Glaucoma
Glaucoma Causes Blindness
Glaucoma is a leading cause of blindness in the United States, especially for older people. But the loss of sight from glaucoma is usually preventable if you get treatment early enough. Glaucoma is a disease of the optic nerve. The optic nerve carries the images we see to the brain. Many people know that glaucoma has something to do with the pressure inside the eye.
The higher the pressure inside the eye, the greater the chance of damage to the optic nerve. The optic nerve is like an electric cable containing a huge number of wires. Glaucoma can damage nerve fibers, causing blind spots to develop. Often, people don’t notice these blind areas until much optic nerve damage has already occurred. If the entire nerve is destroyed, blindness results. Early detection and treatment by your ophthalmologist are the keys to preventing optic nerve damage and blindness from glaucoma.
Open-Angle Glaucoma
Open-angle glaucoma typically occurs with few early warning signs and no painful symptoms. As compared to closed-angle glaucoma, this type occurs slowly over time and often does not cause noticeable sight loss for years. Open-angle glaucoma is the most common type of the disease.
Closed-Angle Glaucoma
Closed Angle Glaucoma is a sudden large increase in the intraocular pressure of the eye. It can be triggered by anything that dilates the eye, including dilating drops, dim lighting, and certain medications. Usually, it is sudden, but some forms can be prolonged.
Typically this is caused by one or more of the following reasons:
- Pupillary Block. Eye fluid known as the aqueous flows easily through the pupil into the front of the eye. If the back of the iris adheres to the lens inside the eye, this pupillary channel becomes blocked. Then fluid backs up behind the iris, pushing the iris forward until it closes the drainage angle in the anterior chamber.
- Iris Plateau. In this condition, the iris is attached to the ciliary body too close to where drainage occurs. When the pupil dilates, the iris tissue bunches up in the drainage angle, causing pressure to rise quickly. This type of narrow-angle glaucoma attack can occur in conditions when the pupil dilates in dim lighting or when eye drops are used to intentionally enlarge the pupil during an exam.
- Hyperopia. People who are farsighted are more likely to have eyes with shallow anterior chambers and narrow angles, increasing their risk for angle-closure glaucoma from pupil dilation or aging changes in the eye.
- Tumors and Other Causes. A tumor behind the iris and alteration of the shape of the eye after surgery for a detached retina can cause angle-closure glaucoma.
Glaucoma Symptoms
Patients with closed-angle glaucoma typically complain of a very sudden, sharp pain with light sensitivity, a very painful headache accompanied by nausea as well as very blurry vision. Upon examination, the eye is very red and inflamed, the intraocular pressure is very high and the cornea looks cloudy.
Patients who have open-angle glaucoma typically experience very few symptoms before irreversible vision loss has occurred. Open-angle glaucoma can cause tunnel vision in its advanced stages, and in early stages can cause blind spots in peripheral vision.
How is Glaucoma Detected?
Regular eye examinations by your ophthalmologist are the best way to detect glaucoma. An ophthalmologist can detect and treat glaucoma. During a complete and painless examination, your ophthalmologist will:
- Measure your intraocular pressure (tonometry)
- Inspect the drainage angle of your eye (gonioscopy)
- Evaluate any optic nerve damage (ophthalmoscopy)
- Test the visual field of each eye (perimetry)
- Take specialized images of the optic nerve fiber layer (tomography)
- Measure the rate of aqueous outflow from the eye (tonography)
- Measure the corneal thickness (pachymetry)
Some of the tests may not be necessary for every person. You may need to repeat these tests on a regular basis to determine if glaucoma damage is increasing over time. To schedule your consultation, contact our greater Boston location today! You can reach us at 1-877-373-2020.
Glaucoma Treatment
Damage caused by glaucoma cannot be reversed. Eye drops, pills, and laser or surgical operations are used to prevent or slow further damage from occurring. With any type of glaucoma, periodic examinations are very important to prevent vision loss.
Because glaucoma can worsen without your being aware of it, your treatment may need to be changed over time.
Medicine
Glaucoma is usually controlled with eye drops taken several times a day. These medications decrease eye pressure, either by slowing the production of aqueous fluid within the eye or by improving the flow leaving the drainage angle. For these medications to work, you must take them regularly and continuously. It is also important to tell all of your doctors about the eye medications you are using. Glaucoma medications can have side effects. You should notify your ophthalmologist immediately if you think you may be experiencing side effects.
Some eye drops may cause:
- A stinging sensation
- Red eye
- Blurred vision
- Headaches
- Changes in pulse, heartbeat or breathing
Laser Surgery
Laser Surgery treatments may be effective for different types of glaucoma. The laser is usually used in one of two ways. In open-angle glaucoma, the drainage angle itself is treated. The laser is used to enlarge the drain (trabeculoplasty) to help control eye pressure. In angle-closure glaucoma, the laser creates a hole in the iris (iridotomy) to improve the flow of aqueous fluid to the drainage angle.
Operative Surgery
When operative surgery is needed to control glaucoma, your ophthalmologist uses miniature instruments to create a new drainage channel for the aqueous fluid to leave the eye. The new channel helps to lower the pressure. Though serious complications of modern glaucoma surgery are rare, they can occur, as with any surgery. Surgery is recommended only if your ophthalmologist feels that it is safer to operate than to allow optic nerve damage to continue. To see if you may be a candidate for glaucoma surgery, contact our greater Boston location!
The Nielsen Eye Center offers comprehensive glaucoma screenings and treatment in the Greater Boston region. Contact our offices today for your vision screening, or to learn more about your options for glaucoma treatment. We are proud to serve the Greater Boston community and have convenient offices located in Quincy, Weymouth, Norwood, and Norwell Massachusetts. You can reach us at 877-373-2020 and book an appointment at the most convenient location for you.
