Glaucoma is often referred to as the “sneak thief of sight.” Glaucoma is generally associated with elevated pressures inside the eye, though there are some forms of glaucoma where the intraocular pressure, or IOP, can be normal as well.
What are the types of glaucoma?
The most common type of glaucoma is called primary open angle glaucoma. This is caused by a chronic elevation in the intraocular pressure and damage to the optic nerve over time. This type of glaucoma is typically painless and causes slow changes to the peripheral vision over time.
Another type of glaucoma is narrow angle or angle closure glaucoma. This occurs when the drainage channels of the eye close down and fluid builds up within the eye. This can cause a sudden or chronic rise in the intraocular pressure leading to severe pain, blurring of vision, and vision loss if not treated. If this happens, it is an eye emergency as damage to the optic nerve can happen very quickly in these cases.
What symptoms does glaucoma cause?
For most people, there are no symptoms of glaucoma! This is why it is vital to have routine screening exams to check for signs of glaucoma inside the eye. Over time, glaucoma can affect the peripheral vision. If this progresses without treatment, over time this can lead to the central vision being affected and even blindness. However, if glaucoma is detected early in the course of disease, initiating treatment can slow or even stop the progression of visual field loss.
Who is at risk for glaucoma?
You may be at increased risk for glaucoma if you:
- Have a family history of glaucoma
- Are especially near or far sighted
- Have a history of eye trauma
- Have higher than normal eye pressures
- Are African or Hispanic in descent
How is glaucoma diagnosed?
There are several components of the eye exam that are checked to aid in the diagnosis of glaucoma. These include your eye (intraocular) pressure, inspection of the drainage angles of the eye, measurement of the corneal thickness, and visual inspection of the optic nerve. Ancillary tests such as peripheral visual field testing and computed tomography of the optic nerve help confirm the diagnosis of glaucoma.
What are the treatments for glaucoma?
There are many treatments available for glaucoma, depending on the type and severity with which you are diagnosed. In general, the goal of any type of treatment is to lower the intraocular pressure and thus minimize damage to the optic nerve.
Drops: Eye drops are the mainstay of glaucoma therapy. They work by either decreasing the production of or increasing the drainage of fluid from the eye. Drops are administered directly into the eyes and thus have very little side effects for the body itself. Sometimes people are put on more than one drop to control their eye pressures.
Glaucoma Lasers: There are multiple types of laser procedures that can be done for glaucoma. For patients with narrow angles, a laser peripheral iridotomy may be recommended to create additional drainage channels for the eye fluid. For patients with open angle glaucoma, a laser treatment called ALT or SLT can be done to reduce the intraocular pressure and possibly the dependence on eye drops.
Glaucoma Surgery: For more advanced cases of glaucoma, special glaucoma surgical procedures may be indicated to try to control the eye pressure. There are also newer devices that may be implanted at the time of cataract surgery for patients with mild to moderate glaucoma. Your surgeon can discuss these options with you at the time of cataract surgery if that is indicated.
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