Glaucoma

Read our Consumer Guide to help you make informed decisions about treatment for glaucoma.

What is glaucoma?

Glaucoma is a condition that is characterized by increased pressure in the eye and impaired eyesight, ranging from slight vision loss to total blindness. Glaucoma is not a single disease, but a group of eye diseases that have one feature in common: progressive damage to the optic nerve caused by increased pressure within the eyeball. The pressure comes from a clear fluid called the aqueous humor. This fluid helps to nourish the eye, and flows in and out of the eye through a mesh-like channel. In people with glaucoma, the fluid does not drain properly and pressure builds up in the eye, damaging the nerve that transmits images to the brain. As this deterioration of the optic nerve continues, vision worsens, and eventually, blindness can result.

Glaucoma treatment cannot restore vision that is lost. But treatment can prevent additional loss of vision from occurring. That is why screening and early detection of glaucoma are so important.

Are there different types of glaucoma?

There are two main types of glaucoma found in adults:

• Open-angle glaucoma is the most common type, found in approximately 90 percent of glaucoma patients in the United States. In open-angle glaucoma, the structures in the eye appear to be normal, but fluid does not drain properly because of tissue changes in and along the drainage passage. This type of glaucoma has no early warning signs and can go undetected for years.
• Chronic or acute angle-closure glaucoma accounts for about 10 percent of glaucoma cases in this country. Here, the normal drainage passage in the eye is narrowed and then becomes blocked.

If either type of glaucoma is diagnosed early enough, a simple laser treatment can be used to improve the drainage.

Who is most likely to get glaucoma?

Glaucoma is more commonly found in people over the age of 35. You are more likely to get glaucoma if you:

• Are of African-American, Irish, Russian or Scandinavian descent
• Have family members with glaucoma
• Have poor vision
• Have diabetes
• Take corticosteroid (Prednisone) medications

Glaucoma is usually present in both eyes, although one eye may be more affected than the other.

What are the symptoms of glaucoma?

Most patients with glaucoma do not notice any symptoms at first, until they have lost some of their peripheral (side) vision - and often this is not recognized by the patient until the disease has progressed. When other symptoms are present, they may include:

• Pain in the eye (If you experience sudden, severe eye pain, headache and blurred vision, your internal eye pressure may be very high. You should call your ophthalmologist or go to an emergency room right away.)
• Redness in the eye
• Vision in one or both eyes appearing hazy
• Seeing halos around lights
• Narrowing of vision (tunnel vision)

If there are no recognizable symptoms, how can I tell if I have glaucoma?

Your ophthalmologist will perform regular examinations of your eyes and will be able to tell if you have glaucoma. Glaucoma tests are painless and take very little time. The ophthalmologist uses a device called a tonometer to measure the pressure in your eyes. He or she also uses an ophthalmoscope and other instruments to examine the eye's interior and detect damage to the optic nerve. If indicated, your ophthalmologist may also test your field of vision (the range in which you see clearly), including your peripheral vision.

How is glaucoma treated?

The goal of glaucoma treatment is to prevent further vision loss by controlling pressure in the eye - similar to controlling blood pressure to prevent a stroke. There are several ways in which glaucoma can be treated successfully.

• Medications, in the form of eye drops or pills, lower pressure by reducing the amount of fluid produced in the eye and increasing drainage. One or more medicines may be used at the same time.
• Laser therapy, performed on an outpatient basis, is used to reduce pressure in the eye. A procedure called laser trabeculoplasty improves fluid drainage in patients with open-angle glaucoma. People with closed-angle glaucoma usually must be treated with a procedure called laser iridotomy, which creates a tiny opening in the iris (colored part of the eye), allowing the drainage angle to open.
• Surgery may be needed to create a second drainage channel in the eye to supplement the natural one. This generally is performed on an outpatient basis using local anesthesia, and may allow the patient to reduce or eliminate glaucoma medications.
• For more advanced cases, an artificial glaucoma drainage implant may help to decrease pressure. The implant helps to drain excess fluid, which is then absorbed into the body.

I have glaucoma and cataracts. What can be done to help?

A cataract is a clouding of the lens of the eye that prevents light from entering. Since many people develop cataracts as they age, many people with glaucoma also have them. The two problems can be treated in many patients using a single combined procedure. Vision is restored faster, and further surgery usually is not needed.

Can vision loss or blindness from glaucoma be cured?

Unfortunately, no. Treatment cannot bring back vision that has been lost as a result of glaucoma. But treatment can stop any further vision loss from happening. See your ophthalmologist for regular eye examinations and glaucoma screenings.

Click here to make an appointment now. Or call 216/444-2020 or 1/800-223-2273 Ext. 42020 to schedule an appointment with a Cole Eye Institute ophthalmologist.

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