Glaucoma Disease & Treatments
Glaucoma is an eye condition that damages the optic nerve. Normally, this nerve carries information from the eye to the brain. However, in glaucoma, the nerve is damaged by high eye pressure, causing slow vision loss.
Once vision is lost, it cannot be regained. Luckily, with early detection and treatment, blindness can be prevented. If you are at risk, get your eye pressure tested at least once a year!
Causes & Risk Factors:
Normally, your eyes are filled with a watery fluid. This fluid is made in the eyes and it presses against the walls of the eyeball to give it a round shape (Think of the fluid as air filling a balloon).
In healthy eyes, old fluid leaves the eyes as new fluid is produced. But in glaucoma, fluid cannot exit the eye. As the eye makes more fluid, the amount of fluid in the eye increases. This fluid buildup raises eye pressure, which damages the optic nerve.
Eye with glaucoma
Normal Optic Nerve
Damaged Optic Nerve
A few things can increase your risk for glaucoma:
- Family history
- Use of corticosteroids (Tablets / inhalers)
- Eye trauma
People above the age of 40 are at risk. It is very common for older people to have glaucoma, but most won’t notice it in the early stages. At later stages, glaucoma is more obvious but less treatable.
All adults over the age of 40 or with a family history of glaucoma should get their eyes screened every year.
Types of Glaucoma:
There are two main types of glaucoma: Open Angle and Angle Closure.
If you have glaucoma, your symptoms will depend on the type.
There are very few symptoms in the early stages. Your side (peripheral) vision will slowly get worse.
You may have sudden, severe symptoms, like:
- Dull, aching eye pain
- Eyebrow ache
- Halos or colored rings around lights
At later stages, both types may cause symptoms, such as:
- Intense eye pain
- Eye redness
- Watering eyes
- Blurry vision & vision loss
If you have sudden changes in vision, see a doctor right away. It may not be glaucoma, but it is important to get it checked.
Remember: once your vision is lost, it cannot be regained. However, early treatment can prevent future vision loss!
Regular visits to an eye doctor are the BEST way to save your eyes from blindness.
Glaucoma can also occur in newborns and children who have undergone cataract surgery at an early age.
Signs seen in newborns are:
- Large cornea, opacified cornea
- Watering of eyes
- Child withdraws from light / buries his head to prevent exposure to light
Older children may not show any signs
When to See Your Doctor for an Eye Screening:
All adults over the age of 40 should see an eye doctor once a year. Make sure this visit includes an eye pressure test for glaucoma! If you experience sudden pain or changes in vision, see a doctor immediately. Do not wait until your next doctor’s visit.
Yearly screening is important for ALL adults over the age of 40 and anybody with a family history of glaucoma. Don’t wait until it’s too late to save your sight!
Glaucoma cannot be cured. Treatment cannot reverse vision loss, but it can stop your vision from getting worse. That is why it is so important to treat glaucoma in the early stages. Your doctor will choose the best treatment option for you, depending on your specific case. In most cases, you will need to control your eye pressure for the rest of your life. Your doctor will create an individualized plan to keep your eyes healthy. This plan will depend on the type of glaucoma you have. For the best results, follow your treatment plan . Remember – once your vision is lost to glaucoma, it cannot be restored. The earlier you start treatment, the better the outcome!
With treatment, most glaucoma cases can be controlled. However, in a few cases, vision cannot be saved. For those patients, Vision Rehabilitation may teach patients how to adjust to their new lives with low vision.
The three main types of treatment for glaucoma are:
- Eye Drops
- Laser Treatment
For most patients, eye drops are the most important part of treatment. They work by reducing the eye pressure. There are different types. In fact, some patients must take more than one type of eye drop for the best results.
How they work: Eye drops reduce eye pressure by lowering the amount of fluid in the eye. They may reduce the amount of fluid made by the eye, or, they may improve the eye’s drainage channels, so that fluid exits the eye more easily.
Side Effects: Eye drops may irritate the eye. If you have other eye conditions, you may not be able to use the drops. You may also experience eye swelling, itchy eyes, red eyes, and an abnormal heart rate.
Using the Eye Drops: Your doctor and counselor will work with you to develop a detailed treatment plan. This plan MUST be followed as closely as possible. Your vision is at risk if you stop following the treatment plan. To apply the eye drops:
- Gently pull down the lower eye lid with a finger.
- Hold the eye drop bottle over your eye at a slight tilt.
- Squeeze the eye drop bottle very slightly so a single eye drop falls into the space behind your lower lid.
- Close your eye. Keep it closed for a few minutes.
- If you use more than one type of eye drop, wait at least 5 more minutes before applying the second type.
Laser treatment may be another option for some glaucoma patients. The type of laser therapy will depend on the type of glaucoma that you have.
Laser Trabeculoplasty: This laser is used to treat open angle glaucoma. It opens the eye’s fluid-draining channels. This reduces eye pressure because it lets the fluid exit the eye. Laser trabeculoplasty is done in patients who need to reduce their eye pressure to prepare for glaucoma surgery. However, it is a temporary solution. It is not an end treatment.
Peripheral Iridotomy: All patients who either 1) show signs of angle closure or 2) have been diagnosed with angle closure glaucoma MUST get peripheral iridotomy. This minimizes the risk of glaucoma and vision loss. The procedure uses a high-energy laser beam to create a small hole in the iris. This allows fluid to drain away from the eye.
What to Expect: About Laser Treatment
- You will be given a local anesthetic. This means you will be awake, but should not feel pain.
- You may need to go for laser treatment many times before you see any effects.
- Some patients may still need to use eye drops after laser treatment.
For patients with severe refractory glaucoma, there may be no chance of improving vision. In these cases, a special diode laser is used to safely lower the eye pressure and reduce the patient’s pain.
Surgery is performed in patients who have advanced/progressive glaucoma, have a coexisting significant cataract, or are not responding to medication.