What You Need to Know: Glaucoma
Glaucoma is a general term that refers to a set of eye diseases that damage the optic nerve. These diseases increase pressure within the eye, which harms the optic nerve – leading to irreparable vision loss.
In fact, glaucoma is the most common type of vision loss in people over the age of 50. So even though this eye disease can happen to people of all ages, it’s most common in older adults.
The problem with glaucoma is that it is a “silent” disease. You might not notice any symptoms indicating that glaucoma is occurring.
Since there are no warning signs, most people don’t realize that there is a problem until it has progressed to an advanced stage.
Because the symptoms can be silent, it’s critical that you maintain regular, comprehensive eye exams with an experienced ophthalmologist. These tests check the pressure within the eyes to identify potential issues in the earliest stages.
The good news is that early detection can slow the progression of glaucoma. In addition, an experienced eye doctor monitors your health condition and provides a proactive approach to reduce your symptoms in the future.
What Causes Glaucoma?
Doctors are still trying to determine the exact reason why pressure builds within the eye. A few known risk factors affect a person’s likelihood of having glaucoma, but no specific findings of the exact cause of glaucoma.
Typically, vitreous fluid flows through the eye before it drains in the area where the cornea and iris meet (known as the trabecular meshwork). If this drainage system isn’t working right, then eye pressure goes up because the fluid can’t move out.
As the pressure in the eye increases, it causes damage to the optic nerve, which is the part of the eye that sends signals to your brain. This type of eye damage is irreversible, which means that vision loss is permanent.
Family history is a factor that can increase the risk of glaucoma. If you have family members with this diagnosis, talk to your doctor about your personal risk of glaucoma.
Types of Glaucoma
Treatment recommendations vary depending on the type of glaucoma that is affecting your eyes. Common types of glaucoma include:
- Open-Angle Glaucoma: This type is the most common type. Even though the drainage angle in the iris and cornea is open, there is a partial obstruction in the trabecular meshwork. As a result, the pressure gradually increases over time.
- Closed-Angle Glaucoma: Also known as angle-closure glaucoma, this type of glaucoma causes a bulging in the iris, which causes a narrowing or blockage in the eye. Since fluid can’t circulate, the pressure builds. This type of glaucoma can start gradually or suddenly.
- Normal-Tension Glaucoma: There are instances where the optic nerve can be damaged even though the internal eye pressure is normal. Researchers don’t understand why this happens, but it could be related to a reduced blood supply or having a sensitive optic nerve.
Other types of this disease include pediatric glaucoma (affecting children in their earliest years of life) and pigmentary glaucoma (caused by a buildup of pigment granules in the eye).
Diagnosis Process for Glaucoma
A comprehensive, dilated eye exam is the first step for glaucoma diagnosis. This process involves a group of tests to check your eyesight, measure pressure in the eye, and determine the extent of damage (if any).
An ophthalmologist is a medical doctor trained in eye conditions, so it’s best to meet with an ophthalmologist instead of a general eye doctor (optometrist).
Your comprehensive eye exam might include tests such as:
- Tonometry: This test uses a small puff of air to measure eye pressure.
- Pachymetry: A test that determines the thickness of the outside layer of the eye, known as your cornea.
- Perimetry: A visual field test to see the extent of your side vision.
- Dilation: Eye drops that open the pupils, so the doctor can see into the back of the eye to check for damage to the optic nerve.
- Gonioscopy: When the eyes are dilated, a handheld device uses a mirror that lets the eye doctor look into the eye in different directions.
Treatment Options for Glaucoma
Certain types of glaucoma are considered a medical emergency, such as closed-angle glaucoma, because it develops so quickly. Long-term vision loss can occur, especially if you aren’t proactive about seeking prompt medical support.
The best approach is to use modern medical treatments to control glaucoma and make necessary lifestyle changes. Treatments might include:
- Eye Drops: Prescription medications that you drop into your eyes, which can improve fluid drainage and decrease eye pressure. In addition, some drops reduce the amount of fluid generated into the eye.
- Medications: Certain oral medications can also be used for bringing down eye pressure. One of the most common prescriptions is for a doctor to suggest a carbonic anhydrase inhibitor.
- Laser Therapy: Patients with open-angle glaucoma can often benefit from laser therapy, an outpatient procedure performed in the doctor’s office. The laser opens the blocked drainage channels.
- Surgery: Various types of surgery can be helpful for glaucoma, such as placing drainage shunts that lower eye pressure or removing a portion of the trabecular meshwork.
There are also various minimally-invasive glaucoma surgical techniques that are lower-risk treatments (compared to other types of glaucoma surgery).
What to Expect: Recovery After Treatment
Recovery time after glaucoma surgery varies, depending on the patient and type of surgery completed. Usually, it’s a pain-free and uncomplicated recovery, but you still need to take it easy after the surgery to minimize the risk of complications.
Most patients need between 3 to 6 weeks for recovery after glaucoma surgery. You might need to wear a shield or glasses over the eye in the first few days for protection.
Temporary side effects after glaucoma surgery might include irritation, redness, tearing, swelling, or the feeling of having something in your eye.
Your eye doctor might have recovery suggestions, such as using eye drops or other types of medications during your recovery time. Always follow these instructions to optimize the outcome of your treatment.
Most patients don’t have pain during recovery. However, if you start to have significant pain, you should consult your eye surgeon right away.