Glaucoma is a progressive disease of the eye that if left untreated, can eventually lead to blindness. Glaucoma is commonly associated with increased pressure in the eye due to an imbalance in production and outflow of ocular fluid. In a healthy eye, fluid is produced to help maintain the eye’s shape. Normally, this natural fluid flows out through an area called the trabecular meshwork, and is absorbed into the bloodstream. If the fluid does not drain at the same rate that it is produced, pressure will begin to build in the eye. Over time, this increased pressure can damage the optic nerve and destroy vision.
Glaucoma is a disease that affects the optic nerve, the part of the eye which receives images collected by the retina and sends them to the brain. Every eye maintains a certain amount of internal pressure, called intraocular pressure. When this pressure rises to abnormal levels however, it can put extra stress on the optic nerve, causing significant damage. Optic nerve damage results in loss of vision, and ultimately blindness.
The front of the eye is constantly producing a fluid called aqueous humor. A healthy eye will continually produce small amounts of aqueous humor to ensure consistent pressure within the eye. When normal drainage becomes slowed or blocked, pressure increases, and may lead to glaucoma. There are several different types of glaucoma the two most common types being chronic open-angle glaucoma and closed-angle glaucoma.
Chronic open-angle glaucoma is the most common form of the disease and usually develops with age. With this type of glaucoma, pressure gradually increases around the eye causing it to work less effectively over a period of time. There are no symptoms in the early stages of open-angle glaucoma. Peripheral vision is usually the first to deteriorate. As the disease becomes more advanced, blank spots begin to appear in one’s vision. If left untreated, it eventually develops to blindness. The best way to avoid serious vision loss is early diagnosis and treatment.
Risk factors for chronic open-angle glaucoma include:
- Advanced age
- Family history of the disease
- Higher than normal intraocular pressure
- Certain ethnic races, particularly those of African descent
- Certain diseases or conditions, especially diabetes, farsightedness or nearsightedness, or previous eye trauma or surgery
- Closed-angle glaucoma is less prevalent, but is considered a real eye emergency. This type occurs when a patient’s pupil moves or dilates and actually blocks off the drainage angles in the eye. This is considered a medical emergency in which an ophthalmologist should be contacted immediately to avoid any loss of vision.
Symptoms of closed-angle glaucoma include:
- Severe eye pain
- Blurred Vision
- Nausea or vomiting
- Rainbow halos around lights
High risk factors for closed-angle glaucoma include:
- Extreme farsightedness
- An iris that is abnormally large or far back in the eye
- Advanced age
- Certain ethnic races, especially Asians
There are a wide range of glaucoma procedures for this disease, including medication, laser surgery and traditional surgery. The treatment (or combination of treatments) for an individual is chosen based upon the type of glaucoma and other details of the particular case. One option is medication such as prescription eye drops which help to reduce intraocular pressure, or pills called carbonic anhydrase inhibitors which slow down fluid production within the eye.
Laser surgery has also become the most common of glaucoma procedures. For open-angle glaucoma the doctor may choose a trabeculoplasty, a painless laser procedure which uses light to shrink and stretch eye tissue to allow more drainage of fluid. For closed-angle cases, in which the iris is blocking drainage of aqueous humor, a laser surgery called iridotomy may be preformed.
Other glaucoma procedures involve various traditional surgeries. A common surgery for open-angle glaucoma is the trabeculectomy, where a doctor creates a small flap in the sclera (white part of the eye). Underneath the surface of the sclera, the doctor creates a small reservoir, called a filtration bleb, into which aqueous fluid may drain and then be disbursed, further reducing intraocular pressure.
There are a number of treatments available for patients. If diagnosed with glaucoma, your ophthalmologist will consult with you on your options in order to maintain the best possible health of your eyes.
If you are experiencing any symptoms of glaucoma, we encourage you to contact us today to schedule a consultation.