What is glaucoma?

Glaucoma is a disease that causes a gradual degeneration of cells that make up the optic nerve which carries visual information from the eye to the brain. As the nerve cells die, vision is slowly lost, usually beginning in the periphery. Often, the loss of vision is unnoticeable until a significant amount of nerve damage has occurred. Therefore, it is believed that as many as half of all people with glaucoma may be unaware of their disease.

What causes glaucoma?

At the front of the eye, there is a small space called the anterior chamber. Clear fluid flows in and out of the chamber to bathe and nourish nearby tissues. In glaucoma the fluid drains too slowly out of the eye. As the fluid builds up, the pressure inside the eye rises. Unless this pressure is controlled, it may cause damage to the optic nerve and loss of vision.

Who is most likely to get glaucoma?

Nearly 3 million people have glaucoma, a leading cause of blindness in the U.S. Although anyone can get glaucoma, some people are at higher risk, for example, African Americans over age 40, anyone over age 60, or people with a family history of glaucoma.

What are the symptoms?

At first, there are no symptoms. Vision stays normal, and there is no pain. However, as the disease progresses, a person with glaucoma may notice his or her side vision gradually failing. That is, objects in front may still be seen clearly, but objects to the side may be missed. As the disease progresses, the field of vision narrows and blindness results.

How is it diagnosed?

We use advanced retinal imaging (OCT) that allows the doctor to see beneath the surface to the nerve fiber layer where the damage can be seen. Visual field loss, optic nerve swelling, increased eye pressure, and a family history of glaucoma are also signs of glaucoma.

How can glaucoma be treated?

Although open-angle glaucoma cannot be cured, it can usually be controlled. The most common treatments include:

  • Medications – These may be either in the form of eye drops or pills. Some drugs are designed to reduce pressure by slowing the flow of fluid into the eye. Others help to improve fluid drainage. For most people with glaucoma, regular use of medications will control the increased fluid pressure. But, these drugs may stop working.
  • Laser Surgery – During laser surgery, a strong beam of light is focused on the part of the anterior chamber where the fluid leaves the eye. Small changes result, making it easier for fluid to exit the eye. Over time, the effect of laser surgery may wear off. Patients who have this form of surgery may need to keep taking glaucoma drops.
  • Surgery – Surgery can also help fluid escape from the eye and thereby reduce the pressure. However, surgery is usually reserved for patients whose pressure cannot be controlled with eye drops, pills, or laser surgery.


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