Glaucoma is a common eye disease that normally affects older patients. The optic nerve becomes damaged and results in vision loss. Glaucoma can be classified into two different forms: open angle glaucoma and angle closure glaucoma. Open angle glaucoma is the more common form and is often undetected until the later stages of the disease. People who have open angle glaucoma do not realize that their vision is slowly weakening because there are no warning signs. Eventually, the disease will present itself and become severe. Angle closure glaucoma is less common than open angle glaucoma but the impact is felt almost immediately. Angle closure is often more painful and progresses much faster. That is why it is important to have regular eye exams with your doctor in order to detect these diseases.
The results of glaucoma are the same regardless of the form. The optic nerve becomes increasingly damaged as the glaucoma progresses. The optic nerve fibers are destroyed, causing the optic nerve to look like it has been scraped out. As the optic nerve becomes more and more damaged it is easy for the doctor to make a diagnosis of glaucoma. The loss of optic nerve tissue can result in the loss of vision. The peripheral vision is normally the first affected then central vision or total blindness may occur.
Causes of glaucoma:
Glaucoma is a well known disease but the origins that cause glaucoma are still being studied. Doctors and surgeons are still trying to determine the exact cause(s) of glaucoma. The prevailing belief among doctors is that glaucoma is caused by problems related to the drainage system of the eye, called the trabecular meshwork. In open angle glaucoma, the trabecular meshwork looks normal when examined by a doctor. Many believe the problem may lie internally and cannot be seen. The belief is that the abnormalities do not allow for the drainage system to properly drain the fluid from the eye. Failure of the trabecular meshwork causes fluid to remain in the eye and causes increasing eye pressure. In angle closure glaucoma, the trabecular meshwork drain can become blocked by the iris, abnormal blood vessels or scar tissue which can create an increase in eye pressure.
Increasing eye pressure in the eye may be one of the causes of the optic nerve becoming damaged. In fact, many people who suffer from open angle glaucoma have abnormally high eye pressures, suggesting there is a correlation between high eye pressure and glaucoma. However, some patients who have high eye pressure do not suffer from either form of glaucoma and vice versa some patients with normal eye pressure suffer from glaucoma. Doctors still believe that eye pressure plays a role in glaucoma and they take preventative measures to lower the eye pressure.
Symptoms of Glaucoma:
Open angle glaucoma often has no clear symptoms that are noticeable for a patient. As the glaucoma progresses and advances into the later stages, the loss of vision becomes apparent. Normally, a patient will lose their peripheral vision first and then their central vision. The central vision will begin to deteriorate over time and may leave a person with tunnel vision. Patients with glaucoma should have regular eye exams as the symptoms progress.
Most forms of angle closure glaucoma have recognizable symptoms. Patients may have periods of pain that range from mild to extreme in the eye and head. During each episode of pain the vision becomes blurry. This noticeable symptom is often the reason patients with angle closure glaucoma seek medical help sooner rather than later. Angle closure glaucoma patients can have mild symptoms as well that go undetected.
When being screened for glaucoma, your eye doctor will perform a series of eye tests. A thorough evaluation will be performed in order to make sure that everything is checked. It is important that a number of tests are performed because an early diagnosis can help to prevent the glaucoma from becoming worse over time. Your eye doctor will perform the following tests:
- Visual acuity test
- Measurement of corneas
- Pupil examination
- Peripheral vision
- Slit lamp examination
- Trabecular drainage system examination
- Dilated eye exam
- Optic nerve examination
Over time the glaucoma develops into the moderate or advance stages of the disease. fibers in the optic nerve as destroyed. The destroyed fibers cause the optic nerve to become hollow. Your doctor may be able to see the loss of small sections of retinal nerves or small areas of bleeding on the optic nerve. In angle closure is present, your doctor may see iris or scar tissue physically blocking the trabecular drainage system.
Glaucoma treatment normally involves eye drops that are used to lower eye pressure. These medications will help to decrease the amount of fluid produced in the eye. The less fluid in the eye the lower the eye pressure. Other forms of eye drops work by allowing eye fluids to drain from the eye. These medicated eye drops can slow or halt the formation of glaucoma.
Eye drops are not always enough to slow the onset of glaucoma. In cases where eye drops are not working to slow or halt the disease, your doctor may recommend surgery. Depending on the form and the severity of the disease, your doctor will determine which surgery will be right for you.
Vision cannot be restored once it has been lost due to glaucoma. The best prevention for glaucoma is to have regularly schedule eye exams to ensure your eye health. By having regularly scheduled eye exams your doctor can help to catch the disease before it progresses. If you have a family history of eye disease then it is more important for you to seek regular eye exams because you may be at greater risks. If you have questions about glaucoma or would like to schedule an eye exam please contact us.