Glaucoma

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Glaucoma

Glaucoma is a disease of the optic nerve — the part of the eye that carries the images we see to the brain. The optic nerve is made up of many nerve fibers, like an electric cable containing numerous wires. When damage to the optic nerve fibers occurs, blind spots develop. These blind spots usually go undetected until the optic nerve is significantly damaged. If the entire nerve is destroyed, blindness results.

Glaucoma is a leading cause of blindness in the United States, especially for older people. Early detection and treatment by your ophthalmologist are the keys to preventing optic nerve damage and blindness from glaucoma.

Causes of Glaucoma

Clear liquid called aqueous humor circulates inside the front portion of the eye. To maintain a healthy level of pressure within the eye, a small amount of this fluid is produced constantly while an equal amount flows out of the eye through a microscopic drainage system. This liquid is not part of the tears on the outer surface of the eye.

You can think of the flow of aqueous fluid as a sink with the faucet turned on all the time. If the drainpipe clogs, water collects in the sink and the sink may overflow. Because the eye is a closed structure, the excess fluid cannot overflow if the drain gets clogged. If the drainage area of the eye - called the drainage angle - is blocked, the fluid pressure within the inner eye may increase, which can damage the optic nerve.

Types of Glaucoma

Chronic Open-Angle Glaucoma

This is the most common form of glaucoma in the United States. The risk of developing chronic open-angle glaucoma increases with age. The drainage angle of the eye becomes less efficient over time causing pressure within the eye to gradually increase. Increasing pressure in the eye can cause damage to the optic nerve. In some patients, the optic nerve becomes sensitive even to normal eye pressure and is at risk for damage. Treatment is necessary to prevent further vision loss.

Typically, chronic open-angle glaucoma has no symptoms in its early stages and vision remains normal. As the optic nerve becomes more damaged, blank spots begin to appear in the field of vision. You typically won't notice these blank spots in your day-to-day activities until the optic nerve is significantly damaged and these spots become large. If all the optic nerve fibers die, blindness results.

Closed-Angle Glaucoma

Some eyes are developed with the iris (the colored part of the eye) too close to the drainage angle. In these eyes, which are often small and farsighted, the iris can be sucked into the drainage angle and block it completely. Since the fluid cannot exit the eye, pressure inside the eye builds rapidly and causes an acute closed-angle attack.
Symptoms may include:

blurred vision
severe eye pain
headache
rainbow-colored halos around lights
nausea and vomiting

An acute closed-angle attack is a true eye emergency. If you have any of these symptoms, call your ophthalmologist immediately. Unless this type of glaucoma is treated quickly, blindness can result. Unfortunately, two-thirds of those with closed-angle glaucoma develop it slowly without any symptoms prior to an attack.

Glaucoma Risk Factors

Your ophthalmologist considers various factors to determine your risk for developing the disease.
The most important risk factors include:

Age
elevated eye pressure
family history of glaucoma
African or Spanish-American ancestry
farsightedness or nearsightedness
past eye injuries
thinner central corneal thickness
systemic health problems, including diabetes, migraine headaches and
poor circulation

The doctors of Eye Surgical Associates will weigh all of these factors before deciding whether you need treatment for glaucoma or whether you should be monitored closely as a glaucoma suspect. This means your risk of developing glaucoma is higher than normal, and you will need to have regular examinations to detect the early signs of damage to the optic nerve.

Vision Plans and Insurance

Eye Surgical Associates accepts many major insurance plans. Please check with your provider for coverage details. Learn more >