What is Glaucoma?
Glaucoma is a disease that damages the optic nerve of the eye. The optic nerve is the “cable” that takes what our eye sees and sends the signal to our brain. 3 million people are estimated to have glaucoma, BUT only half of them are aware they have the disease. Early in the disease there are no symptoms and for that reason glaucoma is often referred to as “the silent thief of sight”.
The damage to the optic nerve is progressive without treatment and the loss of vision is irreversible. For this reason it is important to be screened for glaucoma in hopes of identifying the disease in its earliest stages and initiate treatment to preserve vision.
What are the risk factors for glaucoma?
Glaucoma is a multifactorial disease with several risk factors associated:
Age: Glaucoma is found more often in those over the age of 50.
Race: African Americans are 3-4 times more likely to develop glaucoma. Hispanics are 1-2 times more likely to develop glaucoma.
Intraocular pressure (IOP): Increased IOP is a risk factor for developing glaucoma. Understand that IOP can have diurnal fluctuation and may be consistently “normal” at certain times during the day, yet abnormal at other times during the day.
Family history: Patients with immediate family members who have Primary Open Angle Glaucoma (the most common type) are 4-9 times more likely to develop glaucoma.
Corneal thickness: Patients with thinner corneas are at a greater risk to develop glaucoma.
Steroid usage: Topical steroids used chronically have been shown to increase IOP in a certain percentage of the population. Patients who take topical steroids on a chronic basis should have their eye pressure checked throughout the year.
- Eye injuries: Blunt injuries to the eye that result in damage to the iris or drainage angle of the eye can lead to increased IOP. The increased IOP can occur immediately following the injury or sometimes 10-20 years following the incident.
What are the different types of glaucoma?
There are several different types of glaucoma, all of which have progressive optic nerve damage and visual field loss in common. Below is a list of the different types:
- Primary Open Angle Glaucoma
- Normal or Low Pressure/Tension Glaucoma
- Narrow Angle Glaucoma
- Secondary Glaucoma
- Pigmentary Glaucoma
- Pseudo exfoliative Glaucoma
- Neovascular Glaucoma
- Congenital Glaucoma
- Glaucoma Suspect
What are the symptoms?
- Severe eye pain.
- Nausea and vomiting (accompanying the severe eye pain)
- Sudden onset of visual disturbance, often in low light.
- Blurred vision.
- Halos around lights.
- Reddening of the eye.
- Patchy blind spots in your side (peripheral) or central vision, frequently in both eyes.
A number of effective medications exist to treat glaucoma. Most commonly topical eye medications (“eye drops”) are prescribed on a daily schedule to be used 1-2 times per day depending on the medicine. Oral medication to lower eye pressure can be prescribed although these options are usually used as second line agents or in short term emergency situations. Your doctor will set a “target eye pressure” prior to treatment and will usually begin a single glaucoma medication. After using the medication for 3-6 weeks, your doctor will recheck your eye pressure to see if the target eye pressure has been reached.
Glaucoma Laser Treatment
(LPI) is a laser treatment applied to the iris of the eye for patients who have narrow drainage angles and are at risk of having an angle closure attack. Again, this laser treatment is for the treatment of Narrow Angle Glaucoma or used emergently for patients having a Narrow Angle Glaucoma Attack.
SLT is a laser treatment applied to the drainage angle of the eye. Topical numbing drops are used to anesthetize the eye and the treatment takes just a few minutes to complete. The laser treatment is effective in reducing the pressure in the eye in 80-90% of patients. The effect can wear off with time and your doctor may recommend a repeat treatment.
There are several surgical procedures used to reduce pressure in the treatment of glaucoma. Historically surgical options for glaucoma have been the third line of treatment after topical medicines or laser surgical procedures, but newer surgical options termed Micro Invasive Glaucoma Surgery or Minimally Invasive Glaucoma Surgery (MIGS) are being considered first line options for some patients.
* Not Currently FDA Approved
Glaucoma Filter Surgery
Our Glaucoma Team
Daniel Bettis, M.D.
Glaucoma/MIGS and Cataract Specialist
John Gelvin, O.D.
Glaucoma, Cataract and Refractive Care
Clinic Manager and Surgical Coordinator