Eye Health – Part 2 – Glaucoma

Glaucoma is a group of eye diseases that damage the optic nerve and cause vision loss. This condition has to be treated or it could lead to irreversible blindness. Please, if you feel pressure in your eye, see your eye doctor/specialist right away.

According to the CNIB – glaucoma is the leading cause of vision loss in Canadian seniors. It’s also the second leading cause of irreversible blindness worldwide.  As many as half of the people who have glaucoma may not know they have the disease, as initially it presents no symptoms and the loss of peripheral vision is not noticed.

The risk factors contributing to this condition are increased pressure in the eye, family history (in my case both my parents had glaucoma), and high blood pressure. It most usually doesn’t show up until later in life, and those who see their eye doctor on a regular basis are likely to catch it fairly early on in the process. We see an ophthalmologist every year now, so he’s keeping a close watch on both of us.

Just because you have a possible heredity does not mean you will actually have this condition. Sometimes it does and sometimes it doesn’t. As long as you keep your body healthy, your eyes should hopefully follow suit.

Web-MD says that, “If you’re over age 40 and have a family history of the disease, you should get a complete eye exam from an eye doctor every 1 to 2 years. If you have health problems like diabetes or a family history of glaucoma or are at risk for other eye diseases, you may need to go more often.”

So just what is glaucoma anyway – it is a disease of the major nerve of vision called the optic nerve. It is usually, but not always associated with the buildup of fluid (intraocular) pressure inside of your eye(s). It happens when the fluid (called the aqueous humor) that normally travels through the front of your eye(s), doesn’t flow properly out of the eye(s) and causes a build up of pressure.

Some less common causes are an eye injury, severe eye infection, blocked blood vessels in the eye, inflammatory conditions, and sometimes eye surgery can bring it on.

There are two types of glaucoma – Open-angle glaucoma (wide angle glaucoma) where the fluid doesn’t flow out of the eye the way it should. Angle-closure glaucoma (acute or chronic angle-closure or narrow angle glaucoma) where the angle between the iris and cornea is too narrow which can cause a sudden buildup of pressure in the eye.

This condition usually affects adults over 40, but can affect other adults, children and even infants. African-Americans tend to be more susceptible to it when they are younger with greater vision loss. If you are of African-American, Irish, Russian, Japanese, Hispanic, Inuit, or Scandinavian descent, are over 40, have a family history, have poor vision, are diabetic, take steroid medications (like prednisone), or have had eye trauma then you are more likely to develop glaucoma.

Glaucoma is sometimes called the “sneak thief of vision” because it can go unnoticed until its very late in the disease. This is why it is imperative that you get regular eye exams every 1-2 years by an eye specialist. The pressure inside the eye can rise high enough to cause sudden eye pain, headache, blurred vision, or you might see “halos” around lights. If you experience any of the following symptoms, get to your eye doctor/specialist right away: seeing halos around lights, redness in the eye, vision loss, nausea or vomiting, eye pain, or narrowed (tunnel) vision.

The doctor will dilate the eye with drops and test your vision, checking the optic nerve to see if he/she sees any sign of nerve damage. They will likely do a test called a tonometry to check eye pressure. Another test is a field of vision test to see if you’ve lost side or peripheral vision.

There are a few ways glaucoma is treated.

Eye drops to reduce pressure – these drops can have side effects including: allergies, redness, stinging, blurred vision and irritated eyes. Some of these drugs can affect your heart and lungs, so you should make sure your eye doctor knows what other medications you are currently taking, and make sure your regular physician is aware of your condition and what you are taking to help with symptoms.

Laser surgery can be used to increase the flow of the fluid from the eye when you have open-angle glaucoma. It can also stop fluid blockage if you have angle-closure glaucoma. This procedure can include – Trabeculoplasty which opens the drainage area; Iridotomy which makes a tiny hole in the iris to let fluid flow more freely; and Cyclophotocoagulation which treats the middle layer of the eye to reduce fluid production.

Microsurgery – a Trabeculectomy creates a new channel to drain the fluid to ease eye pressure. This type of surgery comes with it’s own set of issues as it may fail and have to be redone, or the surgery may cause temporary or permanent vision loss and bleeding or infection.

Most doctors will start with eye drops before going on to the next options, but in some cases laser or micro-surgery may be the better option.

Glaucoma cannot be prevented, but if treated early it can be controlled. But it is wise to note that many people affected by glaucoma may have other eye diseases such as cataract or macular degeneration. Your ophthalmologist will be able to determine if any visual loss being experienced is being caused by glaucoma or some other eye issues.

If glaucoma is diagnosed before significant optic nerve damage has occurred and the treatment prescribed is followed closely, then you should have a pretty good outcome with little or no vision loss. But be aware that optic nerve damage is permanent, and it is recommended to stay in touch with your eye doctor/specialist during treatment to help ensure reduced possibility of further damage.

It is now thought that glaucoma may be more of a neurological condition than an eye disorder, and researchers are investigating possible therapeutic roles of neuroprotection of the optic nerve, especially in patients who seem to have progressive nerve damage and visual field loss despite the fact they have normal intraocular pressure. Also, new surgical methods are being studied to lower the intraocular pressure more safely without significant risk of damage to the eye or loss of vision.

Early detection is the best hope for a reduction in vision loss from glaucoma.

Have a wonderful day and week ahead.