Glaucoma is an eye disease that causes damage to the optic nerve. There are several types of glaucoma but they all result in optic nerve damage if left untreated. Optic nerve damage makes it harder for it to do its job and can therefore result in permanent vision loss.
High eye pressure is a risk factor for glaucoma because it damages the delicate fibers in the optic nerve. The eye develops this high pressure because of slower drainage of fluid from the interior of the eye back into the bloodstream.
It is important to note that normal eye pressure is not the same for everyone. Generally, the intraocular pressure, or IOP, is between 12-22 mm Hg (millimeters of mercury). What is normal for one person could be high for another. What counts is the amount of pressure the optic nerve can withstand without suffering damage.
Annual eye exams are important as it relates to glaucoma because high pressure has no outward symptoms. Patients are unaware that anything is wrong—until a noticeable amount of vision has been lost. The earliest signs of vision loss are usually in the peripheral vision areas, which we can’t evaluate as easily.
As with most diseases, early detection is critical. Glaucoma is treated initially with prescribed eye drop medication which lowers eye pressure. The latest drops work very well and have very few side effects. On occasion, a second or third eye drop medication will need to be prescribed. If glaucoma cannot be adequately controlled by eye drop therapy, laser surgery or another type surgical procedure can be performed to lower the pressure and control the disease.
Who Is Most At Risk?
- Patients with high eye pressure
- Over age 60
- African or Latino descent
- Family history of glaucoma
- Thin corneas
- Regular use of oral steroids
- Diabetes
- Severe nearsightedness
How Does My Eye Doctor Check for Glaucoma?
Glaucoma is sometimes a very subtle disease in its early stages and difficult to detect. Often, your doctor may request that you come back for a work-up specifically to rule out glaucoma. These battery of tests help him or her make the final diagnosis. The tests usually run are optic nerve fiber imaging (to assess the integrity of the many fibers in the optic nerve), peripheral vision testing (where glaucoma usually begins), intraocular pressure measurement (the catalyst for getting glaucoma) and corneal thickness testing (to ensure IOP measurements are accurate).
How is Glaucoma Treated?
In the initial stages, glaucoma is most often treated with eye drop medication. This lowers the intraocular pressure (IOP) and reduces the risk of the condition advancing. Like most diseases, early detection greatly enhances treatment success. Often a second or third eye drop medication will be necessary to get the IOP to a level the doctor is comfortable with.
In moderate to advanced cases, surgery may be necessary. These range from laser surgery to conventional open incision surgery. These surgeries are to relieve elevated pressure when eye drop medication alone cannot get the disease under control. These are outpatient procedures, meaning no hospital stay is required. Often the patient will still need eye drop medication and surgeries may need to be repeated if IOP elevates at a later time. We at Bowman Optometry do not do glaucoma surgery but have access to several outstanding ophthalmologists to assist in the care of these patients.