Glaucoma

This is what you would see if you had glaucoma

What is glaucoma?

If you are 40 years of age or older, you have a special reason to learn how to prevent blindness from the eye disease called glaucoma (pronounced glaw-coma).  Glaucoma is a very common cause of blindness in adults. Today two million to three million Americans have glaucoma. In fact, glaucoma is the cause of blindness in one out of every nine people who are blind.

Half of the people with glaucoma don’t know it because it usually destroys eyesight without any pain. By the time people notice changes in their vision, glaucoma has already caused permanent damage. But if glaucoma is diagnosed in its earliest stages, it is usually a readily treated condition.  Only by a regular eye examination through dilated pupils can glaucoma be detected and treated before loss of vision occurs. That’s why it’s important to know the facts about glaucoma.

How does glaucoma destroy sight?

Glaucoma destroys your healthy vision by damaging the optic nerve at the back of your eye. The optic nerve sends information from your eyes to your brain, telling it what you’re seeing.  The eyeball is similar in size to a ping-pong ball. A thick, jelly-like substance (called the vitreous) fills most of the eyeball to give it shape. The eye also makes a watery fluid (called aqueous humor) that circulates and drains out through the channels located at the front of the eye.

In many cases of glaucoma, for reasons still being studied, the watery fluid does not drain as quickly as it should. When this happens, the fluid backs up and puts pressure on the delicate optic nerve, which can damage it.  At first, the increased fluid pressure damages only those nerve cells and fibers that enable you to see to the side (your peripheral vision). As a result, side vision is gradually destroyed.

In the final stages of the disease, the pressure destroys the nerve fibers that permit front or central vision, and all sight is gone.  The amount of pressure it takes to cause damage is different from person to person. A pressure that would be normal for most people may be too high for others.  Only careful examination of the back of the eye can reveal the damage that shows glaucoma is present

The cornea and lens of the eye are bathed and nourished by a fluid (aqueous humor), which is constantly being formed and drained. It circulates over the lens and behind the cornea before leaving through sieve-like outflow structures. In glaucoma, the outflow structures fail to drain off sufficient fluid. Excessive pressure builds up within the eye. In time, the pressure caused by fluid build-up destroys sensitive cells that make up the optic nerve and causes loss of sight.

What are the types of glaucoma?

There are four types of glaucoma. Here is a brief description of each:

  • Chronic:

    • The most common type, it happens slowly and usually without pain; the person is only vaguely disturbed by symptoms that come and go. As a result, a person with chronic glaucoma often postpones visiting an eye doctor. African-Americans are at much higher risk than others for this type.

  • Acute:

    • Not nearly as common: it happens suddenly, is very painful, and is an emergency condition. Caucasians and Asians are at higher risk than others.

  • Secondary:

    • Occurs due to something else that happened to the eye, such as an eye injury or eye surgery.

  • Congenital:

    • A rare condition, present at birth.

Can blindness from glaucoma be prevented?

If glaucoma is discovered early, medical treatment usually keeps it from worsening. However, sight destroyed by glaucoma cannot be restored. That’s why the best defense against glaucoma is an eye examination through a dilated pupil at least once every two years, or more often for those at high risk.

For many people, using prescribed eye drops is sufficient to reduce the eye pressure and prevent further loss of vision. But if eye drops are unsuccessful, either laser surgery or glaucoma filtration surgery (or both) may be necessary. Glaucoma filtration surgery to reduce pressure is performed usually with a local anesthetic and may require only a short hospital stay.

If drugs are prescribed, they usually must be used regularly for the rest of the patient’s life. It’s also important that the patient let his or her eye doctor know of any other drugs taken, because the drugs could interact and interfere with each other’s effectiveness. Furthermore, any additional doctors treating the patient should be told about the glaucoma medications.

What are the main risk factors to remember about glaucoma?

  • The likelihood of developing glaucoma increases with age
  • African-Americans are at a much higher risk
  • It tends to run in families
  • People with diabetes are at higher risk; So are people who are very nearsighted
  • Those who have had eye surgery or eye injuries
  • Anyone using steroid medications for extended periods of time

What are the signs and symptoms?

Here are some common signs and symptoms that strongly suggest you should be examined for glaucoma or other eye problems.  Check any that you’ve experienced and be sure to discuss them with your eye doctor.   But remember, you may have glaucoma even if you don’t experience any symptoms:

  • Frequent changes of eyeglasses, none of which is satisfactory
  • Inability to adjust the eyes to darkened rooms, such as movie theaters
  • Loss of vision
  • Blurred or foggy vision
  • Rainbow-colored rings around lights.

What can you do?

Learn about your family’s history of eye problems, especially if an older relative became blind.  Find out now if you have glaucoma by getting a complete eye examination through dilated pupils during which your optic nerve is carefully evaluated. Regular eye exams are the most important thing you can do. If glaucoma is found early, it can be treated and you’ll probably be saved from significant loss of sight.  These eye tests are not painful, but they may not be part of the routine eye exam for a new pair of glasses or contact lenses. So be sure to ask your eye doctor who treats glaucoma for a comprehensive eye examination.

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