Glaucoma


Optometrist administers a glaucoma pressure test

A U.S. Navy optometrist administers a glaucoma pressure test.

Glaucoma is a progressive, blinding and incurable disease.  Although most have heard of glaucoma, few know what this devastating disease is or how it needs to be managed.

A person is said to have glaucoma when the nerves in the retina begin to die, thus rendering light detection impossible. Very rarely does this happen instantaneously, instead occurring usually over the course of years. Since glaucoma is painless, it may take years for a patient to realize there is anything happening to their vision, by which time the disease has likely progressed to an advanced stage.

Glaucoma can be found at any age, but is most common in middle-age to elderly, with a stronger incidence in African-Americans and diabetics. There is no current agreed-upon cause of glaucoma, but several theories are still being investigated.

Glaucoma is detected by piecing together different tests. The first and most recognizable test is the eye-pressure test. This is usually performed by a machine that blows air into the eye, or by your eye care provider using dye and a microscope to manually measure pressure. Both results yield similar results, and can be the first warning sign that glaucoma is present. Many times, it is necessary to test the eye pressure at different times of the day to create a graph of pressure spikes when the most damage might be occurring.

Secondly, your eye care provider will look at the optic nerve in the back of the eye. This nerve is the collection of all the light-detecting nerves in the eye and has a characteristic appearance that can change in specific ways when glaucoma has developed. As more and more nerves die, the changes in the optic nerve become more and more obvious. These changes lead to losses in vision, which can be measured by a visual field machine. Repeated tests with this machine can track physical differences in the vision and give a map of progression that can be evaluated by your doctor.

Additionally, your doctor can use an instrument to measure the thickness of the optic nerve and compare it to what is normal. If glaucoma is in its beginning stages, or if there is doubt as to whether the disease is truly present, this machine can be important in swaying the diagnosis one way or another.

Unfortunately, there is no cure for glaucoma. But there are many treatment options to help preserve vision for many years, possibly indefinitely.

All current methods of glaucoma treatment involve lowering the fluid pressure in the eye. This is most commonly achieved by using eye drops every day. Occasionally, multiple drops are needed to get the desired effect, and many patients can successfully use these for many years.

There are also several laser procedures available to lower eye pressure, as well as conventional surgical techniques. Although surgery is not generally the first line of defense in glaucoma, it remains an invaluable tool for the right patients and can be extremely effective in long-term care.

Yearly comprehensive eye exams are vital in establishing baseline readings that can be used to help detect developing glaucoma. Changes over time will help your eye care provider notice a if a glaucoma pattern is emerging, and what the appropriate treatment option will be for you.