Glaucoma
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GENERAL INFORMATION:
What is it? Glaucoma (glaw-KO-muh) is an eye disease that can damage your optic nerve and cause loss of vision (sight). Although it can happen quickly, glaucoma more commonly steals a person's vision slowly over time. Some people do not know they have glaucoma until they begin to lose their side vision. Many people do not even know they have glaucoma until they have their eyes checked by an eye doctor. Glaucoma is a disease you will have for the rest of your life. You can have it in one or both of your eyes. There is no cure for glaucoma, but it can be controlled with medicine or surgery. Without treatment, you can lose some or all of your vision.
How does glaucoma damage the eyes? A clear fluid flows through the eye all the time to keep it moist (wet) and healthy. As new fluid is made, old fluid flows out of the eye through the trabecular (truh-BEK-u-ler) meshwork. The trabecular meshwork is a tiny drain system located where the iris and the cornea join together. With glaucoma, the drain system becomes blocked or clogged. Like a sink drain, clogging causes the old eye fluid to drain too slowly or not drain at all. Fluid builds up and increases pressure in the back of the eye. When the fluid pushes too hard against the optic nerve, the nerve becomes damaged. The optic nerve is the nerve of sight, which sends messages to your brain. When the messages reach the brain, you are able to understand what you are seeing. When the optic nerve is damaged, you may lose parts of your vision or you may become blind.
Is glaucoma always caused by high eye pressure?
- No. People with normal eye pressure can have glaucoma, too. Doctors have found that some people have damage because even a normal eye pressure is too high for their eyes. When a person with normal eye pressure has glaucoma, it is called "normal-tension" or "low-tension" glaucoma. If you have this glaucoma, your doctor will give you medicine to keep your eye pressure lower than it normally is. This will help to stop or slow down damage caused by normal eye pressure.
- Doctors have also found that some people with high eye pressure do not have glaucoma. High eye pressure without glaucoma is called "ocular hypertension". If you have ocular hypertension, it is important to see your eye doctor regularly. The doctor will check the health of your optic nerve and make sure you are not developing glaucoma.
Who is at high risk for having glaucoma?
- Anyone over 60 years old.
- African-Americans over 40 years old.
- People who have a family member with glaucoma.
- People who have diabetes (di-uh-BE-tees) or high blood pressure.
- People who have had a severe (very bad) eye injury. Glaucoma can occur immediately after the injury or may happen any time in the future.
What is primary open-angle glaucoma?
- Most people have this type of glaucoma. Open-angle glaucoma is a slow forming type of glaucoma that is common in people as they get older. With open-angle glaucoma, your eye drain system may become clogged and drains fluid much too slowly. Fluid build-up causes your eye pressure to become too high and optic nerve damage to happen. There are usually no clear signs or symptoms until damage to the eye has already been done.
- If glaucoma goes untreated, you can lose your side vision first. You may have blurred vision on one side toward your nose. You may have problems focusing on work that is close to your eyes. You may need to change your glasses prescriptions often. Poor night vision or blind spots in your vision are other late signs. At night, you may see rainbows or halos (circles) around lights as your glaucoma gets worse.
What are other less common types of glaucoma?
- Angle-closure glaucoma: This is a quick forming type of glaucoma that may also be called "acute glaucoma". There is a sudden total blockage of fluid behind the iris (colored part of the eye). Pressure inside the eye increases quickly because of the fluid backup. You may have blurred vision and a bad headache. You may have red eyes, severe throbbing eye pain, or see colored rings around lights. You may feel sick to your stomach or may vomit (throw up). Acute angle-closure glaucoma is a medical emergency. It must be quickly treated to prevent blindness.
- Secondary glaucoma: This may be caused by an injury, infection, or certain medicines, such as eye drops containing steroids. It may be caused by a tumor, bleeding or blood clots inside the eye, or diabetes. These problems can cause pressure inside the eye to increase.
- Congenital (kun-JEN-ih-tull) glaucoma: Congenital glaucoma happens to a baby while he is growing inside his mother's uterus (womb). With this type of glaucoma, the passages inside the eye are not normal. A baby with this kind of glaucoma may have eyes that water a lot. Bright lights may bother the baby's eyes. This is not a common type of glaucoma.
How is glaucoma diagnosed? You will need a complete eye examination by an eye doctor. One or more of the following may be done to learn about your glaucoma:
- Tonometry (tuh-NOM-uh-tree): This test measures your eye pressure. Your eye pressure is also called "intraocular (in-truh-OC-u-ler) pressure" or "IOP". While you look ahead, air will be puffed or a special light will shine in your eyes to measure your eye pressure. For other types of tonometry tests, you may need eye drops that will numb your eyes for a short time. An instrument may be put on your eye to measure the eye pressure.
- Ophthalmoscope (op-THAL-muh-skop): This is a special instrument used to look at your optic nerve. Your doctor will dim or turn off the lights in the room. While you look ahead, your doctor will shine a light into your eyes to see if you have any optic nerve damage. Your doctor may use special eye drops to dilate (DIE-late) your eyes. Dilating your eyes causes the pupil (black dot in the middle of the eye) to become very wide. This helps your doctor have a better view of the inside of your eye.
- Other tests: Your doctor may do a test to look directly at your eye drain system. Your doctor may do a test and make a "map" of your side vision in both eyes. This will help your doctor learn if there are areas where you have lost your sight. Side vision is the first part of your vision that can be lost if you have glaucoma.
How is glaucoma treated? Glaucoma can be controlled and treated if it is found at an early stage. Finding and treating glaucoma early will decrease the chances of eye damage and loss of vision. If caregivers find and treat glaucoma before damage has occurred, blindness can be prevented. If your entire optic nerve is already damaged, you may become blind. The following may be used to control your glaucoma:
- Medicine: Medicine may be given to you in eye drops or by pill. Medicines help to decrease your eye pressure in two ways. Some medicines decrease the amount of fluid your eye makes. Other medicines help your eye to drain fluid better. For the medicine to work, you must take it every day and exactly as directed by your doctor.
- Laser Surgery: This surgery is usually done if medicines cannot control your glaucoma. During this surgery, your doctor will use a laser (light beam) to open your eye drain system if it is clogged. It may also be used to create a new opening for eye fluid drainage.
- Filtering Surgery: This surgery is usually done if medicines and laser surgery cannot control your glaucoma. Your doctor will use tiny surgical instruments to make a new drain system for your eye.
If I lose part of my vision from glaucoma, can it be fixed? No. Once you have lost a part of your vision from glaucoma, you cannot get it back. Treatment with medicine or surgery is the only way to stop or slow down the damaging effects of glaucoma.
Support: You may contact the following organizations for more information about glaucoma:
- Glaucoma Research Foundation
251 Post St, Ste 600
San Francisco, CA 94108
Phone: 1-415-986-3162
Web Address: http://www.glaucoma.org
- The Glaucoma Foundation
80 Maiden Lane, Ste 1206
New York City, NY 10038
Phone: 1-212-285-0080
Web Address: www.glaucomafoundation.org
- International Glaucoma Association
15 Highpoint Business Village
Henwood Ashford, Kent, TN24 8DH
Web Address: http://www.iga.org.uk
- Prevent Blindness America
211 W. Wacker Dr, Ste 1700
Chicago, IL 60606
Phone: 1-800-331-2020
Web Address: www.preventblindness.org
CARE AGREEMENT:
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
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