What is Glaucoma?
Glaucoma is an eye disease where the pressure inside the eye becomes too high resulting in progressive damage to the main nerve of the eye (the optic nerve). This progressive damage initially causes a gradual loss of side vision that is not noticeable until it is very advanced. Untreated glaucoma will eventually cause blindness. Most forms of glaucoma produce no noticeable symptoms until major, irreversible nerve damage has already occurred. This is the real danger of the disease. However, if diagnosed early, glaucoma is very treatable. Therefore, being examined for glaucoma on a regular basis is very important. In addition, if it is determined that you are at high risk for glaucoma or you already have the condition, careful examination, testing, and follow-up care are needed to preserve your sight.
Although glaucoma can occur at any age, the risk of developing the disease increases as we age. being most common after 35 - 40 years of age. It is estimated that glaucoma will affect 1 of every 50 adults. Anyone can get glaucoma, but people at higher risk include:
- Those who are significantly near-sighted (high myopia)
- Those with a family history of glaucoma
- Those with Type I or Type II diabetes
- Those who have had significant trauma to an eye (even decades earlier)
- Those who have had major eye surgery
- Those of African descent
However, it is important to emphasize that even low-risk patients over the age of 35 should have their eyes examined by their family doctor of optometry for glaucoma at least every two years. Also, testing for glaucoma involves much more than a"pressure check" at a health fair. Many early glaucoma patients have intra-ocular pressures that vary significantly from day to day or even from one hour to the next. It has been estimated that as many as one-third of all early glaucoma patients will present to an eye doctor with "normal" eye pressure. Therefore testing for glaucoma based on intraocular pressure measurements alone will result in a significant number of patients with progressive glaucoma being missed. Bottom line: A "pressure test" is not enough.
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What is the difference between open-angle and narrow-angle glaucoma?
Glaucoma is often divided into two major types: open-angle glaucoma and closed-angle glaucoma. The angle is that part of the eye where the intra-ocular fluid gradually drains out into the bloodstream. If the angle is open and yet the pressure in the eye is elevated and causing nerve damage, it is called Open Angle Glaucoma.
If the angle is very narrow or closed with the resulting elevated intraocular pressure causing nerve damage, it is called Narrow or Closed Angle Glaucoma. Open-angle is by far the most common of the two forms. Only a small percentage of people ever develop narrow or closed-angle glaucoma. However, those few that do can experience a sudden elevation in pressure causing a rapid onset of blurred vision, pain, eye redness, and headache. They may also see"rainbows" or"halos" around lights. This sudden closing of the angle with elevated intraocular pressure is called Acute Angle Closure. Immediate treatment is indicated.
If you think you are having an angle-closure attack, and do not live in the Lincoln area, call your local eye doctor or emergency room immediately and advise the doctor on-call of your symptoms and concerns.
What is ocular hypertension?
Some people simply have high eye pressures but no signs of optic nerve damage or side vision loss. These patients are said to have"Ocular Hypertension". Recent studies have indicated that in some instances it is important to start ocular hypertensive patients on glaucoma medications in order to prevent future damage. Deciding which patients to treat or not treat is thus a difficult decision. At the Lincoln Eye & Laser Institute, we pride ourselves on making sure you are making an informed decision on this crucial question.