GLAUCOMA

The Basics of Glaucoma

Glaucoma is a condition that affects 1 in 75 Americans. Glaucoma is usually associated with high pressure in the eyeball (unrelated to blood pressure) that causes damage to the optic nerve. The optic nerve is the "cable line" that connects the eyeball to the brain. If left untreated, glaucoma will eventually lead to blindness. At Fox Eye, Dr. Richard Stangler, a board-certified ophthalmologist with extensive experience in glaucoma, sees patients with glaucoma.

What are the symptoms of Glaucoma?

Unfortunately, this condition often goes undetected by the patient because the symptoms are gradual. Most patients experience a painless gradual loss of side vision over many years before losing central vision. Occasionally there may be symptoms of red eye, eye pain, halos around lights, nausea, and vomiting; this type of glaucoma is less common and is called angle closure glaucoma.

What causes glaucoma?

The likely cause of glaucoma is an overproduction of fluid inside the eye or a difficulty in draining the eye fluid. This excess eye fluid builds and results in an increase in eye pressure. Sometimes glaucoma can develop from medications such as steroids or a previous eye surgery or injury.

How is glaucoma diagnosed?

Glaucoma is diagnosed by a combination of 3 factors:

• (1) Measuring eye pressure
  
• (2) Side vision testing by a computer showing loss of side vision
  
• (3) Examining the optic nerve for evidence of damage called "cupping".

This is done with a physical exam as well as a scanning laser test.

Glaucoma tends to be hereditary; therefore, all family members of a patient with glaucoma should be evaluated routinely. African-Americans and highly nearsighted individuals are at an increased risk for developing glaucoma.

How is glaucoma treated?

An eye drop or in-office laser treatment is initially used to lower the pressure in the eye. There are several kinds of drops available. If pressure needs to be lowered further because of continued damage to side vision and the optic nerve, then a surgical procedure called a trabeculectomy can be considered.

How is glaucoma managed?

Your doctor follows glaucoma on a regular basis by checking the eye pressure, repeating the side vision test and re-examining the optic nerve for further damage. To help evaluate the optic nerve, photographs of the optic nerve are obtained on a regular basis. This allows a fine detailed comparison to be made in order to determine if further damage is occurring.

Does high pressure mean you have glaucoma?

Not necessarily. Unless there is evidence of side vision loss by testing or evidence of optic nerve damage by examination, the diagnosis of glaucoma is not made. The diagnosis would be "ocular hypertension" which means high eyeball pressure without damage to the optic nerve.

Can you have normal pressures and still have glaucoma?

Yes. This is a less common type of glaucoma. This type of glaucoma is termed "low tension glaucoma" or normal pressure glaucoma. It is diagnosed by loss of side vision and damage to the optic nerve.