Glaucoma is an eye disease that is one of the leading causes of blindness in the United States. Glaucoma is fairly common in adults over age 35. Two out of every 100 persons in this age group have vision threatened by this disease. When diagnosed early, blindness from glaucoma is almost always preventable.
When we look at an object, the image is carried from the retina to the brain by the nerve of sight (the optic nerve). This nerve is like an electric cable. It contains a million wires, each carrying a message to the brain, which join together to provide side vision, as well as sharp, central reading vision. Glaucoma can produce damage to the "wires", causing blind spots in areas of vision to develop. People seldom notice these blind areas in the side vision until considerable optic nerve damage has occurred. If the entire nerve is destroyed, blindness results. Fortunately, this rarely occurs if glaucoma is diagnosed and treated before major damage has taken place.
The key to preventing optic nerve damage or blindness from glaucoma is early diagnosis and treatment. Many doctors can test for glaucoma as part of a periodic physical examination. Medical eye examinations from your eye care professional are the best defense against glaucoma.
Causes and Symptoms
A clear transparent liquid called aqueous humor flows through the inner eye continuously. This inner flow can be compared to a sink with a faucet turned on all the time. If the drainpipe gets clogged, water collects in the sink. If the drainage system of the eye gets similarly blocked, the fluid pressure within the inner eye is increased and can cause damage to the optic nerve.
Blockage of the "pipes" can occur in four ways:
Most commonly, the drainage system can be clogged with deposits and cellular material over the years. This partial blockage causes a gradual build-up of pressure within the eye. This is known as chronic open angle glaucoma because it develops slowly over a period of time. Most adult glaucoma patients have this type of glaucoma. Chronic open angle glaucoma can steal vision so quietly that the patient is often unaware that they are losing vision as there is no pain. Because no symptoms occur, the best way to diagnose this form of glaucoma is by periodic eye examinations.
Second, the drainage system of the eye may be poorly formed. This type of defect is seen in congenital glaucoma when the drainage openings are abnormal from birth. Since an infant's eye has more elasticity than an adult's, when pressure inside the eye is increased, the easily stretchable eye may enlarge. The front of the eye may become cloudy like fog on a windshield. The infant may be sensitive to light and tear excessively. This is a rare condition. However, such symptoms or other suspicion of trouble in the eyes of an infant or child should lead to an immediate visit to a pediatric ophthalmologist.
Third, in some cases of glaucoma, parts of the eye’s anatomy may completely or partially obstruct the drainage system of the eye. This is the case in narrow angle glaucoma. The iris in this case vaults forward in the eye blocking the drainage channels and, therefore, increases intraocular pressure dramatically and more acutely than in chronic open angle glaucoma. Such sudden, complete blockage of fluid flowing out of the eye results in acute angle-closure glaucoma. Blurred vision, severe pain, rainbow haloes around lights, nausea and vomiting should bring the patient quickly to an eye physician. Unless this condition is relieved promptly, blindness can result in a day or two.
Fourth, other conditions including injuries, certain drugs, hemorrhages, tumors, and inflammations can sometimes block outflow channels in the eye. This may increase inner eye pressure an lead to secondary glaucoma.
The Glaucoma Examination
Your optometrist or ophthalmologist, in the course of a periodic eye examination can make early diagnosis. During the painless examination, the eye physician will determine the pressure of the eye. This is only part of the examination for glaucoma. Using an instrument called an ophthalmoscope, the doctor will examine the back of your eye to see if the optic nerve is healthy and that no damage is occurring. Some times, side vision will be tested for shrinkage or blind spots. If necessary, still other tests may be done.
What is the treatment for Glaucoma?
Glaucoma is usually controlled with eye drops given 2 to 4 times a day or by pills given in various combinations. These medications act to decrease eye pressure either by assisting flow of fluid out of an eye or by decreasing the amount of fluid entering the eye. To be effective, these medications must be taken regularly and continuously.
Patients with any type of glaucoma need periodic examinations. Glaucoma sometimes gets worse (or better) without the patient being aware of it, and as a result, treatment may need to be changed after awhile. As a rule, damage caused by glaucoma cannot be reversed. Eye drops, pills and surgery are used to prevent further damage from occurring, and to preserve existing vision.
Glaucoma and You
Control of glaucoma by drugs can only be effective if patients adhere to the treatment schedule prescribed by their eye doctor. The treatment "team" is made up of both you and your doctor. Medication should never be stopped without first consulting your doctor. It is always important to inform all the physicians you visit about the eye medications you are using. Remember, it is your vision, and you must do your part in maintaining it. You should notify your eye care professional immediately if there is a question of side effects.
Loss of Vision is Largely Preventable
If you are over age 35, you should have your eyes checked for glaucoma every 2 or 3 years. Your eye care professional should be consulted whenever there is any decrease in vision or recurrent pain, or when any of the other symptoms discussed in this brochure are present. When diagnosed promptly, eye pressure can be brought under control and future glaucoma attacks can be prevented. For further information on glaucoma, click on the following links:
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Glaucoma is an eye disease that is one of the leading causes of blindness in the United States. Glaucoma is fairly common in adults over age 35. Two out of every 100 persons in this age group have vision threatened by this disease. When diagnosed early, blindness from glaucoma is almost always preventable.
When we look at an object, the image is carried from the retina to the brain by the nerve of sight (the optic nerve). This nerve is like an electric cable. It contains a million wires, each carrying a message to the brain, which join together to provide side vision, as well as sharp, central reading vision. Glaucoma can produce damage to the "wires", causing blind spots in areas of vision to develop. People seldom notice these blind areas in the side vision until considerable optic nerve damage has occurred. If the entire nerve is destroyed, blindness results. Fortunately, this rarely occurs if glaucoma is diagnosed and treated before major damage has taken place.
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