National Glaucoma Awareness Month

January 3, 2019

January = Time to Learn About Glaucoma
Don’t worry, you can keep eating all the avocados you want!

Holy glaucomole, it’s a new year already! In honor of National Glaucoma Awareness Month, it is only fitting that we discuss the topic. Many people have heard of the term, but few actually understand what glaucoma truly is or is not. In this blog post, we will review everything you need to know about the sneaky vision thief.

What is glaucoma?

Glaucoma is a chronic, progressive condition that causes damage to the optic nerve. The optic nerve is a “cable” of approximately 1 million individual nerve fibers that connects the eye to the brain. When damage occurs to the optic nerve, even a perfectly healthy eye is incapable of transmitting necessary information back to the brain for processing into vision. The nerve fibers responsible for peripheral vision are typically the first to become damaged, which correlates to a permanent loss of peripheral vision. Blindness is possible in advanced or severe forms of glaucoma.

Damage to the optic nerve most commonly occurs from increased pressure within the eye. However, it is possible to develop glaucoma with normal eye pressure or have high eye pressure without glaucoma. Each individual’s optic nerve can withstand a certain amount of pressure before glaucoma occurs, so the timing of diagnosis can be different for each person.

What causes glaucoma?

There are two main types of glaucoma: open-angle glaucoma and closed-angle glaucoma. Each type has a different cause.

Open-angle glaucoma is the most common form of glaucoma, which occurs when the drainage system of the eye inadequately removes fluid from within the eye. Ocular pressure builds up from the increased fluid. This extra pressure on the optic nerve then causes damage to the individual nerve fibers. There are few to no symptoms associated with open-angle glaucoma. If left untreated for long enough, the first symptom is loss of peripheral vision; However, this is generally difficult for people to notice.

Closed-angle glaucoma occurs when the drainage angle (space between the cornea and iris) is too narrow and blocks fluid from exiting the eye. Pressure increases within the eye, and the optic nerve is damaged. This form of glaucoma is usually more acute at its onset and could be associated with symptoms, such as:
          – Extreme eye pain
          – Nausea and/or vomiting due to severe eye pain
          – Hazy or blurry vision

Who is more likely to have glaucoma?

Although anyone can have glaucoma, there are several risk factors that increase a person’s chance of developing glaucoma.
          – Family history of glaucoma
          – Age: those over 60 years old are more likely to develop glaucoma
          – Race: African Americans have a significantly higher risk of glaucoma than other races
          – Thinning optic nerve
          – Poor circulation: this could be due to diabetes, migraines, or sleep apnea
          – History of eye injury or trauma
          – Thin corneas

How is glaucoma diagnosed?

Glaucoma is diagnosed during comprehensive eye examinations with supplemental testing. The scary thing about glaucoma is that there are little to no symptoms, which makes it nearly impossible to diagnose without a comprehensive eye exam. Eye pressure and optic nerve appearance are two important factors in detecting glaucoma. If the eye pressure or optic nerve appearance are abnormal, further testing is performed to detect any damage to the optic nerve. Diagnosis is further supported when there is evidence of progressive changes over multiple years.

What is the treatment for glaucoma?

The most common (and easiest) treatment for glaucoma is a prescription eye drop that is usually used every night before bedtime. The only modifiable risk factor for glaucoma is to decrease the eye pressure, which makes the prescription drop very important in controlling glaucoma. If the drop does not work, there are other drops that can be added throughout the day. There are also surgical procedures that can be completed for more severe cases or those not responding well to the drops.

There is no cure to glaucoma, which means lifelong treatment is necessary to minimize progressive damage and vision loss. Once diagnosed with glaucoma, eye pressure is frequently checked several times throughout the year to ensure the drops are working properly. Additional testing may also be repeated every 6 months to one year.

 

Since the most common form of glaucoma is a symptomless, slowly-progressing disease, it is best to have a comprehensive eye exam every year. This allows us to identify any changes related to glaucoma that could be occurring behind the scenes.

 

Resources
1. https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/glaucoma

2. https://www.aao.org/eye-health/diseases/what-is-glaucoma