Glaucoma Treatment

Understanding Glaucoma

Glaucoma is a disease which occurs when there is increased fluid pressure within the eye. In patients with glaucoma, the fluid within the eye doesn’t drain properly. If glaucoma is not treated, the increased pressure can cause irreversible damage to the optic nerve that can result in permanent vision loss. Glaucoma is one of the leading causes of blindness in the world. Many people with glaucoma may not be aware they have the disease because there are no symptoms in the early stages of glaucoma.

 

How Do You Get Glaucoma?

There are two major types of glaucoma.

 

Open-angle glaucoma

This is the most common type of glaucoma. It happens gradually, where the eye does not drain fluid as well as it should (like a clogged drain). As a result, eye pressure builds and starts to damage the optic nerve. This type of glaucoma is painless and causes no vision changes at first.

Some people can have optic nerves that are sensitive to normal eye pressure. This means their risk of getting glaucoma is higher than normal. Regular eye exams are important to find early signs of damage to their optic nerve.

 

Angle-closure glaucoma (also called “closed-angle glaucoma” or “narrow-angle glaucoma”)

This type happens when someone’s iris is very close to the drainage angle in their eye. The iris can end up blocking the drainage angle. You can think of it like a piece of paper sliding over a sink drain. When the drainage angle gets completely blocked, eye pressure rises very quickly. This is called an acute attack. It is a true eye emergency, and you should call your ophthalmologist right away or you might go blind.

Here are the signs of an acute angle-closure glaucoma attack:

  • Your vision is suddenly blurry
  • You have severe eye pain
  • You have a headache
  • You feel sick to your stomach (nausea)
  • You throw up (vomit)
  • You see rainbow-colored rings or halos around lights

Many people with angle-closure glaucoma develop it slowly. This is called chronic angle-closure glaucoma. There are no symptoms at first, so they don’t know they have it until the damage is severe or they have an attack.

Angle-closure glaucoma can cause blindness if not treated right away.

What Happens if You Have Glaucoma?

Open-angle glaucoma symptoms

With open-angle glaucoma, there are no warning signs or obvious symptoms in the early stages. As the disease progresses, blind spots develop in your peripheral (side) vision.

Most people with open-angle glaucoma do not notice any change in their vision until the damage is quite severe. This is why glaucoma is called the “silent thief of sight.” Having regular eye exams can help your ophthalmologist find this disease before you lose vision. Your ophthalmologist can tell you how often you should be examined.

Angle-closure glaucoma symptoms

People at risk for angle-closure glaucoma usually show no symptoms before an attack. Some early symptoms of an attack may include blurred vision, halos, mild headaches or eye pain. People with these symptoms should be checked by their ophthalmologist as soon as possible. An attack of angle-closure glaucoma includes the following:

  • severe pain in the eye or forehead
  • redness of the eye
  • decreased vision or blurred vision
  • seeing rainbows or halos
  • headache
  • nausea
  • vomiting

Normal tension glaucoma symptoms

People with “normal tension glaucoma” have eye pressure that is within normal ranges, but show signs of glaucoma, such as blind spots in their field of vision and optic nerve damage.

 

Who is at risk to develop glaucoma?

Some people have a higher than normal risk of getting glaucoma. This includes people who:

  • have high eye pressure
  • are farsighted or nearsighted
  • have had an eye injury
  • use long-term steroid medications
  • have corneas that are thin in the center
  • have thinning of the optic nerve
  • have diabetes, migraines, high blood pressure, poor blood circulation or other health problems affecting the whole body
  • are over age 40
  • have family members with glaucoma
  • are of African, Hispanic, or Asian heritage

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.

 

Can Glaucoma Be Stopped? 

Glaucoma damage is permanent—it cannot be reversed. But medicine and surgery help to stop further damage. To treat glaucoma, your ophthalmologist may use one or more of the following treatments.

 

Medication

Glaucoma is usually controlled with eyedrop medicine. Used every day, these eye drops lower eye pressure. Some do this by reducing the amount of aqueous fluid the eye makes. Others reduce pressure by helping fluid flow better through the drainage angle.

All medications can have side effects. Some drugs can cause problems when taken with other medications. It is important to give your doctor a list of every medicine you take regularly. Be sure to talk with your ophthalmologist if you think you may have side effects from glaucoma medicine.

Never change or stop taking your glaucoma medications without talking to your ophthalmologist. If you are about to run out of your medication, ask your ophthalmologist if you should have your prescription refilled.

Laser surgery

There are two main types of laser surgery to treat glaucoma. They help aqueous drain from the eye. These procedures are usually done in the ophthalmologist’s office or an outpatient surgery center.

 

  • Trabeculoplasty. This surgery is for people who have open-angle glaucoma and can be used instead of or in addition to medications. The eye surgeon uses a laser to make the drainage angle work better. That way fluid flows out properly and eye pressure is reduced.
  • Iridotomy. This is for people who have angle-closure glaucoma. The ophthalmologist uses a laser to create a tiny hole in the iris. This hole helps fluid flow to the drainage angle.

 

The only sure way to diagnose glaucoma is with a complete eye exam. A glaucoma screening that only checks eye pressure is not enough to find glaucoma.

Glaucoma is a silent thief of sight

Glaucoma has no symptoms in its early stages. In fact, half the people with glaucoma do not know they have it! Having regular eye exams can help your ophthalmologist find this disease before you lose vision. Your ophthalmologist can tell you how often you should be examined.