What is Glaucoma?
Glaucoma is a progressive disease of the optic nerve caused when the pressure inside the eye is higher than the optic nerve can withstand. The most common form of glaucoma will cause a patient to slowly lose their vision, starting with their peripheral vision. For many years this loss of vision will go unnoticed by a patient. Left untreated, glaucoma will result in blindness. According to W.H.O. glaucoma is the second most common cause of blindness after cataracts worldwide.
What are the symptoms?
At first, open-angle glaucoma has no symptoms. Vision stays normal, and there is no pain. As glaucoma remains untreated, people may notice that although they see things clearly in front of them, they miss objects to the side and out of the corner of their eye. Typically, patients will notice no symptoms related to glaucoma until the late stages of the disease. Unless treated early it results in permanent loss of vision.
What is the Treatment for Galucoma?
Glaucoma is a lifelong disease that will always require treatment. Glaucoma is much like hypertension and diabetes. We can control these diseases, however we cannot, as of yet, cure them. If glaucoma cannot be controlled with medications other procedures, including lasers & surgery may be considered.
The concern of most patients is will I go blind from glaucoma? That is difficult to answer and depends on numerous factors. Due to the many excellent medications available to us today most people, with early treatment, will not go blind from glaucoma.
Glaucomatous blindness is preventable with the current treatments available. Keeping regular visits at intervals recommended by your doctor and using the medications as prescribed will prevent the progression of glaucoma.
You can also help protect the vision of family members and friends who may be at high risk for glaucoma – especially, African Americans over age 40 and everyone over age 60. Encourage them to have an eye examination through dilated pupils every year.
What Tests are used to Diagnose Glaucoma?
Traditionally glaucoma was diagnosed by evaluating a patient's peripheral vision with a visual field. Recent advances in laser technology, along with new studies have improved our ability to diagnose glaucoma more accurately and at an earlier stage. A patient that is being evaluated for glaucoma will typically have the following tests.
Ophthalmoscopy-Direct view of the optic nerve head to look for damage to the optic nerve.
Tonometry-Measures the intra ocular pressure i.e. pressure inside the eye.
Gonioscopy-Helps to visualize the drainage system (angle) of the eye. Helps in classifying the type of glaucoma.
Pachymetry- Measures the central thickness of the cornea. Too thick or thin cornea gives false IOP readings.
Perimetry- Measures the actual loss of peripheral visual field and hence damage due glaucoma.
What is perimetry?
Perimetry is the evaluation of your visual field. It helps in testing your peripheral vision (side vision). Perimetry is considered to be the gold standard in the evaluation of glaucoma. It is also useful to rule out patterns of visual loss in other diseases.
We at Sparsh eye clinic have the Carl Ziess Humprey perimeter 740i which is considered to be the gold standard for glaucoma diagnosis world over with the largest normative database.
What can you do to protect your vision?
If you are being treated for glaucoma make sure you use the glaucoma medications every day and visit your ophthalmologist regularly to monitor the progress. Medications should never be stopped or changed without first consulting your ophthalmologist.
It is important to tell all your treating doctors about your glaucoma medications.
You can also help to protect the vision of your family members and friends who are at high risk, especially those over 50 years of age. Encourage them to have a regular eye check up every year so that if glaucoma develops it can be picked up early.
Who is at Risk?
Although anyone can get glaucoma, some people are at higher risk than others. Some of the most common risk factors include:
- Age Over 40
- People with a family history of glaucoma
- Patients with diabetes
- Patients with high minus numbers or plus numbers
- Past history of injury to the eye
- Long term use of steroids –local or oral.