What is Glaucoma?

 

It’s Glaucoma Awareness Month, so it’s a good time to talk about what it is and why regular eye exams are so important.

Glaucoma is an eye disease that if left untreated can cause damage to the optic nerve and blindness. About 3 million Americans have glaucoma, and it is the second leading cause of blindness worldwide. The most common type in the United States is called “open-angle glaucoma.” 

Here’s What’s Happening in the Eye

Scientists aren’t sure of the root cause of glaucoma, but many people with glaucoma have high eye pressure (called intraocular pressure or IOP) and treatments that lower eye pressure help to slow the disease. Glaucoma can occur in one or both eyes.

Each eye is constantly making aqueous humor, which is a plasma-like watery fluid that holds lots of nutrients. This fluid is constantly bathing our cornea and lens and keeping them healthy. As fresh aqueous flows into your eye, the same amount needs to drain out, keeping the eye pressure (IOP) constant. This drainage is called the drainage angle, and if this is not working as it should, the fluid builds up. This causes the high IOP which eventually damages the optic nerve and harms eyesight. There are millions of tiny optic nerve fibers, and as they die blind spots will occur in your vision. 

Get That Eye Exam!

Because there are few if any early symptoms, many people have high IOP, also called ocular hypertension, and don’t know it. Very slowly over time peripheral (side) vision will deteriorate, especially on the inside nearest your nose. 

You are probably familiar with the “puff of air” test to see if the pressure inside your eye is normal. This is a good indicator but does not replace a thorough eye exam with your eyes dilated. Your eye doctor, or ophthalmologist, will put drops in your eyes that cause them to dilate; your vision will be temporarily blurry and you’ll be sensitive to bright light. This way she can view your optic nerve and look for any damage. Your field of vision will also be checked for loss of peripheral vision. 

Who is at Risk for Glaucoma?

You’re at higher risk if you: 

• Are over age 60, especially if you’re Hispanic/Latino 
• Have a family history of glaucoma 
• Have a blood relative with glaucoma (the risk of early-onset glaucoma depends mainly on heredity) 
• Having optic nerve or visual field findings on the border between glaucoma and normal
• Have African American ethnicity
• Are myopic (near-sighted)
• Have a thin cornea
• Have a condition called exfoliation or pigment dispersion that increase the risk of developing glaucoma

It is recommended that everyone over age 60 get a complete dilated eye exam yearly. Exams every 1 to 2 years after age 35 for people at high risk, every 2 to 4 years before age 40, and 1 to 3 years between ages 40 and 60.

Treatment for Glaucoma 

Cleveland Clinic treatment recommendations include:

• Eye drops/Medication: Prescription eyedrops decrease fluids and increase drainage to alleviate eye pressure. There are many types of eye drop medications that can be used for this condition. Because glaucoma is a lifelong condition, you may need to use daily eyedrops for life.
• Laser treatment: Your eye doctor uses a laser (strong beam of light) to help improve fluid drainage from your eye. While the laser can complement the use of eye drops, it may not replace it completely. The results from laser treatments vary, but can last up to five years. Some laser treatments can also be repeated.
• Surgery: Surgery is another way to help reduce eye pressure. It is more invasive but can also achieve better eye pressure control faster than drops or laser. Surgery can help slow down vision loss, but it can’t restore lost vision or cure glaucoma. There are many types of surgeries for glaucoma, and depending on the specific type and severity, your eye doctor may choose one over another.