Glaucoma FAQ

Glaucoma is the result of optic nerve damage with resultant visual field loss that may be caused by elevated intraocular (eye) pressure. If the condition is left untreated, blindness will occur.

Glaucoma is often referred to as a “silent thief” of sight because many times there are no major symptoms of the condition in its early stages. The only way to identify and treat glaucoma in the early stages is by having a complete eye exam every 1-2 years.

Symptoms of more advanced forms of glaucoma may include:

• Blurred vision
• Eye pain
• Headache
• Halos around lights
• Peripheral vision loss
• Tunnel vision
• Eye redness
• Hazy-looking eye
• Nausea

Yes. Once glaucoma is detected, you need to take steps to lower the eye pressure as soon as possible. Vision loss due to glaucoma cannot be recovered.

Glaucoma is usually caused by an increase of fluid pressure in the eye. The front part of the eye contains clear, nourishing fluid called aqueous which constantly circulates through the eye. Normally, this fluid leaves the eye through a drainage system and returns to the bloodstream. When there is an overproduction of fluid or the drainage system isn’t working properly, the fluid can’t flow out at its normal rate and eye pressure increases. This causes a deterioration of the nerves, resulting in the development of blind spots in your visual field.

Glaucoma tends to run in families. In some people, scientists have identified genes related to high eye pressure and optic nerve damage. For most types of glaucoma, there aren’t many lifestyle factors that have been definitely linked to the disease.

There are two major categories of glaucoma; open-angle glaucoma and narrow angle glaucoma. The “angle” refers to the drainage angle inside the eye that controls the outflow of the watery fluid (aqueous) which is continually being produced inside the eye. If the fluid can access the drainage angle, the glaucoma is known as open angle glaucoma. If the drainage angle is blocked and the fluid cannot reach it, the glaucoma is known as narrow angle glaucoma. Depending on the type that you have, the symptoms can vary:

Open-angle glaucoma:

• Patchy blind spots in your side (peripheral) or central vision, frequently in both eyes
• Tunnel vision in the advanced stages

Narrow angle glaucoma
This type of glaucoma is a medical emergency and if not treated immediately, blindness could occur in one to two days. See a doctor immediately if you are experiencing these symptoms.

• Severe headache
• Eye pain
• Nausea and vomiting
• Blurred vision
• Halos around lights
• Eye redness

Normal-tension glaucoma
In normal-tension glaucoma, your optic nerve becomes damaged even though your eye pressure is within the normal range. No one knows the exact reason for this. You may have a sensitive optic nerve or you may have less blood being supplied to your optic nerve. This limited blood flow could be caused by atherosclerosis — the buildup of fatty deposits (plaque) in the arteries — or other conditions that impair circulation.

Pediatric glaucoma
It’s possible for infants and children to have glaucoma. It may be present from birth or develop in the first few years of life. The optic nerve damage may be caused by drainage blockages or an underlying medical condition.

Pigmentary glaucoma
In pigmentary glaucoma, pigment granules from your iris build up in the drainage channels, slowing or blocking fluid exiting your eye. Activities like jogging can stir up the pigment granules, depositing them on the trabecular meshwork and causing pressure to intermittently rise.

Glaucoma is detected through a comprehensive eye exam that includes:

• An ophthalmic technician gathering baseline information, including personal history, vision, pressure, visual field examination, optic nerve photos, and OCT nerve imaging.
• Next, you will either have a gonioscopy exam or have your eyes dilated in order to properly diagnose your glaucoma.
• In some cases, you will return for additional testing.

Treatment depends on the kind of glaucoma, the stage of the disease, and the patient’s lifestyle. In many cases, we begin medical therapy with eye drops. We monitor the responsiveness and make changes depending on eye pressure and visual field changes. We can also offer laser treatments to lower eye pressure. When medications and/or laser trabeculoplasty are unable to reduce the eye pressure enough, the best choice is to surgically make a new drain for the eye to allow the fluid that cannot get out through the natural drain and decrease the eye pressure.