If you are over 40 years of age and have a family history of the condition, you should see us for an eye exam as soon as possible.

Treatment options

There are three common glaucoma treatments available:

  • Eye drops
  • Laser surgery
  • Microsurgery

Depending on what you are comfortable with and how far your glaucoma has progressed, we will discuss with you which of the above options is the wisest course of action for you.

Glaucoma

Glaucoma is a disease of the optic nerve, which transmits the images you see from the eye to the brain. The optic nerve is made up of many nerve fibers (like a phone cable with its numerous wires). Glaucoma damages nerve fibers, which can cause blind spots and vision loss.

A big factor in Glaucoma is the pressure inside the eye, known as the intraocular pressure (IOP). When the aqueous humor (a clear liquid that normally occupies then exits from the eye) cannot drain properly, pressure builds up in the eye. The resulting increase in IOP can damage the optic nerve and lead to vision loss.

The most common form of glaucoma is primary open-angle glaucoma, in which the aqueous fluid is blocked from flowing back out of the eye at a normal rate through a tiny drainage system. Most people who develop primary open-angle glaucoma notice no symptoms until their vision is impaired.

In angle-closure glaucoma, the iris (the colored part of the eye) may drop over and completely close off the drainage angle, abruptly blocking the flow of aqueous fluid and leading to increased IOP or optic nerve damage. In acute angle-closure glaucoma there is a sudden increase in IOP due to the buildup of aqueous fluid. This condition is considered an emergency because optic nerve damage and vision loss can occur within hours of the problem. Symptoms can include nausea, vomiting, seeing halos around lights, and eye pain.

Even some people with "normal" IOP can experience vision loss from glaucoma. This condition is called normal-tension glaucoma. In this type of glaucoma, the optic nerve is damaged even though the IOP is considered normal. Normal-tension glaucoma is not well understood, but lowering IOP has been shown to slow progression of this form of glaucoma.

Several risk factors will affect whether you will develop glaucoma, including the level of IOP, family history, and corneal thickness. If your risk is high, your eye specialist may recommend treatment to lower your IOP to prevent future damage.

Childhood glaucoma, which starts in infancy, childhood, or adolescence, is rare. Like primary open-angle glaucoma, there are few, if any, symptoms in the early stage. Blindness can result if it is left untreated. Like most types of glaucoma, childhood glaucoma may run in families. Signs of this disease include clouding or enlargement of the eye.

The goal of glaucoma treatment is to lower your eye pressure to prevent or slow further vision loss. Your eye specialist will recommend treatment if the risk of vision loss is high. Treatment often consists of eye drops, but can include laser treatment or surgery to create a new drain in the eye. Glaucoma is a chronic disease that can be controlled but not cured. Ongoing monitoring is needed to watch for changes. Ask your eye care specialist if you have any questions about glaucoma or your treatment.

During a glaucoma evaluation, your eye care specialist will perform many of the following tests:

- Tonometry.
This measures the pressure in your eyes (intraocular pressure, or IOP) using a technique called tonometry. Tonometry measures your IOP by determining how your cornea responds when an instrument (or sometimes a puff of air) presses on the surface of your eye.

- Gonioscopy. For this test, your doctor inspects the area where fluid drains out of your eye. During gonioscopy, you sit in a chair facing the microscope used to look inside your eye. The mirrored lens is placed lightly on the front of your numbed eye, and a narrow beam of light is directed into your eye to illuminate the area involved.

- Ophthalmoscopy.
With this test, your doctor can evaluate whether or not there is any optic nerve damage by looking at the back of the eye (called the fundus). There are two types of ophthalmoscopy: direct and indirect.

- Visual Field Test
. The peripheral or side vision of each eye is tested with visual field testing, or perimetry. For this test, you sit at an instrument called a perimeter. While you look only at the center, small lights or patterns will flash randomly in different locations around the center. Each time you see a flash, you press a button. A computer records your response to each flash. This test shows if you have any areas of vision loss. Loss of peripheral vision is often an early sign of glaucoma.

- Photography or Special imaging. Sometimes photographs or other computerized images are taken of the optic nerve to inspect the nerve more closely for damage from elevated pressure in the eye. This also allows comparisons to be made over time.

Each of these evaluation tools is an important way to monitor your eye health to help avoid vision loss. Some of these tests will not be necessary for everyone. Your eye care specialist will discuss which tests are best for you. Some tests may need to be repeated on a regular basis to monitor any changes in your vision caused by glaucoma.