Did you know that glaucoma is the second most common cause of blindness in the United States? So, if you’ve dealt with glaucoma or are at high risk for developing glaucoma, let’s look at the basics of what you need to know.

Glaucoma Defined

Your eyes contain an optic nerve, which carries visual information from the eye to the brain. Glaucoma refers to a group of eye conditions that cause damage to this nerve. In most cases, damage to the optic nerve is due to increased pressure in the eye, also known as intraocular pressure (IOP).

There are four major types of glaucoma:

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

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. This pressure is called intraocular pressure (IOP). In most cases of glaucoma, this pressure is high and causes damage to the optic nerve.

Symptoms

You and your doctor can discuss the specifics of how your glaucoma developed or why you may be at risk, but for now, let’s look at the symptoms.

Open-angle Glaucoma

With open-angle glaucoma, most people have no symptoms. Once you actually experience vision loss, the condition is advanced, and the damage already severe. 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 and/or tunnel vision, seek a professional immediately, as it can lead to blindness.

Angle-closure Glaucoma

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 your eyes are swollen. Some experience even nausea and vomiting.

Congenital Glaucoma

Congenital glaucoma occurs in children, and is often detected when the child is only a few months old. You will notice cloudiness of the front of the eye, and even enlargement of one or both eyes. Children with congenital glaucoma can be sensitive to light and have red eyes that tear up.

Signs And Tests

A complete eye exam is needed to diagnose glaucoma. You may be given eye drop 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) is done to check 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 doctor 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

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

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

Another emergency situation includes an iridotomy, 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.

Congenital glaucoma is almost always treated with surgery. This is done using 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. Other treatments may be needed.

Expectations (Prognosis)

Open-angle glaucoma cannot be cured, but symptoms can be managed following your doctor’s instructions. In order to prevent blindness, make sure you get regular checkups. Angle-closure glaucoma is a medical emergency. You need 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 with secondary glaucoma does depends on the disease causing the condition.

Contact Milan Eye Center

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. You are more likely to get glaucoma if you are African American or have a family history of open-angle glaucoma.

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