What is a Glaucoma?
Glaucoma is a leading cause of blindness in the United States, especially for older people. Loss of sight from glaucoma is often preventable if you get treatment early enough. Glaucoma is a disease of the optic nerve. The optic nerve carries the images we see to the brain. Most people have no warning signs or symptoms in the early stage, that is why early detection via an annual eye exam is key. Many people know that glaucoma has something to do with pressure inside the eye. The higher the pressure inside the eye, the greater the chance of damage to the optic nerve.
The optic nerve is made up of a large number of nerve fibers, like an electric cable containing a huge number of wires. Glaucoma can damage nerve fibers causing blind spots to develop. Usually people don’t notice these blind areas until much of the optic nerve damage has already occurred. If the entire nerve is destroyed, blindness results. Early detection and treatment by a qualified ophthalmologist are the keys to preventing optic nerve damage and blindness from glaucoma.
What are the symptoms of Glaucoma?
Open-angle glaucoma symptoms
With open-angle glaucoma, there are no warning signs or obvious symptoms in the early stages. As the disease progresses, blind spots develop in your peripheral (side) vision.
Most people with open-angle glaucoma do not notice any change in their vision until the damage is quite severe. This is why glaucoma is called the “silent thief of sight.” Having regular eye exams can help your ophthalmologist find this disease before you lose vision. Your ophthalmologist can tell you how often you should be examined.
Angle-closure glaucoma symptoms
People at risk for angle-closure glaucoma usually show no symptoms before an attack. Some early symptoms of an attack may include blurred vision, halos, mild headaches, or eye pain. People with these symptoms should be checked by their ophthalmologist as soon as possible. An attack of angle-closure glaucoma includes the following:
- severe pain in the eye or forehead
- redness of the eye
- decreased vision or blurred vision
- seeing rainbows or halos
Normal tension glaucoma symptoms
People with “normal tension glaucoma” have eye pressure that is within normal ranges, but show signs of glaucoma, such as blind spots in their field of vision and optic nerve damage.
Do glaucoma suspects have symptoms?
Some people have no signs of damage but have higher than normal eye pressure (called ocular hypertension). These patients are considered “glaucoma suspects” and have a higher risk of eventually developing glaucoma. Some people are considered glaucoma suspects even if their eye pressure is normal. For example, their ophthalmologist may notice something different about their optic nerve. Most glaucoma suspects have no symptoms. That is why you need to be carefully monitored by your ophthalmologist if you are a glaucoma suspect. An ophthalmologist can check for any changes over time and begin treatment if needed.
Pigment dispersion syndrome and pigmentary glaucoma symptoms
Pigment dispersion syndrome (PDS) happens when the pigment rubs off the back of your iris. This pigment can raise eye pressure and lead to pigmentary glaucoma. Some people with PDS or pigmentary glaucoma may see halos or have blurry vision after activities like jogging or playing basketball
See your eye care provider if you have these or other symptoms.
What causes Glaucoma?
Clear liquid circulates inside the eye. A small amount of the fluid is produced constantly and 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 fluid as a sink with the faucet turned on all the time.
If the “drainpipe” gets clogged, 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 is clogged. If the drainage area of the eye is blocked, the fluid pressure within the inner eye may increase which can damage the optic nerve.
How is Glaucoma diagnosed?
Regular eye examinations by your eye care provider are the best way to detect glaucoma. During a complete and painless eye exam for glaucoma, a qualified doctor will:
- measure your eye pressure
- inspect your eye’s drainage angle
- examine your optic nerve for damage
- test your peripheral (side) vision
- take a picture or computer measurement of your optic nerve
- measure the thickness of your cornea
Early detection is the key to preventing vision loss. Call our office at (309) 243-2400 to schedule your glaucoma screening.
Source: American Academy of Ophthalmology
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Treatment Options for Glaucoma
If you are diagnosed with glaucoma, eye drops may be prescribed to control pressure in your eye. Eye drops lower eye pressure, either by decreasing the amount of aqueous fluid produced within the eye or by improving the flow through the drainage angle.
Glaucoma medications can preserve your vision, but they may also produce side effects. You should notify your ophthalmologist if you think you may be experiencing side effects.
Some eye drops may cause:
- A stinging or itching sensation
- Red eyes or redness of the skin surrounding the eyes
- Changes in pulse and heartbeat
- Changes in energy level
- Changes in breathing
- Dry mouth
- Changes in sense of taste
- Blurred vision
- Change in eye color
Drops alone may not always treat glaucoma. For more information, ask your doctor about more treatment options concerning glaucoma.
There are two main types of laser surgery to treat glaucoma. They help aqueous drain from the eye. These procedures are usually done in the ophthalmologist’s office or an outpatient surgery center.
- Trabeculoplasty. This surgery is for people who have open-angle glaucoma. The eye surgeon uses a laser to make the drainage angle work better. That way fluid flows out properly and eye pressure is reduced.
- Iridotomy. This is for people who have angle-closure glaucoma. The ophthalmologist uses a laser to create a tiny hole in the iris. This hole helps fluid flow to the drainage angle.
If you have angle-closure glaucoma, your doctor may perform laser iridotomy to restore normal fluid flow and eye pressure. This laser creates a hole in the iris to improve the flow of aqueous fluid to the drain and is usually made in the upper part of the iris to avoid any visible scarring. You may return to your normal activities after the procedure. For additional information, ask you doctor about the laser iridotomy procedure.
A laser surgical option for treatment of open-angle glaucoma is called selective laser trabeculoplasty or S.L.T. During the S.L.T. procedure, your doctor directs a low frequency laser beam into the trabecular meshwork, which is the primary drainage region of the eye. The S.L.T. laser selectively treats specific cells leaving untreated portions of the trabecular meshwork intact. The procedure increases drainage of fluid out of the eye, resulting in lowered pressure in the eye. After the procedure, the patient is typically treated with anti-inflammatory eye drops for a few days and most resume normal activities within a few days. For more information, ask your doctor about the S.L.T. procedure.
Our ophthalmologist may implant a tiny drainage tube in your eye. The glaucoma drainage implant sends the fluid to a collection area (called a reservoir). Your eye surgeon creates this reservoir beneath the conjunctiva. The fluid is then absorbed into nearby blood vessels.
Implants or other types of glaucoma surgery performed by our team may include:
- Kahook Dual Blade
- Ahmed ClearPath®
- Glaucoma Filtering