What is Glaucoma?

Glaucoma is one of the leading causes of blindness in the United States. It is a disease that typically affects older people, but it can occur at any age. It occurs when the normal pressure inside the eye rises high enough to damage the optic nerve.

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The eye has about 1 million tiny nerve fibers which run from the back of the eye to the brain. These nerve fibers allow us to see. As a disease, glaucoma destroys these fibers. Glaucoma specialists once thought that the loss of these fibers was due strictly to increased pressure in the eye, also known as intraocular pressure (IOP). Now, they know that even patients with normal pressure can have glaucoma  (Normal Tension Glaucoma) and potentially lose the nerve fibers that connect the brain and the eye.

The reason that normal pressure increases in many glaucoma patients is that the drainage system in the eye is not working properly. Your eye is filled with a clear fluid called aqueous humor. This fluid is always being made behind the colored part of your eye (the iris). Now, if the fluid is always being produced, it has to leave the eye somehow, right? Your eye contains channels through which the excess fluid leaves, but as you can imagine, if the fluid is blocked from exiting the eye, it builds up, increasing the pressure in your eye.

To learn more, read our Definitive Guide to Glaucoma.

Types of Glaucoma

There are several major types of glaucoma:

  • Open-angle (chronic) glaucoma
  • Angle-closure (acute) glaucoma, or narrow-angle glaucoma
  • Congenital glaucoma
  • Secondary glaucoma (a result of another health problem)

Your eye’s drainage system lies in a part of the eye called the angle, which is between the cornea and the iris of the eye. This angle can be open or closed. The most common form of glaucoma is chronic open-angle glaucoma or primary open-angle glaucoma. The drainage angle is open in these patients, but the eye fluid does not drain as quickly as it should. Closed-angle glaucoma occurs when the drainage angle closes, and almost no eye fluid can escape.

Glaucoma Symptoms             

Unfortunately, there are no symptoms of glaucoma until advanced, irreversible damage has occurred. Therefore, routine testing by an ophthalmologist or optometrist can detect glaucoma before symptoms appear. If treatments are started early enough, vision loss can be prevented. The main aim of glaucoma treatment is to lower the eye pressure, either with eye drops, laser, or surgery.

The symptoms of glaucoma are gradual and can vary depending on the type and stage of progression.

For Open Angle Glaucoma many patients will begin to notice:

  • Occasional blind spots in either the peripheral vision or center vision in both eyes
  • With more advanced stages, tunnel vision will form

With open-angle glaucoma, most people have no symptoms. Once you experience vision loss, the condition is advanced, and the damage is already severe. Have you ever heard of tunnel vision? If you have open-angle glaucoma, chances are you may experience a slow loss of your peripheral vision, commonly referred to as tunnel vision. If you’re experiencing vision loss or tunnel vision, seek a professional immediately, as it can lead to blindness.

For Narrow Angle Glaucoma, the effects are more sudden and can appear in one or both eyes.

  • Eye pain
  • Headaches
  • Nausea and vomiting
  • Blurred vision
  • Redness
  • Light Sensitivity

Symptoms with angle-closure glaucoma may be intermittent at first or may steadily worsen. You could also experience sudden, extreme pain in one eye. You could have decreased or cloudy vision, see “halos” around lights, have red eyes, or feel like you have swollen eyes. Some experience even nausea and vomiting.

Congenital Glaucoma occurs in children.

Glaucoma specialists often detect congenital glaucoma when the child is only a few months old. You will notice the front of the eye’s cloudiness and even enlargement of one or both eyes. Children with congenital glaucoma can be sensitive to light and have red eyes that tear up.

If left untreated, glaucoma can eventually lead to blindness so it is important to establish care with an optometrist or ophthalmologist to manage your care and track any progression.

If you have severe eye pain or a sudden loss of vision, especially loss of peripheral vision, contact us immediately. Also, we recommend scheduling an appointment if you have risk factors for glaucoma and have not been screened for the condition. 

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Who’s at Risk?

If you have diabetes or hypertension, you could be at a higher risk. A study conducted by a leading research team at the University of Michigan Kellogg Eye Center shows that these individuals may have an increased risk of developing open-angle glaucoma (OAG), the most common form of glaucoma in the country.

During the study, researchers focused on the possible connections between various components of metabolic syndrome. A metabolic syndrome includes hypertension, diabetes, obesity, and hyperlipidemia (high cholesterol and high triglyceride levels). 

The team concluded that people with diabetes alone had a 35 percent increased risk of developing open-angle glaucoma and those with hypertension alone had a 17 percent increased risk. Also, people suffering from diabetes and hypertension had a 48 percent higher chance of developing OAG. The symptoms of glaucoma surface later in the progression of the disease, and therefore getting regular eye exams is critical in detecting and treating the disease early.

Tests for Glaucoma

A complete eye exam is needed to diagnose glaucoma. You may receive eye drops to widen (dilate) your pupil. The eye doctor can look at the inside of the eye when the pupil is dilated.

A test called (tonometry) checks eye pressure. However, because eye pressure changes all the time, eye pressure can be normal in some people with glaucoma. This is called normal-tension glaucoma. Your doctor will need to run other tests to confirm glaucoma.

Some of the tests your glaucoma specialist may do can include:

  • Visual acuity
  • Visual field measurement
  • Using a special lens to look at the eye (gonioscopy)
  • Slit-lamp examination
  • Photographs or laser scanning images of the inside of the eye (optic nerve imaging)
  • Examination of the retina in the back of the eye

Treatment

Milan’s glaucoma specialists serve the Atlanta area across 8 convenient locations. Dr. Philip Garza is a board certified-fellowship trained glaucoma specialist on our team of award-winning surgeons. He offers complete care for glaucoma and performs the full range of techniques, including laser procedures and state-of-the-art, minimally-invasive glaucoma surgery. Our team has spent years educating themselves on the most innovative treatments available today.

The goal of treatment is to reduce the normal pressure on your eye. Treatment depends on the type of glaucoma that you have. If you have open-angle glaucoma, you will probably receive eye drops. Most people can be treated successfully with eye drops. Most eye drops used today have fewer side effects than those used in the past. You may also get pills to lower pressure in the eye. Your doctor may also recommend Selective Laser Trabeculoplasty laser therapy, iridotomy, and eye surgery in challenging cases where other treatments don’t work.

Congenital glaucoma is almost always treated with surgery and general anesthesia, so the patient is asleep and feels no pain.

If you have secondary glaucoma, treatment of the underlying disease may help your symptoms go away. Patients may need other treatments.

Emergency Treatment

An acute angle-closure attack is a severe medical emergency. Blindness will occur in a few days if it is not treated. If you have narrow-angle glaucoma, you will receive eye drops and medicine by mouth and through a vein.

An iridotomy is another emergency treatment when doctors use a laser to open a new pathway through the colored part of your eye. This opening relieves pressure and prevents future attacks.

Expectations (Prognosis)

Open-angle glaucoma cannot be cured, but symptoms can be managed following your doctor’s instructions. To prevent blindness, make sure you get regular checkups. Angle-closure glaucoma is a medical emergency. It would be best to have treatment right away to save your vision. If your child may suffer from congenital glaucoma, rest assured that most babies usually do well when surgery is done early.

How well a person sees with secondary glaucoma does depend on the disease-causing the condition.

Affordability

Milan Eye Center offers zero-down financing options with approved credit through Wells Fargo, CareCredit, and Alphaeon. We also accept all FSA/HSA plans.

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