Explore Ophthalmology & EyeGlaucoma
What Is Glaucoma?
Glaucoma is a progressive eye disease that can damage the optic nerve and lead to permanent blindness. There are often no symptoms in its early stages, so regular eye exams are crucial for early detection. Risk factors include age, family history, and certain medical conditions.
Causes
The fluid inside your eye, called aqueous humor, usually flows out of your eye through a mesh-like channel. Aqueous builds up if this channel gets blocked or the eye produces too much fluid. Sometimes, experts don’t know what causes this blockage, but it can be inherited, meaning it’s passed from parents to children. Less common causes of glaucoma include a blunt or chemical injury to the eye, severe eye infection, blocked blood vessels inside the eye, and inflammatory conditions. It’s rare, but eye surgery to correct another condition can sometimes cause it. Glaucoma usually affects both eyes, but it may be worse in one than the other. There are two main types of glaucoma:
- Open-angle glaucoma (or wide-angle glaucoma) occurs when the drainage structure in your eye looks fine, but fluid doesn’t flow the way it should.
- Angle-closure glaucoma (or acute-angle glaucoma) occurs when your eye doesn’t drain properly because the drainage space between your iris and cornea becomes too narrow, leading to a sudden buildup of pressure in your eye. It’s also linked to farsightedness and cataracts – a clouding of the lens inside your eye.
Less common types of glaucoma include:
- Secondary glaucoma occurs when another condition, such as cataracts or diabetes, causes added pressure in your eye.
- Normal-tension glaucoma occurs when you have blind spots in your vision or your optic nerve is damaged, but your eye pressure is within the average range
- Pigmentary glaucoma occurs when pigment from your iris gets into the fluid inside your eye and clogs the drainage canals.
Risk Factors
There are several key risk factors for glaucoma, including:
- Elevated eye pressure (this is not the same as elevated blood pressure)
- Large optic nerve or thinning of the optic nerve
- Closed drainage angle of the eye
- Family history (especially siblings)
- Race
The best way to reduce or prevent eye damage is simple: Get your eyes checked every year! Don’t wait for symptoms to show up. Once glaucoma starts, it can be treated, but the damage it causes cannot be reversed.
Treatment
If you have glaucoma, you’ll want to learn more about managing it as soon as possible. Treatment options may include medications, laser therapy, or surgery to lower eye pressure and prevent vision loss.
Glaucoma Medications
- Eyedrops can either lower the creation of fluid in your eye or increase its flow out of the eye, lowering eye pressure. Side effects include allergies, redness, stinging, blurred vision, and irritated eyes.
- Oral medications such as carbonic anhydrase inhibitor might also be prescribed. These drugs can slow the creation of fluid in your eye. Because of potential drug interactions, be sure to tell your doctor about any other medical problems you have or other medications you take. Also, let them know if it’s hard to follow a plan involving two or three eyedrops or if they have side effects. They may be able to change your treatment.
Procedures & Surgery
- Laser procedure. If you have open-angle glaucoma, a laser can open the meshwork and allow more fluid to flow into the drainage canal. This is an effective way to lower pressure and potentially avoid drops. If you have angle-closure glaucoma, lasers can prevent potential painful and often vision-threatening symptoms. Both types of lasers are performed in the office.
- Minimally invasive glaucoma surgeries. These are a newer, less invasive type of surgery that usually involve tiny openings and use devices that can’t be seen with the naked eye. They're generally faster and safer, well-tolerated and effective for pressure lowering. Your doctor can discuss the different procedures so you can make an informed decision. These procedures can also be done at the same time as others, such as cataract surgery
- Microsurgery. In a trabeculectomy procedure, your doctor creates a new channel to drain the fluid and ease eye pressure. This form of surgery may need to be done more than once. Your doctor might implant a tube to help drain fluid. Your doctor can discuss the potential benefits and risks of these surgeries, which are usually reserved for severe disease not treated by other methods.