Glaucoma Treatment

Glaucoma or “pressure” in the eye can lead to vision loss and blindness. Glaucoma is a group of diseases. Glaucoma is a condition within the eye that develops whenever there is too much fluid inside the eye. This fluid pressure builds up and presses on the optic nerve and over time, glaucoma can damage the optic nerve, which would result in a severe decrease in vision or even blindness. With early detection and treatment, you can treat this disease and protect your eyes from serious vision loss.

Glaucoma is the main cause of blindness in the United States. Because most people have no symptoms or pain from this increased pressure, you should have an eye exam for early detection. There is no way an individual would know they suffered from this disease until it was too late. The signs and symptoms are so gradual the loss becomes unnoticed until it is a severe loss. Glaucoma tends to be inherited and may not show up until later on in life. Vision lost due to glaucoma cannot be restored. This is why early detection and treatment of this disease is critical.

Communities at High Risk for Glaucoma

• African Americans over age 40
• Everyone over age 60, especially Mexican Americans
• People with a family history of glaucoma
• Those who take systemic corticosteroid medications such as Prednisone
• Diabetics

When the fluid pressure in the eye's anterior chamber, the area between the cornea and the iris, rises, this is considered elevated intraocular pressure. This fluid is called aqueous humor and it flows through a mesh-like channel. When the channel becomes blocked for whatever reason, it causes the fluid to sit there and build up. Usually, this is an inherited trait passed from parents to children.

There are other causes of glaucoma, including blunt or chemical injury to the eye, severe eye infection, blockage of blood vessels in the eye, inflammatory conditions of the eye, and occasionally after eye surgery from another condition. Glaucoma usually occurs in both eyes, but it could only affect one eye, depending on the different reasons.

Open-angle glaucoma is sometimes referred to as wide-angle glaucoma. This is the most common form of glaucoma. It is when the structures of the eye usually appear normal, but the fluid in the eye doesn’t flow properly through the trabecular meshwork to drain out of the eye.

Angle-closure glaucoma is sometimes referred to as acute or chronic angle-closure glaucoma or narrow-angle glaucoma. This type is less commonly seen. Drainage may be poor because the angle between the iris and cornea is too narrow, causing the fluid to build up and not drain properly. Sometimes it is caused by a pupil that opens too wide, which narrows the angle and blocks the flow of the fluid through the channel. There is also congenital glaucoma, which often runs in the family. It is present at birth and is less commonly seen. It results from abnormal development of the channels where the fluid flows.

Secondary glaucoma is caused by drugs such as steroids or eye disease such as uveitis, and also from systemic diseases.

Glaucoma is diagnosed by a complete eye examination:

• Tonometry — determines the amount of pressure in the eye
• Pachymetry — determines the thickness of the cornea
• Gonioscopy — allows the doctor to view the interior of the eye from different directions and angles
• A dilated eye exam — eye drops stretch the pupil open to allow the doctor to view the back of the eye
• Ophthalmoscopy — a handheld instrument that allows the doctor to look directly through the pupil to view the optic nerve
• Visual field testing — a testing instrument that maps out the visual field showing any areas of loss of vision peripherally
• GDX — a machine that takes a picture of the nerve fiber layers

There is no cure for glaucoma. You can protect your eyes from decreasing visual fields and loss of vision by working with Dr. Cape regularly. Early treatment is very important to preserve vision.

Three Ways to Lower Eye Pressure

• Use eye drops or pills
• Laser treatment
• Surgery

Dr. Cape will discuss the severity of your glaucoma with you and consult with you on the best treatment possible. Since there are no signs or symptoms initially from glaucoma, you may be tempted to stop taking medications. The medications are very important to help control your eye pressure, along with regular monitoring by Dr. Cape.