Glaucoma | Portland OR
Glaucoma is the leading cause of blindness and visual impairment in the United States. A simple, painless eye exam can detect the disease. With early detection and treatment, glaucoma can usually be controlled and blindness prevented.
While some patients may experience symptoms from glaucoma as the disease progresses, others do not learn they have the condition until they undergo a routine eye exam. There are several different exams performed to diagnose glaucoma, including a visual field and visual acuity test. These tests measure peripheral vision and how well patients can see at various distances. Other tests may also be performed, such as tonometry to measure the pressure inside the eye and pachymetry to measure the thickness of the cornea.
Treatment for Glaucoma
Once glaucoma has been diagnosed, treatment should begin as soon as possible to help minimize the risk of permanent vision loss. There is no cure for glaucoma, so treatment focuses on relieving symptoms and preventing further damage from occurring. Most cases of glaucoma can be treated with eye drops, laser surgery or microsurgery. The best treatment for your individual case depends on the type and severity of the disease, and can be discussed with your doctor.
- Eye drops are used to reduce fluid production in the front of the eye or to help drain excess fluid, but can lead to redness, stinging, irritation or blurry vision. Patients should tell their doctor about any allergies they have to minimize the risk of side effects.
- Laser surgery for glaucoma aims to increase the outflow of fluid from the eye or eliminate fluid blockages through laser trabeculoplasty, iridotomy or cyclophotocoagulation.
- Microsurgery involves a surgical procedure called a trabeculectomy, which creates a new channel to drain fluid from the eye and reduce the pressure that causes glaucoma. Surgery is often performed after medication and laser procedures have failed.
While there are no surefire ways to prevent glaucoma from developing, regular screenings and early detection are the best forms of protection against the harmful damage that the disease can cause. Patients should have a comprehensive dilated eye exam at least once every two years, especially if they have a higher risk of developing glaucoma. Older patients may be encouraged to be tested more frequently.
What is glaucoma?
Glaucoma is a group of eye conditions where pressure builds inside the eye, and this increased pressure damages the optic nerve. It is second only to macular degeneration for blindness across all age groups in the U.S. Glaucoma is especially dangerous because many forms have no warning signs — before the patient realizes there is a problem with his or her vision, damage has already occurred. This damage is permanent.
What causes glaucoma?
A substance known as aqueous humor flows through a normal eye and exits through an area of tissue called the trabecular meshwork. The trabecular network is found where the iris and cornea meet. If the trabecular meshwork has a blockage or is somehow damaged, or when the eye overproduces aqueous humor, pressure increases inside the eye. As the pressure increases and stays elevated this damages the optic nerve. As the nerve gradually deteriorates blind spots develop in the patient’s visual field.
What are the symptoms of glaucoma?
While there are different forms of glaucoma, the two most common forms are known as open-angle glaucoma and acute angle-closure glaucoma. These are the symptoms for these forms:
Primary open-angle glaucoma symptoms:
- Patchy blind spots in your peripheral or central vision, frequently in both eyes
- Tunnel vision with advanced glaucoma
Acute angle-closure glaucoma symptoms:
- Severe headaches
- Eye pain
- Nausea and vomiting
- Blurred vision
- Halos around lights
- Eye redness
Are some people more at risk for developing glaucoma?
Anyone can develop glaucoma, but certain factors increase a person’s risk:
- Having high intraocular pressure
- Being over age 60
- Being black, Asian, or Hispanic
- Having a family history of glaucoma
- Having other medical conditions, such as diabetes, high blood pressure, heart disease, or sickle cell anemia
- Having corneas that are thin in the center
- Being extremely nearsighted or farsighted
- Having had an eye injury
- Having had certain types of eye surgery
- Long-time use of corticosteroid medications, particularly eye drops
Can glaucoma be cured?
Glaucoma can be prevented, but there isn’t a cure once it develops. Damage to the optic nerve is permanent. Once glaucoma is diagnosed, however, treatment can help slow or prevent vision loss, but this can only happen with an early diagnosis. That’s why we stress the importance of regular eye exams at The Eye Clinic. Once diagnosed, the goal is to lower the intraocular pressure.
How is glaucoma treated?Eye drops — There are now a variety of different eye drop options for glaucoma treatment, depending on how your eyes respond. Some of these eye drops increase outflow of the aqueous fluid. Others seek to reduce production of fluid in the eye. Many people don’t comply with their dosages and the need for consistent application of their eye drops. This is the leading cause of continued damage to the optic nerve. This lack of urgency can be attributed to the fact that that the patient isn’t experiencing any pain or symptoms.
Surgery — With surgery the goal is to improve fluid drainage within the eye.
- Laser therapy: There are three options for laser surgery for glaucoma: laser trabeculoplasty, iridotomy, and cyclophotocoagulation. These procedures seek to increase outflow of fluid in the eye or to eliminate blockages in the trabecular meshwork.
- Filtering: In a trabeculectomy, part of the trabecular meshwork is removed to enhance drainage.
- Drainage tubes: Small tubes are inserted, usually through the trabecular meshwork, to open flow.
- Minimally invasive glaucoma surgery: These various techniques are used to lower eye pressure, generally with lower risk and easier recovery.