GLAUCOMA
Overview
What is Glaucoma?
Why does the eye pressure become high?
What are the symptoms of Glaucoma?
Can lost vision be restored?
How is Glaucoma treated?
Do I have to change my lifestyle because
of Glaucoma?
For More In-Depth Information
Current
Status of Glaucoma Diagnosis and Treatment
Glaucoma
Information for Health Care Professionals
Further Glaucoma Resources
Links to the
American Academy of Ophthalmology library
Links to Foundation
web sites
Overview
The physicians
and surgeons at EyeHealth Northwest are committed to providing
personalized, expert care to patients with glaucoma. Up-to-date
diagnostic technologies are used to catch glaucoma at its early
stages and to monitor the progress of established patients. Our
physicians use the latest medications and surgical techniques to
preserve vision while minimizing the impact of glaucoma therapy
on the patient's lifestyle.
A fellowship-trained glaucoma specialist (J.
Kevin McKinney, MD) is also available for consultation, second
opinions and on-going care.
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What is Glaucoma?
Glaucoma is
a disease condition in which the pressure inside the eye causes
damage to the optic nerve. This usually occurs when the eye pressure
is higher than normal. The optic nerve carries information from
the eye to the brain where images are formed of what our eyes see.
The system functions like a video camera (the eye), connected by
a cable (the optic nerve) to a television (the brain). When exposed
to high intraocular pressures for prolonged periods of time, the
optic nerve begins to die and consequently cannot relay visual information
from the eye to the brain. Side (peripheral) vision is lost first
and this early loss is rarely noticed by the patient. With continued
high pressures, irreversible damage to the optic nerve causes loss
of reading (central) vision and eventual blindness. Unfortunately,
this visual loss is permanent since the optic nerve cannot be replaced
or repaired, not even at the best eye centers around the world.
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Why does the eye pressure become high?
The normal eye
maintains its spherical shape (like an inflated balloon) by means
of a watery fluid, called the aqueous humor, that is constantly
secreted within the eye. As this fluid slowly drains out of the
eye and into the blood stream through small channels in the wall
of the eye, the eye pressure is maintained at a constant, normal
level. Tears are produced by glands around the eye and are
totally different than the aqueous humor inside the eye.
If the aqueous
channels are blocked so that the fluid is trapped inside the eye,
then the pressure may build up to dangerous levels. In many cases
in Saudi Arabia, the eye is small and the iris (the brown or blue
part of the eye) blocks the channels (angle closure glaucoma). This
can happen suddenly with pain and immediate loss of vision, but
often develops slowly without pain or noticeable changes in sight.
In other parts of the world, open angle glaucoma is more common.
These aqueous channels appear normal but fail to allow the aqueous
fluid to pass through. The tendency to develop both kinds of blocked
channels is often inherited and may affect several members in one
family. In most patients, this blockage and high pressure is not
related to the blood or to anything one eats or drinks, although
physical inactivity, obesity and smoking can have an adverse affect
on glaucoma.
Infants and
children may also develop glaucoma. Any infant or child with enlarged
eyes or cloudy eyes needs to have immediate evaluation by an ophthalmologist.
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What are the symptoms of Glaucoma?
Unfortunately,
the common kinds of glaucoma have no early symptoms. Once loss of
vision is noticed, the damage is usually severe and irreversible.
All adults over the age of 30 years should have eye examinations
every 2-3 years to make sure they do not have early glaucoma. Despite
what most people think, people cannot "feel" an elevated
pressure inside their eyes unless the pressure is very high or has
risen suddenly. However, intermittent pain, blurring of vision or
seeing haloes around lights may indicate glaucoma and should be
evaluated by an ophthalmologist. Any sudden, severe eye pain or
loss of vision should prompt an immediate visit to an ophthalmologist.
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Can lost vision be restored?
