At his routine eye exam, Alberto was startled when the ophthalmologist told him that he had developed glaucoma. “I didn’t have any symptoms at all!” Alberto said. His doctor prescribed medication to prevent vision loss. Without treatment, Alberto might have experienced a gradual loss of eyesight before he realized anything was happening.
Glaucoma is the leading cause of preventable blindness. According to Prevent Blindness America, glaucoma is a fast-growing health problem in the U.S. Today, over 2.7 million Americans have glaucoma—which represents an increase of 22 percent from only ten years ago! Just as troubling, half of the people who have glaucoma are unaware that they have the sight-robbing condition until they have lost up to 40 percent of their vision. This is why glaucoma is often called “the sneak thief of sight.”
Q: What causes glaucoma?
Your eye is about the size of a golf ball. It is filled with a clear, jelly-like fluid that keeps it round. The eyeball is constantly being filled with new fluid, and the old fluid drains away at the same rate. But if too much fluid is produced or not enough can drain, pressure builds up in the eye. Left untreated, this excess pressure will damage the nerves that let us see. This can result in loss of sight and eventually blindness. Glaucoma sometimes has a known cause, such as an eye injury, cataracts, scar tissue, or the use of certain medications. But in most cases, the cause is unknown.
Certain people are at higher risk of developing glaucoma: those over 60, family members of people with glaucoma, people with diabetes, and people who are very nearsighted. People of Asian, African and Hispanic descent are also at higher risk.
In about 5 percent of cases, glaucoma strikes suddenly, with severe pain and a sudden vision problem. This is called acute or closed-angle glaucoma. But in most cases, pressure builds up gradually, damage progresses slowly, and there is no pain. This is called chronic or open-angle glaucoma.
Q: What are the signs of glaucoma?
Dr. James Tsai of the National Eye Institute says, “Glaucoma often has no early warning signs. Often, a person will not experience any noticeable vision loss in the early stages of glaucoma. But as the disease progresses, a person may notice his or her side vision decreasing. If the disease is left untreated, the field of vision narrows and blindness may result.”
This loss of sight is often so gradual that the person doesn’t notice until central vision is affected. Other subtle symptoms may also be present, such as blurred vision or rainbow-colored rings around lights.
It is important to catch and treat glaucoma early. People over 40 should have their eyes checked every year by an ophthalmologist (a medical doctor trained in the diagnosis and treatment of eye disease). The eye care professional will test the pressure in your eye, look at the inside of your eye with a special instrument, and test your vision to detect any small changes that would suggest glaucoma. The tests for glaucoma are painless.
Note: In the acute type of glaucoma, symptoms are severe and sudden. Permanent loss of vision can occur within hours. The symptoms of acute glaucoma include redness of the eye, severe pain, headaches, nausea, sudden noticeable change in vision, and colored rings (“halos”) around lights. Acute glaucoma is a serious medical emergency. If you have the above symptoms, you should see a health care practitioner immediately.
Q: How is glaucoma treated?
Unfortunately, affected vision cannot be restored. But medical treatment can help prevent further damage. The goal of glaucoma treatment is to reduce the pressure inside the eye. Medication is usually prescribed. Some medications cut down on the amount of fluid the eye produces; others encourage a better flow of fluid out of the eye. Some drugs are taken in eye drop form, others as pills. It is very important to take your medication as directed.
People with the sudden, acute form of glaucoma usually need immediate surgery. And in some of the slower, chronic cases, the doctor eventually recommends surgery if medication fails to control the pressure well enough, or medicines are causing unacceptable side effects, making surgery the better alternative. Glaucoma surgery is relatively safe and painless, usually requiring only a short hospital stay. Today, laser surgery can make the procedure even shorter and easier.
Remember: glaucoma is treatable if detected early enough! So a glaucoma test should be a regular part of your annual physical examination.
Learn more about glaucoma, and spread the word
Prevent Blindness America provides free resources to educate the public about eye disease, including the Glaucoma Learning Center [link to: http://glaucoma.preventblindness.org].
The Glaucoma Research Foundation provides information about the latest research and treatment options.
Visit the website of the American Academy of Ophthalmology for consumer information about glaucoma
Photo: National Eye Institute, National Institutes of Health
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