Glaucoma is a progressive optic nerve disease normally associated with elevated pressure inside the eye. The resulting damage to the optic nerve makes glaucoma one of the leading causes of blindness in America.
Primary open-angle glaucoma is the most common form of glaucoma. This type develops slowly and is caused when the drainage area clogs, not allowing fluid to properly drain out of the eye. The excess fluid increases the intraocular pressure, which can cause damage to the optic nerve.
Angle-closure glaucoma develops very quickly and is caused when part of the iris blocks the opening of the drainage canals, which allow the fluid to drain from the eye. The fluid builds-up rapidly, as does the rise in intraocular pressure. This is considered a medical emergency and patients require immediate treatment. Without treatment, angle-closure glaucoma can cause blindness within one or two days.
Symptoms and Signs – The following symptoms and signs of angle-closure glaucoma come on suddenly and may disappear only to come back again.
Normal tension glaucoma is similar to primary open-angle glaucoma, but is not as common. The difference is, with normal tension glaucoma, the damage to the optic nerve occurs when the eye has nearly normal fluid pressure.
When glaucoma is found in infants or children, it is called congenital glaucoma. It is a defect of the eye drainage system and occurs when the fluid drains from the eye at a slower rate than normal. This causes an increase in intraocular pressure, which results in optic nerve damage. This form of glaucoma is often hereditary.
Symptoms and Signs – Some children with congenital glaucoma may exhibit no symptoms, others have signs that may be difficult to recognize as eye-related, and some children have obvious symptoms of glaucoma. It may be difficult for children to express a symptom like vision loss, due to age, the inability to verbalize, or incapacity to understand what is happening to them. Symptoms and signs may include the following:
Secondary glaucoma is diagnosed when increased intraocular pressure, along with the resulting optic nerve damage, is caused by another condition or factor. The risks and contributing factors may include: eye injury, steroids, and other diseases. There are several types of secondary glaucoma.
Symptoms and Signs – Like the causes of glaucoma, the symptoms and signs can vary. Some patients do not notice any symptoms, while others experience severe eye pain. As with all other forms of glaucoma, untreated secondary glaucoma can lead to complete loss of vision. Some of the symptoms and signs may include:
Everyone is at risk for developing glaucoma; however, some people have a higher risk than others. The following are possible risks and contributing factors:
Early diagnosis and treatment are essential to detect glaucoma and prevent vision loss. Dr. Smith can detect and diagnosis glaucoma while performing a comprehensive eye exam. He evaluates the pressure inside the eye using tonometry, peripheral vision with a visual field test, and optic nerve damage with dilation. When signs of glaucoma are found during the comprehensive eye exam, further assessment is performed through optical coherence tomography and specialized photographs of the optic disc. Optical coherence tomography uses the reflection of laser light to create a three dimensional image of the optic nerve, providing Dr. Smith with a clear representation of the extent of the damage.
It is imperative to begin treatment immediately following the diagnosis of glaucoma. This helps prevent any further damage to the optic nerve, including resulting blindness. Depending upon the type and severity of glaucoma, Dr. Smith may prescribe drops to lower the intraocular pressure, laser treatment to increase the outflow of fluid from the eye, conventional surgery to remove blockage, or create new drainage canals for fluid to drain from the eye.
Continuing glaucoma treatment is the only way to prevent further irreversible damage, which ultimately leads to blindness. Patients may not have any symptoms or may experience discomfort with the current course of treatment; however, one should never discontinue treatment without consulting Dr. Smith. He is always available to discuss the alternative treatment options available to his patients.