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Eyecare Associates’ eye doctors provides glaucoma care from screening to diagnosis to treatment!

Glaucoma is the term used to describe any of a group of related eye disorders that cause damage to the optic nerve–the structure that transmits visual information from the eye to the brain. In most cases, this eye disease is associated with elevated pressure inside the eye (intraocular pressure, or IOP) that occurs because fluid produced inside the eye does not drain properly. If uncontrolled or left untreated, glaucoma can eventually lead to blindness.

Glaucoma is a silent disease, this means it doesn’t hurt and you won’t notice it’s progressing until significant damage as occurred. Detection and treatment are crucial in preventing this stealthy syndrome from getting a foothold. Glaucoma is a leading cause of blindness in the United States. According to the National Eye Institute, roughly 2.7 million Americans in 2010 have it and that number is expected to increase to nearly 4.3 million in 2030.

Signs and Symptoms

Glaucoma sometimes is called the “silent thief of sight,” because most types typically cause no pain and produce no symptoms until significant, irreversible vision loss occurs. This is why routine comprehensive eye exams that include eye pressure measurements are so important.

But one form of the disease–called acute angle-closure glaucoma–produces sudden symptoms of blurry vision, halos around lights, intense eye pain and nausea. If you experience these symptoms, see an eye doctor immediately so steps can be taken to prevent permanent vision loss.

How do you get it?

Glaucoma generally is caused by a failure of the eye to maintain an appropriate balance of the amount of fluid produced inside the eye and the amount that drains away.

Just as a basketball or football requires air pressure to maintain its shape, the eyeball needs internal fluid pressure to retain its globe-like shape and ability to see. If the internal eye structures fail to properly regulate fluid in the eye, IOP can increase to dangerously high levels and cause nerve damage and vision loss.

Open-Angle vs. Closed-Angle

The most common types of glaucoma are called open-angle and closed-angle.

Glaucomo Eye Pic

The word “angle” in these descriptions refers to the space between the cornea and the iris (the colored part of the eye) that fluid must pass through to drain from the eye and maintain normal intraocular pressure.

Primary open-angle glaucoma (POAG): About half of Americans with this form of silent disease, don’t know they have it. POAG gradually and painlessly reduces your peripheral vision. It’s like a slow drip that eventually fills the bathtub; by the time you notice it, permanent damage has already occurred. If your eye pressure remains high, the destruction can progress until tunnel vision develops, and you will be able to see only objects that are straight ahead.

Acute angle-closure glaucoma: Angle-closure or narrow-angle glaucoma produces sudden symptoms such as eye pain, headaches, halos around lights, dilated pupils, vision loss, red eyes, nausea and vomiting. These signs may last for a few hours, and then return again for another round. Each attack can cause additional vision loss.

Other types include:

Normal-tension glaucoma: also referred to as normal-pressure or low-pressure, this is an open-angle type of glaucoma, but may actually be a completely different disease than the more common POAG. As its name suggests, normal-tension glaucoma, unlike all other forms, is not associated with an increase in IOP. The cause of this is unknown, but it may be associated with poor blood flow to the optic nerve. Normal-tension glaucoma is more common among women, people with lower average blood pressure, people of Japanese descent, and individuals with a history of vascular disease.

Congenital glaucoma: is an inherited form present at birth. Children with congenital glaucoma are born with narrow angles or some other defect in the drainage system of the eye. Symptoms include a cloudy, enlarged or protruding eye.

Pigmentary glaucoma: This rare type is caused by pigment that dislodges from the iris and clogs the draining area of the eye, causing an increase in eye pressure. Pigmentary glaucoma usually has no immediate symptoms, though some pain and blurry vision may occur after exercise. White males in their mid-30s to mid-40s are most at risk.

Secondary glaucoma: This term describes glaucoma that develops due to an eye injury, infection, inflammation, a tumor inside the eye or an enlarged cataract.

How does your eye doctor detect Glaucoma?

The only way to determine if you have glaucoma is to have a comprehensive eye exam that includes measurement of eye pressure and examination of the optic nerve.

Measurement of eye pressure is called tonometry. A number of different types of tonometers can be used to measure IOP.

But eye pressure alone does not tell the whole story. Some people who have higher-than-normal eye pressure do not sustain damage to the optic nerve. High eye pressure without optic nerve damage is called ocular hypertension, and IOP-lowering treatment may or may not be required.

To evaluate the health of your optic nerve and determine if glaucoma-related nerve damage has occurred, your eye doctor will dilate the pupil of your eye and examine the nerve with one or more optical instruments.

Photography or other imaging devices also may be used to document and monitor the appearance of your optic nerve over time. Also, visual field testing will be performed to see if nerve damage from glaucoma has caused blind spots in your field of vision that you often cannot detect on your own.

Glaucoma Treatment

Depending on the severity of the disease, treatment for glaucoma can involve the use of medications, conventional or laser eye surgery, or a combination of these treatments. Medicated eye drops aimed at lowering IOP usually are tried first to prevent or control glaucoma.

Because high eye pressure usually is painless, many glaucoma patients get careless about using their eye drops regularly. In fact, failure to use medicated eye drops as directed is a major cause for glaucoma-related blindness.

If you find that the eye drops you are using for glaucoma are uncomfortable or inconvenient, never discontinue them without first consulting your eye doctor about a possible alternative therapy.

Early Detection Is Key

Early detection and treatment is the best way to prevent vision loss from glaucoma. See your eye doctor for routine comprehensive eye exams that include a check of your IOP.

People at high risk for glaucoma due to elevated intraocular pressure, a family history of glaucoma, advanced age or an unusual optic nerve appearance may need more frequent exams.

Annual exams are the best way to prevent damage from glaucoma. Dr. Laura Nennig with Eyecare Associates of Lees Summit recommends that if you are 35 or older and have not had an eye exam in the last 18 months to call our office today and make an appointment. We carry some of the most advanced technology to detect and treat glaucoma. Call or text our office at 816-524-8900 and one of our friendly staff is waiting to assist you.

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