What is glaucoma?
Glaucoma is a disease that damages your eye’s optic nerve (a nerve in the back of your eye that connects to your brain) . It usually happens when fluid known as “aqueous” builds up in the front part of your eye. That extra fluid increases the pressure in your eye, damaging the optic nerve.
Glaucoma is a leading cause of blindness is people over the age of 60. With early treatment, blindness from glaucoma can be prevented.
What causes glaucoma?
Your eye constantly makes a clear liquid, aqueous fluid, inside the front compartment of your eye. This fluid helps to nourish the eye and hold its shape. As new fluid flows into your eye, the same amount should flow out. The fluid drains out through an area called the drainage angle. This process keeps pressure in the eye (called intraocular pressure or IOP) stable. If the drainage angle is not working properly, fluid will build up causing the pressure inside the eye to rise, which will cause damage by putting stress on the optic nerve.
The optic nerve is made of more than a million tiny retinal nerve fibers. It is like an electric cable made up of many smaller wires. As these nerve fibers are damaged or die, patients can develop blind spots in their vision. You may not notice these blind spots until most of your optic nerve fibers have died. If all of the fibers die, this will result in blindness.
Types of Glaucoma
There are 2 major types of glaucoma.
Primary open-angle glaucoma (POAG)
This is the most common type of glaucoma. It happens gradually, where the eye begins not draining fluid as it normally should (like a clogged drain) or the eye can be making too much fluid causing it to back up the drainage system. As this happens, the eye pressure begins to build, and stretches the walls of the eye which leads to damage of the optic nerve. This form of glaucoma is painless and may not cause immediate changes in vision. Over time, however, the damage can eventually lead to peripheral vision loss and in severe cases it can result in central vision loss and blindness. This is why Glaucoma has earned the nickname, “the thief in the night”.
Some people can have optic nerves that are more susceptible to damage from elevated eye pressure and can even have damage at what is usually considered normal IOP. In these cases the risk of developing glaucoma is higher than normal. Having a regular eye exam is extremely important to detect early signs of damage to the optic nerve.
Angle-closure glaucoma (also called “closed angle glaucoma” or “narrow-angle glaucoma”)
This type of glaucoma happens when the iris is partially or completely obstructing the drainage angle in the eye. If the drainage angle gets completely blocked, eye pressure begins to rise very quickly. This is called an acute angle closure attack. This is an emergency and you need to seek medical attention immediately.
These are signs that you may be experiencing an acute angle-closure glaucoma attack
- Suddenly blurry vision
- Severe eye pain
- Nausea with or without vomiting
- Seeing rainbow colored things or halos around lights.
- Eye Redness
- Whitening of the cornea
Many people with angle-closure glaucoma develop it slowly. This is called chronic angle-closure glaucoma. There are no symptoms at first, so an individual does not know that they have it until the damage is severe or they have an attack. In some people with angle-closure glaucoma, their drainage angle will become blocked suddenly, causing an attack. Angle-closure glaucoma can cause blindness if not treated right away. Your eye surgeon can tell you if your eye anatomy puts you at risk for angle closure glaucoma and offer treatment options to protect your vision.
How is glaucoma diagnosed?
The only way to diagnose glaucoma is with a complete eye exam. A glaucoma screening that only checks eye pressure is not enough to detect glaucoma. During a glaucoma evaluation, your eye care professional should:
- Ask about family history of Glaucoma
- Measure your eye pressure
- Examine your eyes and drainage angles
- Examine your optic nerve
- Test your peripheral vision
- Take pictures and thickness map of your optic nerve
- Measure the thickness of your cornea
Who is at risk for glaucoma?
Some people have a higher than normal risk for getting glaucoma. This includes people who:
- Are over the age of 40
- Have family members with glaucoma
- Are of African or Hispanic heritage
- Have high eye pressure
- Are farsighted or nearsighted
- Have had previous eye injuries/surgeries
- Have corneas that are thin in the center
- Have thinning of the optic nerve
- Have diabetes, migraines, poor blood circulation or other health problems affecting the whole body
Talk with an ophthalmologist about your risk for getting glaucoma. People with more than one of these risk factors have an even higher risk of glaucoma.
The Patients Role in Glaucoma
Treating glaucoma successfully is a team effort between the patient and physician. Your ophthalmologist will prescribe your glaucoma treatment. It is up to each patient to follow the instructions that are given and make sure to use the medications and/or follow all post operative instructions appropriately. Your vision depends on it!
Once you begin taking medications for glaucoma, your ophthalmologist will want to see you on a regular basis. You can expect to visit your physician approximately every 3-6 months, but this can vary depending upon your treatment needs.
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