The eye disease Glaucoma is one of the most common causes of blindness in the United States, which can almost always be prevented when the disease is detected and treated early. Past age 35, Glaucoma occurs in one person out of 50. Among those over 65, one out of 33 has Glaucoma.
With Glaucoma, the pressure of the fluid inside the eye (intraocular pressure) may be increased. This can gradually damage the optic nerve, the nerve that leads from the eye to the brain. Damage to the nerve causes loss of vision. The first to go is peripheral vision, but eventually complete blindness can occur. The key to preventing major damage is early detection and treatment, which is a very good reason why all adults should have regular eye examinations.
Symptoms of Glaucoma
For most people, there are usually few or no symptoms of Glaucoma. Symptoms can include:
- Seeing halos around lights
- Tunnel vision
- Vision loss
- Redness in the eye
- Eye that looks hazy
- Nausea or vomiting
- Pain in the eye
Types of Glaucoma
There are several different kinds of Glaucoma. The most common, about 90% of all cases, is chronic open angle Glaucoma, also known as wide angle Glaucoma. This condition is more common with diabetes, hardening of the arteries or a family history of Glaucoma. It progresses slowly and causes no symptoms until it is very advanced. Eye drops are usually effective; in some cases pills, laser treatment or surgery is needed to control the pressure.
Acute angle closure Glaucoma involves a large sudden increase in intraocular pressure, causing severe pain, blurred vision with halos, and nausea and vomiting. Without immediate treatment, acute angle closure Glaucoma can permanently damage the eye. Significant damage can occur in as little as one day. Treatment is medication followed by a laser iridotomy (using a surgical laser to create a hole in the iris, the colored portion of the eye, so that excess fluid can drain.) In susceptible individuals the attacks can often be avoided by a preventive laser iridotomy.
Glaucoma can also occur as a result of an injury, inflammation and certain drugs. Other types of Glaucoma are related to increased pigment in the drainage systems of the e ye and to pseudoexfoliation, in which material is deposited on the lens and in the drainage system of the eye. Treatment for these is usually similar to that for chronic open angle Glaucoma. Rarely Glaucoma is present from birth. In this case, it would be called congenital Glaucoma.
It is possible to have elevated intraocular pressure that does not cause damage to the nerve of the eye. Such cases may not require treatment. They do, however, require regular examinations to prevent damage. The opposite condition is normal tension Glaucoma, in which optic nerve damage and visual field changes occur in spite of normal intraocular pressure.
Fraser Eye Care Center and the Eye Care Center of Port Huron specialize in the diagnosis and treatment of Glaucoma. During a complete eye care examination, our doctors and staff will test vision acuity, dilate pupils and thoroughly examine the structures of the eye using state-of-the-art technology. A non-invasive test called tonometry will be performed to check the eye pressure. A scanning laser called HRT may be performed to evaluate the condition of the optic nerve. This test is repeated each year to determine the progression of Glaucoma.
There are several treatment choices available for Glaucoma. Treatment for chronic open angle Glaucoma usually involves eye drops taken one to four times daily. These do not cure the Glaucoma, but they do reduce the intraocular pressure and protect the optic nerve. Sometimes it is necessary to take pills by mouth. If medical treatment does not succeed, or if the patient is unable to take the medication, the next step may be a laser procedure called a trabeculoplasty. If the pressure still does not come under control, a surgical procedure called a trabeculectomy may be necessary.
Any form of Glaucoma requires regular visits, several times per year to Fraser Eye Care Center and the Eye Care Center of Port Huron. The patient has no way of knowing whether the condition is under control and whether or not there is nerve damage: therefore, it is critical to regularly measure intraocular pressure, examine the optic nerve, and test the visual fields.