Glaucoma is an eye disease that causes damage to the optic nerve, the nerve that carries vision to the brain. Most cases of glaucoma are caused by high pressure inside the eye, but some types can occur with normal or low eye pressures.
Symptoms Of Glaucoma
There are often no symptoms such as vision loss or pain during the early stages of glaucoma making it difficult for many patients to realize there is a problem. Some types of glaucoma may cause symptoms such as sudden vision loss, headache, nausea, halos around lights, and eye pain.
As glaucoma progresses, vision loss will occur, usually in the peripheral vision but gradually affecting central vision. If untreated, glaucoma may progress to total blindness. Vision loss from glaucoma is permanent, making it especially important to diagnose and treat glaucoma before extensive damage occurs.
Risk Factors For Glaucoma
Glaucoma can occur in anyone and since it usually begins without any symptoms, it is important to have a complete eye exam to determine whether you have glaucoma. Certain risk factors may place you at a higher risk to develop glaucoma including:
- Age over 45 years
- Family history of glaucoma
- African-American ancestry
- History of high eye pressure
- Ocular Injury or trauma
- Certain types of infections
- High degrees of near or far-sightedness
Diagnosis of glaucoma
A complete dilated eye exam is the first step in diagnosing glaucoma.
Other specialized testing to examine the optic nerve and the peripheral visual field may also be performed.
Treatment Of Glaucoma
Glaucoma is treated by lowering the eye pressure. Decreasing the eye pressure will usually slow or stop further glaucoma damage. Treatment cannot remove or repair glaucoma damage that has already occurred which is why early diagnosis and treatment is the best way to prevent vision loss from glaucoma. There are four main strategies to lower eye pressures:
Several different classes of medications exist to lower the eye pressure. Your doctor can help select a medication to treat your glaucoma based on a variety of factors including safety, effectiveness, side effects, cost, and insurance coverage.
Selective Laser Trabeculoplasty (SLT)
SLT is a quick, relatively painless treatment to lower eye pressure. No shots or incisions on the eye are required during the procedure. During SLT, a laser light is used to treat the area in the eye where pressure is controlled and fluid is drained from the inside of the eye.
Minimally Invasive Glaucoma Surgery – iStent
For some patients, minimally invasive surgery with iStent implantation may be an effective way to lower eye pressure. The iStent is a tiny device that is placed in the drainage system of the eye and causes fluid to exit the eye more effectively. For many patients, placement of a iStent may allow them to stop requiring pressure-lowering eye drops or achieve even lower pressures while remaining on their existing eye drops.
In cases where adequate pressure control cannot be maintained by less-invasive treatments, surgeries that create a new filtering pathway for fluid may be considered. These procedures are generally reserved for advanced or aggressive cases of glaucoma where safer and less invasive treatments have failed. The two main types of filtering surgeries are trabeculectomy and tube shunts.
Prognosis for Glaucoma
The prognosis for glaucoma generally depends on when the disease is detected. There is usually a good prognosis if the disease is found before a significant amount of nerve damage has occurred.
Even if significant damage or vision loss has already happened, there can still be a good chance of preventing further loss with proper treatment. Untreated glaucoma generally has a poor prognosis and often leads to permanent blindness.