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Glaucoma

What Is Glaucoma?

Overview

Glaucoma is a condition that damages the eye’s optic nerve, which connects the eye and the brain to allow you to see. Typically the problem is due to abnormally high pressure in the eye. Blind spots in vision occur as elevated pressure destroys the nerve fibers that make up the optic nerve.

Causes

Pressure in the eye rises to harmful levels when a fluid called aqueous humor, which helps keep the eye healthy, cannot drain — or drains too slowly — from the front of the eye.

Symptoms

Open-angle glaucoma, which affects 90 percent of glaucoma sufferers, is sometimes called “the silent thief of sight” as it causes no symptoms in its early stages. As the disease progresses, patients can notice:

  • Loss of peripheral vision — a slow disappearance of side vision that typically occurs so gradually as to be difficult to notice and can produce a tunnel-like field of central vision
  • Impaired color and contrast vision – which can be difficult to recognize with a slowly progressing problem

Acute angle-closure glaucoma, is not a common type but is feared because it causes symptoms that may include:

  • Head and eye pain accompanied by vomiting
  • Blurry vision — Objects both near and far may appear fuzzy or poorly defined.
  • Auras — Rainbow-colored halos may appear around lights.
  • Rapid loss of vision

Treatment Options

  • Medications — Ophthalmologists can use four classes of prescription drugs to reduce eye pressure, which is the goal of glaucoma treatment. Medication can prevent further loss of vision, and patients continue to take it as long as it remains effective.
  • Laser surgery (trabeculoplasty) — If medication is not an option or isn’t working, laser surgery may be appropriate. During this 5–10 minute, outpatient procedure, an ophthalmologist uses a laser to apply energy to the trabecular meshwork which is the structure in the eye that allows fluid to drain. That allows the fluid to leave more efficiently and eye pressure decreases. The treatment can preserve remaining vision but like all glaucoma treatments does not improve sight or restore what has been lost. Patients may be able to resume normal activities the next day.
  • Incisional surgery — Like medications and laser surgery, this outpatient procedure is designed to stem further vision loss. There are many forms of incisional surgery from enhancing the natural drain function to implanting small drains to making a trapdoor incision in the eye.  All are designed to create a new pathway for fluid to drain from the eye. After surgery, patients should temporarily avoid bending, driving, reading and heavy lifting, as directed by their ophthalmologist.

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