GLAUCOMA

Symptoms of Glaucoma

In most cases, glaucoma is asymptomatic (has no symptoms). By the time one feels that they have decreased vision, the disease may unfortunately be in its latter stages. Since early warning signs of glaucoma are rare, it is important to have regular medical eye examinations every one or two years.

Patients with the most common types of chronic glaucoma may not be aware of any symptoms because the disease develops slowly, and they rarely notice loss of peripheral vision. Less frequently, patients with an acute form of glaucoma (acute angle closure) may develop severe symptoms because ocular pressure rises quickly, and they may experience:

  • Blurred vision, especially at night
  • Halos or rainbows around lights
  • Severe headaches or eye pain
  • Nausea

What Causes Glaucoma?

Glaucoma occurs when the normal pressure inside the eyes (intraocular pressure) increases because the aqueous humor fluid – which usually flows in and out of the eye – is unable to drain properly. Additional stress on the nerve may occur if blood circulation is inadequate.

Over time, these factors damage the optic nerve, the structure that sends visual signals from your eyes to your brain. While most glaucoma is hereditary, the underlying reasons for damage usually relate to the type of glaucoma you have.

Common Types of Glaucoma

Primary Open Angle Glaucoma

The most common form of glaucoma where the anatomy of the front of the eye appears to be normal but fluid drainage in inadequate because of failure of the trabecular meshwork. While the cause of this failure is not completely understood, primary open angle is known to be highly hereditary.

Normal Tension Glaucoma

Glaucoma that develops despite having eye pressure in the normal range. This type of glaucoma is believed to associated with episodic of ongoing inadequacy of blood circulation to the nerve.  Ironically, it can often be found in individuals who have blood pressure that is very low.

Acute Angle Closure or Narrow Angle Glaucoma

Acute closure of the peripheral drainage angle is characterized by a sudden increase in intraocular pressure. The iris may obstruct the eye’s drainage angle in a slow, progressive fashion or, with acute angle closure, it may close suddenly. This, less common form of glaucoma, may be associated with severe eye pain and is an eye emergency.

Pseudoexfoliation Glaucoma

Increased eye pressure caused by deposits of a fibrillary material that may contribute to the obstruction of the fluid drainage from the eye. Recent evidence has shown that it is more common in individuals who live further from the earth’s equator.

Pigmentary Glaucoma

Associated with of unusual ocular anatomy where the iris is deeply set. Pigment is dislodged from the iris and then obstructs the eye’s drainage structures (trabecular meshwork). This type of glaucoma is associated with the finding known as pigment dispersion syndrome.

Angle Recession Glaucoma

Scar tissue from previous trauma can damage the trabeculum and obstruct the outflow of fluid. An unusual characteristic of this type of glaucoma is that it might only occur in one eye. Other glaucomas seem to occur in both.

Neovascular Glaucoma

Various disorders such as diabetes of vascular occlusion can cause blood vessels to proliferate on the iris and in the eye’s drainage structures.

Childhood Glaucoma or Pediatric Glaucoma

Childhood glaucoma, also referred to as congenital glaucoma, pediatric glaucoma or primary infantile glaucoma occurs in babies and young children. It is an extremely serious form of glaucoma that must be diagnosed early and treated aggressively.

LASIK and Glaucoma

Over 15 million Americans have had LASIK surgery. While LASIK does not cause glaucoma, it makes it more difficult to diagnose. Most eye pressure measuring devices, fail to read properly after LASIK surgery. This may cause you eye doctor to miss the fact that your eye pressure is high. After having LASIK, always let your examining doctor know that you have had it. Also, have thorough regular eye examinations.

Glaucoma Risk Factors

 Although glaucoma is most common in adults over the age of 40, susceptibility is not determined by age alone. A genetic predisposition of those with a family history of the disease and African-Americans, are at a particularly increased risk. Studies have shown individuals at greater risk for glaucoma may fit one or more of the following criteria:

  • Are over the age of 50
  • Have a family history of the disease, elevated intraocular pressure
  • Are African-American over the age of 40
  • Have diabetes or hypertension
  • Are very nearsighted or farsighted
  • Steroid Users
  • Have had an eye injury
  • Are Asian
  • Are Hispanic over the age of 50

Why Choose The Glaucoma Eye Institute at Harper’s Point Eye Associates?

The specialists at the Glaucoma Institute at Harper’s Point Eye Associates vigorously promote early detection and continuously fight the severe consequences of not detecting the disease in its early stages. We are a glaucoma teaching and research institution with interns from three universities.

To achieve an accurate assessment, our experienced eye doctors perform comprehensive glaucoma screenings that consists of non-invasive, pain-free procedures:

Tonometry

Measurement of the pressure inside your eye. There are various ways of measuring eye pressure and some are more precise, allowing more effective glaucoma diagnosis and therapy.

Visual Field

This test checks for vision loss, including your central and side or peripheral vision.

Spectral Domain and Angio OCT

Newer diagnostic studies using computer-imaging technology such as spectral domain optical coherence tomography (OCT), now permit precise measurements of the retinal nerve fiber layer and vascular layers that cannot be visualized by the unaided human eye. This test helps monitor and detect optic nerve loss over time.

Optic Disc Photography

Specialized optic nerve photographs document the severity of damage to the nerve and are used to monitor changes over time.

Pachymetry

Because corneal thickness can influence your eye pressure reading, this test measures the thickness of your cornea.

Gonioscopy

This exam looks at the drainage angle in your eye through a tiny mirror that works like a periscope.

Electrodiagnostic Testing

Objective tests that electrically measure the integrity of the retina and optic nerve.

Glaucoma Treatment

Eye Drops

Certain prescription eye drops decrease intraocular pressure by reducing the amount of fluid your eye produces. Several different classes of glaucoma medications are available to provide pressure reduction including beta-blockers, prostaglandin analogues, alpha-adrenergic agonists, miotics, Rho kinase inhibitors and oral and topical carbonic anhydrase inhibitors. These medications work by either reducing the rate at which fluid in the eye is produced or by increasing the outflow of fluid from the eye.

Oral Medications

Like eye drops, oral prescription medications may be prescribed to help reduce pressure inside your eye.

Laser Therapy

Using a laser beam, “SLT” procedures may open clogged channels inside the eye, releasing fluid build-up. Laser therapy is an outpatient procedure.

MIGS

Minimally invasive glaucoma surgery (MIGS) has been developed in recent years to lower eye pressure and prevent progression of glaucoma.  MIGS procedures are indicated in certain types of glaucoma and work by using microscopic-sized eye stents. MIGS are typically implanted during cataract surgery.

Filtering Surgery

Filtering surgery to create a new passage for fluid drainage. Surgery is usually reserved for cases that cannot be controlled by medication and after appropriate laser treatment.