Glaucoma is the second leading cause of blindness in the world. About 90% of people in developing countries are unaware they have the disease. Even in the United States, about half of all people with glaucoma don't know they have it.
So what is glaucoma?
Glaucoma is a form of damage to the eye's optic nerve. The optic nerve transmits information from the eye to the brain. If untreated, glaucoma often gets worse over time and can lead to vision loss and even blindness. Although glaucoma is most common in older adults, it can develop at any age.
Because glaucoma usually develops slowly, people often are unaware that they have it until it is very severe. It is important to have routine eye exams to detect glaucoma early and prevent vision loss.
Risk Factors of Glaucoma
You are at increased risk for having glaucoma if you are older than 60 years, have a first degree relative with glaucoma, have a history of major eye injury, or if you are highly near or farsighted.
Glaucoma usually develops so gradually that symptoms are often not recognized until a lot of vision has been lost.
Types of Glaucoma
There are two main types of glaucoma and both usually present without symptoms.
1. Primary open angle glaucoma is the most common type. Early symptoms include cloudy vision and difficulty seeing when lighting conditions change. In later stages of the disease, side vision can be lost and if very severe, even central vision can be damaged.
2. The second type is angle closure glaucoma which occurs when the iris blocks the normal drainage of fluid in the eye. While most people with angle closure glaucoma have no symptoms, some with angle closure can have an acute attack of very high eye pressure.
This is a medical emergency and symptoms include eye pain, headaches, seeing halos around lights, dilated pupils, vision loss, red eyes, and nausea and vomiting.
How is glaucoma diagnosed?
First, glaucoma is diagnosed based on a thorough eye exam. The most important part of this exam is an assessment of the optic nerve. If damage is suspected, then additional tests are needed.
While many think of glaucoma as being high eye pressure, about half of all glaucoma occurs in eyes with pressures in the normal range. People with very high eye pressure often do develop glaucoma, so measuring the eye pressure is part of routine eye care.
If glaucoma is suspected, your doctor will do additional tests including tests of your side vision with a visual field testing machine. This test can identify vision loss that you may not know about. The doctor will also image your optic nerve, which can identify damage even if it's very early.
How is glaucoma treated?
The goal of glaucoma treatment is to slow or stop the progression of vision loss. At present, all treatments for glaucoma lower eye pressure, which can be done with lasers, medications, or surgery.
The decision on how best to treat a patient with glaucoma will depend on different factors such as age and the type and severity of glaucoma.
Recent publications have shown that for patients with open angle glaucoma, initial therapy with a laser is often the best treatment, but medications are an acceptable alternative.
The laser is used to allow more fluid to leave the eye, and the procedure has been performed since the 1970s with an excellent safety profile.
Eye drops can also be used to reduce pressure in the eye. While many can have good eye pressure control using only one eye medication, others require combination therapy.
When glaucoma is more severe, or if the glaucoma is worsening and needs an even lower eye pressure, your doctor may recommend surgery to lower pressure in the eye.
There are several types of glaucoma surgeries, and determining which one is best for you depends on your situation. Throughout treatment, your doctor will regularly check your eye pressure to ensure that it is controlled and that the treatments you are taking are working.
Your doctor will also monitor your side vision and image your optic nerve to see if they have gotten worse or have remained stable.
Although optic nerve damage from glaucoma cannot be reversed, routine eye evaluations can catch the disease early, and those who are under care for glaucoma mostly do well.
Researchers are actively studying why the nerve is damaged in glaucoma, and promising new treatments are already being studied in animals.
Closing Thought
The future of glaucoma care will be even more successful than it is now with our current treatments. Thank you for reading.
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