Unfortunately,
vision lost to glaucoma damage CANNOT be restored. General ophthalmologists
and glaucoma specialists endeavor to preserve what vision a glaucoma
patient still has. Medicine and surgery for glaucoma can prevent
further loss of vision, but cannot improve vision. Persons with
glaucoma who fail to seek or follow the advice of an ophthalmologist
may slowly lose their remaining vision until they become blind.
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How is Glaucoma treated?
The common goal
of all glaucoma treatment is to lower the eye pressure to a safe
range. This can be achieved with eye drops, pills, laser treatment
or surgery. Eye drops usually work well for most cases, but they
only work if taken regularly. If the medications are forgotten,
used incorrectly or taken less often than prescribed, progressive
glaucoma damage may occur. Taking these medications more often than
prescribed is also a bad idea - it may increase side effects and
even cause acute illness.
Glaucoma drops
should be kept in a cool place and protected from intense heat or
sunlight. They should never be left in a parked car. These medications
should not be stopped without consulting the ophthalmologist (unless
severe illness or allergy occurs). Glaucoma medications should be
used regularly, even on the day of an office visit, so that the
treating physician can accurately assess how well the medication
is working. Otherwise, the time of the patient and the physician
will have been wasted. It is also important to bring all of one's
medications to every clinic visit to help the physician determine
if each medication is being taken correctly. Glaucoma drops contain
medication that can affect other parts of the body. Closing the
eye for several minutes will decrease the amount of medicine that
goes into the bloodstream via the nose, thus decreasing bodily side
effects. Like all medications, these drops should never be shared
with anyone else.
Glaucoma cannot
be "cured", so treatment is usually life-long. Multiple
medications are often required and these medications may need to
be adjusted over the course of several visits until the most effective
combination is found. Even after the pressure is controlled, clinic
visits are necessary several times a year to make sure that the
pressure remains controlled.
Glaucoma that
cannot be controlled with medications may respond to laser therapy.
This can be performed on an outpatient basis in the clinic. However,
some patients who do not respond to medications will require glaucoma
surgery which is usually done on an outpatient basis. These procedures
either seek to create an artificial drainage pathway for the aqueous
fluid to leave the eye or attempt to decrease the amount of aqueous
produced inside the eye. Unlike adults, children with glaucoma are
usually treated surgically.
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Do I have to change my lifestyle
because of Glaucoma?
Early in the
disease, there are no restrictions on lifestyle other than taking
medications and keeping follow up visits. Later in the disease,
the vision may be affected to the point that some activities become
dangerous. These include driving and operating hazardous machinery.
You should consult your eye doctor regarding specific restrictions
based on your level of vision.
With modern
medicines and surgical techniques many glaucoma patients can retain
good vision for their lifetime. However, treatment is of greatest
benefit when started early in the course of the disease. Because
glaucoma is a "silent" thief of sight, all persons should
have an eye exam to exclude its presence and re-examination every
few years. These repeat exams must be more frequent for those with
a family history of glaucoma and with advancing age. Only by catching
glaucoma early can the tragedy of irreversible visual loss be prevented.
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Links to the American Academy of Ophthalmology
library
Glaucoma
Introductions:
Glaucoma
General Glaucoma
Information:
What
is Glaucoma
What Causes Glaucoma
Types
of Glaucoma
Who
is at Risk for Glaucoma
How
is Glaucoma Detected
How
is Glaucoma Treated?
Are you at
risk for Glaucoma?
Do
you Know Your Glaucoma Risks?
Elevated
Risk of Glaucoma Among African Americans
Prevention
of Glaucoma
Treatment
of Glaucoma:
Medications for Glaucoma
Surgery
for Glaucoma
The
Use of Marijuana in the Treatment of Glaucoma
Complementary
Therapy Assessment: Marijuana in the Treatment of Glaucoma
Frequently
Asked Questions:
Welcome
to the Glaucoma Q&A Archive! Part I
Welcome
to the Glaucoma Question & Answer Archive! Part II
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Links to Foundation web sites
The
Glaucoma Foundation
Glaucoma
Research Foundation
Yahoo
Health
International
Glaucoma Association
Prevent
Blindness America
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