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The Hidden Mystery Behind What Is Glaucoma

The Hidden Mystery Behind What Is Glaucoma

Glaucoma is one of the most common eye conditions worldwide. Because glaucoma is so common, many people have heard about the condition or know someone with glaucoma. Unfortunately glaucoma can lead to severe and disabling vision loss.

Glaucoma causes progressive loss of your peripheral vision. In the late stages, glaucoma will also cause your central vision to become blurry as well. Most commonly glaucoma results when the pressure inside the eye is too high over a longer period of time. Because of that, many of the treatments for glaucoma work to lower the pressure of the eye.

But the good news is that when caught and treated early, glaucoma can be managed well with treatments to prevent any loss of vision.

The Causes Of Glaucoma

With most forms of glaucoma, patients have high pressure within the eye. This high eye pressure causes damage to the optic nerve within the eye over time causing vision loss.

The eye is filled with a liquid called aqueous humor. Production and drainage of this aqueous humor determines the pressure of the eye.

Flow of Aqueous Humor within the eye

Flow of Aqueous Humor within the eye; http://www.nei.nih.gov/photo/eyedis/index.asp, Public domain, via Wikimedia Commons

This aqueous is produced behind the iris in the ciliary body and flows through the pupil and out through the angle between the cornea and the iris.

  • If the angle closes off (angle-closure glaucoma), aqueous can't drain out of the eye and the pressure goes up. When this happens suddenly, the eye will become painful and red and the vision will become blurry. But the angle can also close off slowly over time causing a slower onset of glaucoma with minimal symptoms.
  • However, the angle can also be open but still slow or prevent aqueous from effectively draining out of the eye (open-angle glaucoma). This is the most common form of glaucoma and can be difficult to detect without screening or testing for it.

Because high eye pressure doesn’t cause any overt symptoms unless extremely high, it must be detected in screening. So getting your eyes examined by an eye doctor is the way to evaluate for glaucoma. Glaucoma is one of the reasons those horrible eye puff tests exists. Those eye puff tests look for high pressure in the eyes (note: I hate those tests too and there are other, less annoying tests to check pressure).

While checking the eye pressure can screen for a risk for glaucoma, high eye pressure doesn't actually indicate damage from glaucoma. For that, there are other tests that measure actual damage from glaucoma. A visual field test can measure and track your peripheral vision over time and scans of the optic nerve can evaluate for any evidence of thinning damage from glaucoma. These tests are not only used to diagnose the glaucoma but are also used to track your response to treatments over time to prevent any further vision loss.

Treating Glaucoma

High eye pressure is important when we talk about the ways to treat glaucoma. The treatments for glaucoma all have the same goal in mind, lower the pressure of the eye. Lowering the pressure of the eye can prevent additional damage from happening. And there are a variety of different treatments:

  • Often the initial treatment for glaucoma is using eye drop medication. Most of these medications work to reduce the production of aqueous humor to lower the pressure of the eye.
  • Alternatively (or in addition), a laser can be used in a painless treatment to help improve the aqueous drain out. This is called selective laser trabeculoplasty or SLT for short.
  • Beyond medication and lasers, there are surgical treatments for glaucoma to reduce the pressure of the eye. These surgical treatments can range from small devices implanted in the eye to improve the drainage to larger procedures to create alternative ways for the aqueous to drain out of the eye.

Summary

What's the biggest takeaway to learn about glaucoma? Have regular eye exams! When caught and when treated early, vision loss can be prevented!

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