Glaucoma can be a scary word to hear, whether you or someone you care about is facing the diagnosis. Maybe you've heard horror stories of blindness or terrifying treatments, or maybe you don't have the first clue about what it is. Whatever the case, knowing the facts about glaucoma can help you relax and make informed decisions or be more supportive of a loved one dealing with this eye problem.
Glaucoma is a medical problem in which the optic nerve (which connects the eyes to the brain) becomes damaged.This is most often caused by high pressure inside the eyes, but not always. Likewise, sometimes people with high eye pressure can have no other signs of glaucoma, in which case they are merely "glaucoma suspects". Everyone should get regular eye check-ups to screen for problems like cataracts and glaucoma, but glaucoma suspects usually need to see their eye doctor more frequently to monitor their eye pressure. People over the age 40, people who suffer from diabetes, people with a family history of glaucoma, and people with African ancestors are most at risk for glaucoma, but it can happen to anyone. Eye doctors recommend that everyone gets their eyes checked every six months to four years, depending on how many risk factors they have.
Types of Glaucoma
There are four basic types of glaucoma: open angle, angle-closure, congenital, and secondary. Open angle glaucoma is the type most people think of when they hear the word glaucoma, and it tends to develop over time. Most people with open angle glaucoma don't have any symptoms except for very slow vision loss. Eye drops are the most common treatment, but sometimes doctors will prescribe pills or laser treatments as well. Someone with this type of glaucoma probably won't even realize they have it until their eye doctor tells them at a routine check-up, which is why seeing an eye doctor regularly is so important.
Angle-closure glaucoma is considered a medical emergency, and having this kind of glaucoma in one eye means someone is at a higher risk to develop glaucoma in their other eye. This type is sometimes caused by medicines or eye drops, and the symptoms are usually very noticeable: nausea, severe pain in one eye, vision problems, and eye redness. People with symptoms of an angle-closure glaucoma should get to a medical professional as soon as possible, because this type of glaucoma can cause blindness in just a couple of days. Doctors usually attack an angle-closure glaucoma from a lot of different angles at once, so they often use eye drops, pills, IV drugs, and even sometimes surgeries to save the patient's eyesight. After the emergency is over, the person will usually start taking preventative glaucoma treatment to keep another angle-closure glaucoma from happening.
Congenital glaucoma results from a birth abnormality and is almost always diagnosed when the person is a baby or toddler. Parents often notice that their baby has red and/or cloudy eyes. Sometimes the baby will have excess tear production, even when they are not crying, and their eyes may seem to be "swollen" to a larger size. The best treatment for this type of glaucoma is surgery.
Secondary glaucoma is usually caused by something else, usually prescription steroids or another disease. Sometimes inflammation of the eye will lead to this type of glaucoma. The symptoms range from unnoticeable to very obvious, and in addition to eye drops or other treatments, doctors must try to take care of the other factor that caused the glaucoma. For example, if someone has glaucoma from taking corticosteroids, their doctor will usually try to lower their dosage of steroids as much as possible.
Eye doctors use a variety of tests to check patients for glaucoma. If you have been to an eye doctor for a check-up, they have almost certainly tested you, whether or not you realized it. The dilating drops the doctor puts in your eyes lets them see the back of your eye, including your optic nerve. They also use the light on the device to make sure your pupils are dilating properly. The light and magnifying device they use to look inside your eye is called an opthalmoscope, and it is the method of glaucoma prevention that people are usually most familiar with.Another common diagnostic method is tonometry, a procedure which usually involves placing your face against a metal frame and having air puffed at your eyes. The air puff helps doctors to measure your eye pressure, which, just like blood pressure, is measured in millimeters of mercury. Doctors consider 12-22mmHg normal, but as previously mentioned, the glaucoma diagnosis does not exclusively depend on eye pressure. Eye doctors also commonly perform a test called perimetry, which is simply a fancy way of saying that they are checking your visual fields. The doctor will flash a light to see how good your peripheral (side) vision is, just like when you get your driver's license renewed, and to check for unusual blind spots.
If a person's eye pressure, visual fields, or optic nerve seem unusual, the eye doctor may perform more tests. A gonioscope is a mirrored contact lens that helps the doctor see many parts of the eye they wouldn't normally be able to see, including the angle connecting the iris to the cornea. The gonioscope can be a huge help to your doctor, and it's only minimally uncomfortable to most people. Another test your doctor might run is the pachymetry test, which involves measuring the thickness of your cornea. It should be painless and quick, and it can help your doctor interpret your eye pressure measurements. Although it seems like a lot, these are only a few of the diagnostic tests available to your doctor! The good news is that even though many of these tests seem scary, they are all minimally invasive and risky. If you can tolerate the level of invasiveness involved in putting on a contact lens, you can tolerate this – and if you can't even tolerate that, your doctor can give you numbing eye drops and sometimes even anti-anxiety medicines to make the procedure as comfortable for you as possible.
Unfortunately, not everyone gets eye check-ups as often as they should, and sometimes treatment with eye drops, pills, and surgery don't work for people.When this happens, a person may experience low vision from glaucoma. Low vision means that a person can still see, but has problems with their eyesight. These problems are typically more closely related to lighting and color perception, rather than the fuzziness that most people who wear glasses experience. Sometimes a person with glaucoma will become extremely sensitive to light, have trouble seeing in normal lighting, or be unable to tell colors apart if they are too close in shade. Luckily, there are many solutions to these problems, ranging from tinted glasses to lighted magnifying glasses to organizations which assist people with low vision. For people who have vision difficulties because of glaucoma, there are many exciting options to help them get back to living their lives, and many volunteers eager to help them adjust and improve their lives.
Today, medical professionals know a lot more about diagnosing and treating glaucoma than they did in the past. As long as you do your part and get an eye check-up as often as your eye-care specialists advises you, chances are good you will be able to prevent blindness and possibly even low vision. Researchers are working hard to develop new treatments and gadgets to help people with glaucoma, so if you or someone you care about is facing this diagnosis, don't be discouraged!