What is glaucoma?
 Glaucoma is the second leading cause of blindness worldwide, and is a disease of the optic nerve. Like a balloon, your eye needs a reasonable amount of pressure to maintain its shape, but too much pressure can damage the optic nerve and cause a loss of peripheral vision.
Glaucoma is typically not painful, and does not cause symptomatic loss of vision until it reaches an advanced state. Glaucoma is readily treatable, but screening and early diagnosis are very important.
My father had glaucoma. Does that put me at risk?
If you have a first degree relative (mother, father, brother, sister, child) with glaucoma, you are at increased risk and should have a screening exam. Because glaucoma does not cause symptoms until late in the disease process, it has been estimated that only about half of patients with glaucoma in this country have been diagnosed. Other risk factors include history of steroid use (even asthma and sinus medications), eye injury, African American ancestry, diabetes, and nearsightedness. Because glaucoma can strike at any age, regular eye exams are recommended.
How is glaucoma detected?
If your doctor feels that you have early signs of glaucoma, further screening tests may be required. Visual field testing is typically performed to look for subtle changes in your peripheral vision. This test typically takes approximately five minutes per eye, and can be a very useful tool for detecting glaucoma.
Because visual field testing can fail to detect very early damage, our doctors also use the Zeiss Optical Coherence Tomographer (OCT), which performs a scan of the optic nerve to evaluate the layer of tissue in the eye that is affected by glaucoma. Often, this test can detect structural changes to the optic nerve before they have a chance to affect the field of vision, allowing for earlier glaucoma detection and treatment.
What is angle closure glaucoma?
The “angle” in this case refers to the drain of the eye, which in some patients can close off and cause a rapid and severe rise in eye pressure. Although this can be treated, the effects of an attack of angle closure glaucoma can be lasting. Farsighted patients or patients with cataracts are at greatest risk for this type of glaucoma. Laser peripheral iridotomy is recommended for at-risk patients to prevent attacks of this type of glaucoma before they occur.
I have been diagnosed with glaucoma. Are there any changes to my lifestyle that I should make?
The only proven treatment for glaucoma consists of reducing pressure in the eye with drops, laser treatments, or surgery. Although not proven to have an impact on glaucoma, adopting a healthy diet and exercise regimen along with smoking cessation will improve your overall health and may have an impact on your long-term treatment.
How is glaucoma treated?
Treatment for glaucoma is directed at reducing the eye pressure, which slows or stops the damage caused by glaucoma. There are three main ways by which eye pressure can be reduced:
- Eyedrops
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For the majority of patients, one or more eyedrops are effective at reducing the eye pressure. While the eyedrops typically have few or minimal side effects, some can be problematic in the setting of certain medical conditions or when used with other medications. It is important to use your eyedrops as prescribed.
- Laser
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When eyedrops prove ineffective or are difficult to take because of side effects or cost, laser treatment may be an excellent option. Laser trabeculoplasty consists of a three minute treatment that is performed in the clinic. From the patient’s perspective, it is very similar to having an examination and requires no restrictions afterward. During the treatment, a laser is used to shrink some of the tissues of the drain of the eye, opening microscopic channels for the fluid in the eye to leave.
- Surgery
- For a minority of patients, surgery to create a new drain for the eye may become necessary.
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