Glaucoma means that the pressure in the eye is too high and that causes damage to the optic nerve, which serves as the connection between the eye and the brain.
There are two main forms of glaucoma and several less common types. The most common are open and closed angle glaucoma. In open angle or chronic open angle glaucoma, the eye produces too much fluid and the pressure builds up over a long period of time. In closed angle glaucoma, the ability of the fluid normally produced in the eye is blocked from getting out of the eye and the pressure becomes extremely high.
Glaucoma is the second most common cause of blindness in the U.S. and in most situations; the blindness can be prevented with treatment. Your risk for glaucoma is increased if you have a family member with glaucoma or are of African descent. Glaucoma is much more likely in the elderly.
There are no symptoms from open angle glaucoma until the very end. There is a gradual loss of peripheral or side vision that occurs very slowly. This is best tested with Visual Field Testing. In contrast, with angle closure or acute glaucoma most people notice decreased or cloudy vision, nausea and vomiting, red eye and severe pain.
A comprehensive examination is needed to make a diagnosis of glaucoma. However, a check of the intraocular pressure alone is not enough. In order to make a diagnosis of glaucoma, it is necessary to examine carefully the inside of the eye and the appearance of the optic nerve looking for damage. Additionally, when a suspicion of glaucoma exists, visual field testing looking for changes in the visual field is needed.
Most individual with open angle glaucoma can be treated with eye drops. Some will require more than one drop, oral medications, laser surgery or even surgery to allow for easier flow of fluid out of the eye.
Those with acute angle closure glaucoma should seek emergency treatment. Those with an angle closure attack complain of severe pain including headache and nausea. Without treatment blindness can happen in only a few days. Treatment includes medications by mouth and IV in addition to drops. Patients with closed angle glaucoma are typically cured with a laser surgical procedure called an iridotomy. This uses a special laser to open a hole in the colored part of the eye called the iris. The new hole prevents another attack. Diagnosis and treatment of an attack should occur as quickly as possible because the pressure in the eye is very high. Please contact our office if you should have pain like this or come in for a comprehensive eye examination to find out if this is a potential concern of yours.