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Glaucoma

Glaucoma refers to a category of eye disorders often associated with a dangerous build up of internal eye pressure (intraocular pressure or IOP), which can damage the eye's optic nerve that transmits visual information to the brain.

With untreated or uncontrolled glaucoma, you might eventually notice decreased ability to see at the edges of your vision (peripheral vision). Progressive eye damage could then lead to blindness.

In fact, glaucoma creates at least some vision loss in more than half of the people estimated to have the eye disease and is the second leading cause of blindness.

Glaucoma Symptoms

Glaucoma often is called the "silent thief of sight," because most types typically cause no pain and produce no symptoms until noticeable vision loss occurs.

For this reason, glaucoma often progresses undetected until the optic nerve already has been irreversibly damaged, with varying degrees of permanent vision loss.

But with acute angle-closure glaucoma, symptoms that occur suddenly can include blurry vision, halos around lights, intense eye pain, nausea and vomiting. If you have these symptoms, make sure you see an eye care practitioner or visit the emergency room immediately so steps can be taken to prevent permanent vision loss.

Diagnosis, Screening and Tests for Glaucoma

During routine eye examinations, a tonometer is used to measure your intraocular pressure, or IOP. Your eye typically is numbed with eye drops, and a small probe gently rests against your eye's surface. Other tonometers send a puff of air onto your eye's surface. An abnormally high IOP reading indicates a problem with the amount of fluid in the eye. Either the eye is producing too much fluid, or it's not draining properly.

Normally, IOP should be below 21 mmHg (millimeters of mercury) - a unit of measurement based on how much force is exerted within a certain defined area.

If your IOP is higher than 30 mmHg, your risk of glaucoma damage is 40 times greater than someone with an IOP of 15 mmHG or lower. This is why glaucoma treatments such as eye drops are designed to keep IOP low.

Visual field testing is a way for your eye care practitioner to determine if you are experiencing vision loss from glaucoma. Visual field testing involves staring straight ahead into a machine and clicking a button when you notice a blinking light in your peripheral vision. The visual field test may be repeated at regular intervals to make sure you are not developing blind spots from damage to the optic nerve or to determine the extent or progression of vision loss from glaucoma .

Types of Glaucoma

The two major types of glaucoma are chronic or primary open-angle glaucoma (POAG) and acute angle-closure glaucoma. The "angle" in both cases refers to the drainage angle inside the eye that controls aqueous outflow. Other variations include normal-tension glaucoma, pigmentary glaucoma, secondary glaucoma and congenital glaucoma.

Primary open-angle glaucoma (POAG)

This common type of glaucoma gradually reduces your peripheral vision without other symptoms. By the time you notice it, permanent damage already has occurred.

If your IOP remains high, the destruction caused by POAG can progress until tunnel vision develops, and you will be able to see only objects that are straight ahead.

Angle-closure glaucoma

Angle-closure or narrow-angle glaucoma produces sudden symptoms such as eye pain, headaches, and halos around lights, dilated pupils, vision loss, red eyes, nausea and vomiting.

These signs may last for a few hours, and then return again for another round. Each attack takes with it part of your field of vision.

Normal-tension glaucoma

Like POAG, normal-tension glaucoma (also termed normal-pressure glaucoma, low-tension glaucoma or low-pressure glaucoma) is an open-angle type of glaucoma that can cause visual field loss due to optic nerve damage. But in normal-tension glaucoma, the eye's IOP remains in the normal range. Also, pain is unlikely and permanent damage to the eye's optic nerve may not be noticed until symptoms such as tunnel vision occur.

Glaucoma Treatments

Treatment can involve glaucoma surgery, lasers or medication, depending on the severity. Eye drops with medication aimed at lowering IOP usually are tried first to control glaucoma.

Because glaucoma often is painless, people may become careless about strict use of eye drops that can control eye pressure and help prevent permanent eye damage.

In fact, non-compliance with a program of prescribed glaucoma medication is a major reason for blindness caused by glaucoma.

If you find that the eye drops you are using for glaucoma are uncomfortable or inconvenient, never discontinue them without first consulting your eye doctor about a possible alternative therapy.

For more information we can direct you to the NHS information website or the International Glaucoma Website.

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