An estimated 3 million Americans have glaucoma – the leading cause of blindness – but half of them don’t know it. By the time glaucoma symptoms appear, it’s often too late to reverse the damage. “Glaucoma is characterized by the loss of nerve fibers in the optic area and is usually, but not always, associated with high pressure in the eye,” says Jackson Giles, M.D., a former ophthalmologist at Piedmont.
The most common types of glaucoma are chronic open-angle glaucoma (which affects 90% of glaucoma patients and is caused over time by a slow clogging in the eyes’ drainage canals) and acute angle-closure glaucoma (which occurs when the drainage canals are blocked). Trauma, diabetes, other systemic diseases, or the use of topical or oral steroids can cause less common forms of glaucoma.
Chronic, open-angle glaucoma
The cause of chronic open-angle glaucoma is unknown, although genetics may play a role. “With chronic, open-angle glaucoma, people in the early stages will have no symptoms, making regular eye exams crucial for detection,” Dr. Giles says. “It usually doesn’t show up until a person’s mid-50s or 60s.”
This form of glaucoma is particularly troubling because there are often no warning signs, like redness or pain. One eye is usually worse than the other, and vision loss occurs slowly. “With chronic, open-angle glaucoma, pressure in the eye rises very slowly,” he explains. “A patient may have no symptoms at all until they notice decreased vision. By then they’ll already have significant damage to the eye.” While this type of glaucoma cannot be cured, there are three categories of treatment:
- Topical drops in eye several times a day.
- An in-office laser procedure that lowers eye pressure to avoid or complement medications.
- If laser or drops are not effective, there are a number of surgical procedures that can be done.
“Surgery is usually a last resort because it can come with more side effects,” he explains.
Angle-closure glaucoma
“Acute angle-closure glaucoma involves a sudden onset of throbbing pain, redness, headache, blurred vision, halos around lights, dilated pupils, vomiting and nausea,” Dr. Giles says. “It can cause blindness if not treated within six to 12 hours.”
In this form, it is common for only one eye to be affected. People who are very far-sighted are at a higher risk for angle-closure glaucoma. Angle-closure glaucoma is considered a medical emergency. If you experience any of the above symptoms, call your doctor or go to the emergency room immediately to reduce your chances of blindness. The most common treatment for this form of glaucoma is a laser iridotomy, where a hole is created in the iris with a laser beam to relieve pressure in the eye.
Eye health and disease prevention
Protecting your eyes, in the first place, is one of the best ways to prevent serious eye disease. Key components of eye health include:
- Regular eye exams. Adults should have an eye exam every 2 years and yearly after age 60. If eye disease runs in your family, ask your doctor if you should schedule an exam more often.
- Proper nutrition.
- Not smoking.
- Proper eyewear: wear sunglasses when you are outside and use safety eyewear when playing sports or working with hazardous or airborne materials.
- Resting your eyes frequently when using a computer.
“In a routine eye exam, there are two things we can do: measure pressure in the eye and evaluate the optic nerve,” he says. “If either test is suggestive of problems, there are further tests we can do.” The vast majority of people whose glaucoma is detected early will maintain good vision and lead a normal lifestyle, he says.
“There are a small percentage of cases that are extremely difficult to control and those patients may have problems throughout their life,” Dr. Giles says. “But it’s really not a handicap. The key is catching it early.” If you experience vision changes, it’s time to see a physician.
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