Glaucoma

Glaucoma is a group of diseases that can damage the eye's optic nerve and result in blindness. In open angle Glaucoma the normal fluid pressure inside the eyes slowly rises. This leads to vision loss or even blindness. This fact sheet focuses on open-angle Glaucoma the most common form of the disease.

At the front of the eye, there is a small space called the anterior chamber, which lies between the lens and the cornea. Clear fluid flows in and out of the chamber to bathe and nourish nearby tissues. In Glaucoma for still unknown reasons, the fluid drains too slowly out of the eye. As the fluid builds up, the pressure inside the eye rises. Unless this pressure is controlled, it may cause damage to the optic nerve and other parts of the eye, leading to loss of vision.

A risk factor is something that increases your chance of getting a disease or condition.

• Age: over 60 years old
• Race: black and Age: over 40 years old
• Family members with glaucoma

Note: Risk factors for other forms of glaucoma may differ from these.

At first, Glaucoma causes no visual symptoms. Vision stays normal, and there is no pain. However, as the disease progresses, side vision gradually begins failing. That is, objects in front may still be seen clearly, but objects to the side may be missed. As the disease worsens, the field of vision narrows and blindness results.

An ophthalmologist or optometrist can detect Glaucoma during an eye examination when your pupils are dilated. To accomplish this, drops are put into your eyes during the exam to enlarge your pupils. This allows the eye care professional to see more of the inside of the eye to check for signs of Glaucoma.
To detect Glaucoma your eye care professional will do the following tests:
Visual Acuity - measures how well you see at various distances
Visual Field - measures your side (peripheral) vision
Pupil Dilation - provides a better view of the optic nerve to check for signs of damage
Tonometry - determines the fluid pressure inside the eye

Although open-angle Glaucoma cannot be cured, it can usually be controlled.
Treatments may include:
Medications
These may be eye drops, eye ointments or pills. Some drugs are designed to reduce pressure by slowing the flow of fluid into the eye. Others help to improve fluid drainage.
For most people with Glaucoma  regular use of medications will control the increased fluid pressure, but these drugs may stop working over time or they may cause side effects. If a problem occurs, your eye care professional may select other drugs, change the dose, or suggest other ways to deal with the problem.
Common Glaucoma medications include:

• Drugs that decrease the production of intraocular fluid:
  • Beta Blockers (Betimol, Betagan, Ocupress)
  • Carbonic Anhydrase Inhibitors [CAI] (Diamox, Neptazane, Azopt)
  • Combination CAI/Beta Blocker (Cosopt)
• Drugs that increase the drainage of intraocular fluid:
  • Miotics (Isopto Carbachol, Ocusert Akarpine, E-Pilo)
  • Prostaglandin (Xalatan)
• Drugs that may decrease production and increase drainage of intraocular fluid:
  • Sympathomimetic Alpha-adrenergic Agonist (Alphagan, Iopidine)
  • Sympathomimetic Nonselective (Epinal, Glaucon, Propine)

Laser Surgery
During laser surgery, a strong beam of light is focused on the part of the anterior chamber where the fluid leaves the eye. This results in a series of small drainage sites where fluid can exit the eye. Over time, the effect of laser surgery may wear off. Patients who have this form of surgery may need to keep taking Glaucoma drugs.
Conventional Surgery
Surgery also can help fluid escape from the eye and thereby reduce the pressure. However, surgery is usually reserved for patients whose pressure cannot be controlled with eye drops, pills, or laser surgery.

There are no guidelines for preventing Glaucoma. Early detection and treatment of glaucoma, before it causes major vision loss, is the best way to control the disease. Since vision loss is gradual and begins only in peripheral vision, most patients dont notice any visual changes until significant damage has been done. If you are at high risk for Glaucoma have your eyes examined through dilated pupils every two years by an ophthalmologist or optometrist.