Glaucoma

JP Bohanan -

Glaucoma is a group of eye conditions that damage the optic nerve which sends visual information from your eye to your brain and is vital for good vision. Damage to the optic nerve is often related to high pressure in your eye, but glaucoma can happen even with normal eye pressure.

Glaucoma can occur at any age but is more common in older adults. It is one of the leading causes of blindness for people over the age of 60.

Many forms of glaucoma have no warning signs with the effect so gradual that you may not notice a change in vision until the condition is in its later stages.

It's important to have regular eye exams that include measurements of your eye pressure. If glaucoma is recognized early, vision loss can be slowed or prevented. If you have glaucoma, you'll need treatment or monitoring for the rest of your life.

The symptoms of glaucoma depend on the type and stage of your condition.

Open-angle glaucoma

  • No symptoms in early stages
  • Gradually, patchy blind spots in your side vision, also is known as peripheral vision
  • In later stages, difficulty seeing things in your central vision

Acute angle-closure glaucoma

  • Severe headache
  • Severe eye pain
  • Nausea or vomiting
  • Blurred vision
  • Halos or colored rings around lights
  • Eye redness

Normal-tension glaucoma

•    No symptoms in early stages

•    Gradually, blurred vision

• In later stages, loss of side vision

Glaucoma in children

  • A dull or cloudy eye (infants)
  • Increased blinking (infants)
  • Tears without crying (infants)
  • Blurred vision
  • Nearsightedness that gets worse
  • Headache

Glaucoma develops when the optic nerve becomes damaged. As this nerve gradually deteriorates, blind spots develop in your vision. For reasons that doctors don't fully understand, this nerve damage is usually related to increased pressure in the eye which occurs as the result of a buildup of fluid that flows throughout the inside of the eye. This fluid also is known as the aqueous humor. It usually drains through a tissue located at the angle where the iris and cornea meet. This tissue also is called the trabecular meshwork. The cornea is important to vision because it lets light into the eye. When the eye makes too much fluid or the drainage system doesn't work properly, eye pressure may increase.

Open-angle glaucoma is the most common form of glaucoma. The drainage angle formed by the iris and cornea remains open. But other parts of the drainage system don't drain properly. This may lead to a slow, gradual increase in eye pressure.

Angle-closure glaucoma occurs when the iris bulges. The bulging iris partially or completely blocks the drainage angle. As a result, fluid can't circulate through the eye and pressure increases. Angle-closure glaucoma may occur suddenly or gradually.

If you experience symptoms that come on suddenly, you may have acute angle-closure glaucoma. Symptoms include severe headache and severe eye pain. You need treatment as soon as possible. Go to an emergency room or call an eye doctor's (ophthalmologist's) office immediately.

Glaucoma can damage vision before you notice any symptoms. So be aware of these risk factors:

  • High internal eye pressure, also known as intraocular pressure
  • Age over 55
  • Black, Asian or Hispanic heritage
  • Family history of glaucoma
  • Certain medical conditions, such as diabetes, migraines, high blood pressure and sickle cell anemia
  • Corneas that are thin in the center
  • Extreme nearsightedness or farsightedness
  • Eye injury or certain types of eye surgery
  • Taking corticosteroid medicines, especially eye drops, for a long time

Get regular eye examinations

Regular comprehensive eye exams can help detect glaucoma in its early stages, before significant damage occurs. As a general rule, the American Academy of Ophthalmology recommends a comprehensive eye exam every 5 to 10 years if you're under 40 years old; every 2 to 4 years if you're 40 to 54 years old; every 1 to 3 years if you're 55 to 64 years old; and every 1 to 2 years if you're older than 65.

Diagnosis

Your health care provider will review your medical history and conduct a comprehensive eye examination. Your provider may perform several tests, including:

  • Measuring intraocular pressure, also called tonometry
  • Testing for optic nerve damage with a dilated eye examination and imaging tests
  • Checking for areas of vision loss, also known as a visual field test
  • Measuring corneal thickness with an exam called pachymetry

Treatment

The damage caused by glaucoma can't be reversed. But treatment and regular checkups can help slow or prevent vision loss, especially if you catch the disease in its early stages.

Glaucoma is treated by lowering intraocular pressure. Treatment options include prescription eye drops, oral medicines, laser treatment, surgery or a combination of approaches.

Eye drops alone may not bring your eye pressure down to the desired level so your eye doctor may also prescribe oral medicine. This medicine is usually a carbonic anhydrase inhibitor. Possible side effects include frequent urination, tingling in the fingers and toes, depression, stomach upset, and kidney stones.

Other treatment options include laser therapy and surgery.

Here is to your good health

Cathy