Often called the “silent thief of sight”, Glaucoma can be a serious and troublesome disease. While glaucoma has no cure, early detection and treatment can help minimize and control the effects of this disease.
What is glaucoma?
Glaucoma is a pressure-related disease of the eye that damages the optic nerve. The optic nerve is essential for eye-sight since its primary function is to transmit light impulses from the retina to the brain. The brain then translates these impulses into the images that we see. If no impulses can travel through the optic nerve, blindness occurs
Glaucoma occurs when the natural fluid in the front portion of the eye (aqueous humor) is not able to drain properly due to poor access to the drainage system, known as closed angle glaucoma, or problems occur in the drainage system (trabecular meshwork) creating open angle glaucoma. Normal pressure glaucoma creates optic nerve damage at “normal” pressures, and is a subset of open angle glaucoma. As the fluids accumulate, pressure in the eye increases pushing against the optic nerve. If the pressure is not relieved or lowered, the optic nerve can sustain significant damage. Left untreated, glaucoma can lead to blindness.
What does glaucoma do?
Glaucoma has two basic characteristics
- Progressive pressure-related damage to the optic nerve
- Peripheral vision that is lost or adversely affected
What causes glaucoma and who does it affect?
Glaucoma affects more than 3 million people and is the leading cause of blindness for older people in the United States. However, glaucoma can also occur in youth and children.
The primary risk factors of glaucoma are elevated intraocular pressures, family history, and age. Other risks may include African or Spanish ancestry, ocular trauma and injuries, ocular hypertension, medications such as steroids, high myopia (nearsightedness), thin central cornea, and medical conditions such as diabetes, hypothyroidism, leukemia, arthritis, or sickle cell anemia.
Signs and Symptoms of Glaucoma
Glaucoma often progresses undetected until the optic nerve has been irreversibly damaged with varying degrees of permanent vision loss. If you experience one or more of the symptoms listed below, check in with Dr. Manjoney as soon as possible for a complete assessment and examination.
- Impaired or decreased vision (usually the first sign)
- Asymptomatic eye conditions for an extended period of time
- Elevated eye pressure
- Severe eye pain
- Blurred, clouded or haloed vision
- Red Eyes
- Light sensitivity
- Excessive blinking or tearing
- Crossed or turned out eyes
- One eye becoming larger than the other
Types of Glaucoma
Listed below is a brief description of the four main types of glaucoma.
- Primary Open Angle (POAG): The most common form of glaucoma, this type is characterized by a blockage inside the eye’s drainage canal and the fluids drain too slowly. Since the fluid cannot drain from the eye properly, the inner eye pressure (IOP) rises. Generally, this type progresses slowly with gradual vision loss and may not be noticed until the disease has progressed significantly.
- Closed or Narrow Angle Glaucoma: This less common type of glaucoma occurs when the eye’s drainage canal is blocked by part of the iris and fluid cannot drain from the eye. In this case, eye pressure usually increases very quickly, may be accompanied by loss of vision or painful side effects and needs to be diagnosed as quickly as possible.
- Normal (or low) Tension Glaucoma: Like POAG, Normal Tension Glaucoma occurs when the eye fluids drain too slowly. In this case however, the eye pressure remains within a normal range and there is little or no pain or symptoms as is often the case with other diseases. Damage to the optic nerve may not be noticed until symptoms such as tunnel vision occur and often the visual field is adversely affected.
- Congenital Glaucoma: This is an inherited form of glaucoma present at birth. Children with this type have a defect in the drainage system of the eye. It is difficult to spot since children are not able to tell you what is happening to them. If you notice a cloudy, white, hazy, enlarged or protruding eye in your child, consult your eye doctor as soon as possible.
How is Glaucoma diagnosed?
The best way to detect glaucoma is through frequent, routine dilated eye examinations that include:
- Gonioscopy : Testing of the eye’s drainage angle
- Ophthalmolscopy : Evaluation of the Optic Nerve
- Tonometry : Measurement of eye pressure
- Perimetry: Testing of the visual field
Information from these examinations monitored at regular intervals provides a history enabling early detection of glaucoma and a study of its progression. If glaucoma is identified early and treated appropriately, good vision can usually be maintained.
If you are a glaucoma suspect or have glaucoma, Dr. Manjoney will use OCT, one of the most sophisticated instruments in detecting and following glaucoma that analyzes the health of your optic nerve. Treatment to control glaucoma includes medications in the form of eye drops or pills, laser surgery and conventional surgery. Dr. Manjoney is skilled at the assessment, monitoring, and treatment of glaucoma.
Treatment for Glaucoma
While there are no cures for glaucoma, there are medications and surgery treatments which help manage Glaucoma progression by lowering the intraocular eye pressure (IOP).
Eye Drop Medications are one of the first lines of treatment to lower intraocular eye pressure. Eye drops reduce eye pressure either by increasing the fluid outflow and/or reducing the amount of fluid produced by the eye. Before prescribing eye drops, Dr. Manjoney will determine whether or not the glaucoma medicine prescribed will not adversely interact with other medications you may be taking.
Laser Therapy is another option used for early treatment of glaucoma. This non-thermal laser works by gently treating the drainage mechanism of the eye to allow for increased outflow of fluid, thus reducing the pressure. Dr. Manjoney can help determine if this safe and effective treatment may be an option for you.
Glaucoma Surgery is suggested for patients who still have elevated eye pressure after medication and laser therapy treatments. The goal of surgery is to drain the eye’s fluids creating a new secondary outlet for the fluids to drain through. Dr. Manjoney will determine the right surgery for you based on detailed review and consultation.