What is Glaucoma?
Glaucoma is an eye disease in which the internal eye pressure rises to a point that can cause damage to the tissue of the optic nerve. As the optic nerve becomes damaged it causes a permanent loss in peripheral vision that may lead to blindness. The process is generally very gradual, occurring over years to decades and usually has no significant symptoms until the disease has become severe.
What Causes Glaucoma?
The exact cause of glaucoma is still unknown. In certain patients, the individual fibers of the optic nerve begin to die when the pressure of the fluids in the eye are too high for that specific individual. Other factors may be involved in nerve loss, but high eye pressure is the biggest controllable risk factor. The precise pressure at which optic nerve tissue begins to die varies from patient to patient; however, the higher the pressure the more likely optic nerve damage will occur.
How Does Glaucoma Affect Vision?
In the early stages, glaucoma will not cause a noticeable change in vision. The patient’s side vision will become gradually less sensitive. Central vision is almost never affected until very late in the disease. Left unchecked, the side vision will continue to deteriorate and a “tunneling” effect will occur with vision appearing as if looking through binoculars. Ultimately, the central vision can become involved and blindness is possible.
What are the Symptoms?
In the vast majority of glaucoma cases, there are no early warning signs of symptoms. Since glaucoma is usually a very slow (years to decades), progressive process, it is virtually impossible for a patient to detect a problem; it is almost always diagnosed by an eye doctor. On the other hand, a very small percentage of glaucoma cases (less than 5%) are associated with symptoms including halos, pain, redness, and blurred vision.
How is Glaucoma Diagnosed?
The diagnosis of glaucoma can only be made after a comprehensive eye exam including assessment of the patient’s medical and family history, measurement of the pressure of the fluid inside the eye, examination of the optic nerve through a dilated pupil, evaluation of the fluid drainage network using a gonioscope, and an interpretation of a visual field test. The visual field is performed using a sophisticated computer analysis of the patient’s peripheral vision. Additionally, a laser optic nerve analysis and retinal photography aid in diagnosis and managing glaucoma patients.
Who is Affected by Glaucoma?
Over 3 million people in the United States have been diagnosed with glaucoma; however, the actual number is probably much higher because it is estimated that 50% of the people with this disease are unaware and go undiagnosed. Every year in the US, more than 120,000 lose vision due to glaucoma. Glaucoma can occur in anyone, but the following are the most important risk factors: age, race, diabetes, family history of glaucoma, history of reduced blood flow, and farsightedness.
How is Glaucoma Treated?
Fortunately, with early detection and prompt intervention, glaucoma can be successfully managed and the long-term outlook is good. Most patients are treated with prescription eye drops specifically designed to lower the pressure in the eyes or enhance ocular blood flow, and thereby reduce the risk of progressive damage to the optic nerve and preventing loss in vision. Sometimes, laser treatment or eye surgery is necessary when the eye drops are not sufficient in controlling the eye pressure or if for any reason the patient is not able to maintain the necessary prescription eye drop regimen. It is very important that we monitor the condition regularly (usually 3-4 times per year) to assess how well our prescribed treatment plan is working and make adjustments as soon as progression is noted. It is equally important that the patient uses any medications exactly as directed and reports ay side effects to us immediately. With early diagnosis along with good care and management most patient can keep their sight and live a very normal and productive life.