What Is Glaucoma?

Glaucoma is a disease characterized by an increase in intraocular pressure (eye pressure) that results in damage to the optic nerve and retinal nerve fibers.

The eyeball is filled with a clear fluid, which has several functions.  One of the more important functions of this fluid is to help the eye maintain its shape.

Within the eye there is a constant "inflow" of new fluid and a subsequent "outflow" which helps the eye maintain a balanced internal pressure.  Fluid is produced by the Ciliary Body, and is drained through the Trabecular Meshwork.  If there is a decrease in drainage of fluid, then the "balance" is disrupted and the pressure within the eye will become greater.  When this happens and damage to the optic nerve occurs, it is referred to as Glaucoma.

The area of the eye most susceptible to pressure damage is the optic nerve.  The increased pressure against the optic nerve results in a gradual, permanent loss of sight.

Glaucoma is most common in people over 40 years of age and can be hereditary.  Glaucoma also seems to be a more aggressive disease in African-Americans.  Glaucoma is called the "sneak thief of sight" because it can come on with little or no warning.  One of the first symptoms noticed is a loss of peripheral vision.  Unfortunately, by the time this is noticed by the individual, significant damage has already occurred.  Regular checkups are important to ensure that glaucoma is caught early so as to prevent loss of vision.  As a rule, GLAUCOMA IS A TREATABLE DISEASE.

Types Of Glaucoma

There are many different types of glaucoma; however, there are three main categories for the purposes of classification:

            Open Angle (Chronic) - This is the most common form of Glaucoma and usually the individual has no symptoms.  It is a chronic condition caused by a decrease in fluid drainage from within the eye.

            Closed Angle (Acute) - Closed angle refers to the anterior chamber angle (drain) in the eye.  At some point the angle becomes completely closed.  The intraocular pressure will quickly rise because the natural "drain" for the fluid has been blocked.  This can cause severe pain, decreased vision, red eye, and may or may not be accompanied by a headache, nausea, and vomiting.  This is an emergency.  The vision can be completely lost in a few days!

            Secondary Glaucoma - When there is an increase in intraocular pressure caused by infection, inflammation, injury, or other similar condition.

Taking Care Of Glaucoma

Regular visits to your Ophthalmologist can help detect glaucoma early and keep the "sneak thief of sight" at bay.  Glaucoma is usually a treatable disease if it is detected.  Once detected there are many modern techniques available to help keep the intraocular pressure down which will help prevent further vision loss.

The first step of treatment is usually a prescription eyedrop.  New medications can be very effective, alone or in combinations, at lowering the pressure.  It is important to remember to take your medication as prescribed to ensure maximum effectiveness.  If your physician has prescribed two or more medications, and you take them at the same time, remember to wait at least 5 minutes between instilling different drops to ensure maximum effectiveness.

Surgical Options Available For Glaucoma

If treatment with eye drops or pills does not lower the pressure to a safe level, your ophthalmologist may determine that glaucoma surgery is necessary.  One of the more common procedures used for open angle glaucoma is called an ALT (Argon Laser Trabeculoplasty).  The procedure involves using a laser to "open holes" in the trabecular meshwork (drain) of the eye.  This will allow the pressure to go down.  Another laser procedure is called an Iridotomy.  In this procedure the surgeon uses a laser to make a small hole in the iris (colored portion of the eye) to allow a greater flow of fluid within the eye.  There are also surgical procedures such as filtering surgery (trabeculectomy), which involves creating a small hole in the sclera (wall) of the eye to release pressure.  These procedures are done on an outpatient basis and are usually beneficial at controlling intraocular pressure.  However, as with any surgery there are some risks involved.  It is always best to talk with your Ophthalmologist about your options, risks, and benefits of each procedure.

FOR INFORMATION REGARDING CHEC's GLAUCOMA PHYSICIAN AND SURGEON.