Glaucoma

Glaucoma is a chronic eye disease that damages the optic nerve, the “connection” that sends visual information from the eye to the brain. It is often related to an imbalance of the pressure inside the eye, called intraocular pressure (IOP). 

Imagine the eye as a small balloon filled with clear fluid. This fluid constantly flows in and out through small drainage channels. If the fluid cannot drain properly, pressure builds inside the balloon and gradually damages the optic nerve. 

However, some people develop glaucoma even when their eye pressure is within the normal range. Other contributors may include reduced blood flow, vascular issues or a structurally sensitive optic nerve. 

Types of Glaucoma

• Primary open-angle glaucoma: The most common form of glaucoma, it progresses slowly and painlessly.
• Angle-closure glaucoma: Caused by a sudden blockage of fluid drainage. it is painful and is an emergency.
• Normal-tension glaucoma: Optic nerve damage occurs even with normal eye pressure and is often linked to circulation or vascular factors.
• Secondary glaucoma: Develops after trauma, inflammation or prolonged corticosteroid use.
• Congenital glaucoma: Present at birth, it usually requires early surgical treatment.

Glaucoma Symptoms

In its early stages, glaucoma often causes no symptoms. Vision loss is gradual and may go unnoticed until significant damage occurs. Once the optic nerve fibers are lost, vision cannot be recovered.

Common symptoms include:

• Blurred or hazy vision
• Halos around lights
• Gradual loss of peripheral vision
• Eye pain, redness and headaches
• In severe cases, sudden vision loss with nausea or vomiting requires urgent medical attention

Diagnosing Glaucoma 

A comprehensive eye exam performed by an eye care professional is the best way to detect glaucoma early. Tests may include: 

• Measuring intraocular pressure (tonometry)
• Examining the optic nerve
• Visual field test
• Optical coherence tomography (OCT) to evaluate nerve fiber thickness
• Looking inside the eye to examine the eye drainage angle

Glaucoma Treatment to Preserve Vision

Treatment focuses on lowering eye pressure — the only factor that can be modified. The goal is to protect the optic nerve and preserve vision. Management is individualized according to the patient’s age, the type and stage of glaucoma, the level of pressure and the rate of disease progression.

Treatment options include:

• Eye drops to reduce fluid production or increase fluid drainage
• Oral medications for short-term pressure control
• Laser procedures to improve drainage
• Surgery when medications and lasers cannot control intraocular pressure

Glaucoma Surgery

Surgery may be used to create a new drainage pathway or place a small device that allows fluid to exit the eye more easily. Both lower intraocular pressures. The type of surgery depends on the individual case.

Traditional surgery creates a small opening that drains fluid and/or drainage implants.

Minimally invasive glaucoma surgeries (MIGS) use microscopic devices or stents to enhance natural fluid outflow. These are often performed during cataract surgery and have shorter recovery times.

Most surgeries are performed with local anesthesia and mild sedation — you’ll be awake but comfortable. Procedures typically take 30 to 60 minutes.

Mild discomfort or blurred vision is common for a few days after surgery. Some patients may require additional laser touch-ups to maintain long-term success.

Causes, Prevention and Risk Factors

While glaucoma cannot always be prevented, early detection is key to preserving vision. Risk factors for glaucoma include:

• Family history of glaucoma
• Over age 40
• African, Asian or Hispanic ancestry
• High myopia (near sightedness) or hyperopia (farsightedness)
• Diabetes
• High blood pressure
• Sleep apnea
• Long-term use of corticosteroids

Protect Your Eyesight

• Schedule regular eye exams with an eye care professional.
• Maintain good control of blood pressure and blood sugar.
• Avoid self-medicating with steroid drops.
• Eat a balanced diet rich in leafy greens, fruits and omega-3 fatty acids.
• Exercise regularly and protect your eyes from injury and UV light.

Glaucoma is a multifactorial disease — not just a matter of high eye pressure. With early diagnosis and individualized care, most people with glaucoma can maintain good vision and quality of life.