Glaucoma is the leading cause of blindness worldwide and affects over 3 million Americans. Despite the potential severity of glaucoma, it is estimated that half of the people who have it don’t know they have it.

In this article, we will take an in-depth look at glaucoma, from exactly what glaucoma is to the available treatment options. Glaucoma is often a misunderstood disease, so read on to find out everything you need to know and how you can protect your eyesight. 

What Is Glaucoma?

Glaucoma is a general term for several progressive conditions that damage the optic nerve in the eye. Unfortunately, most individuals with glaucoma have no early symptoms or discomfort, which means many individuals who have glaucoma do not get diagnosed until the disease is more advanced.

In most cases of glaucoma, fluid builds up in the front part of the eye, increasing pressure in the eye. This is called intraocular pressure, and it can damage the optic nerve. The optic nerve is responsible for sending the images we see to the brain.

As the damage worsens, so does vision, and if left untreated, glaucoma can cause irreversible vision loss and even total blindness in just a few years. As there are often no early symptoms, it is important to get your eyes checked.

Most people do not develop glaucoma until later in life. It is also known to run in families. Once vision is lost, it is not possible to restore it. However, by lowering the intraocular pressure, it is possible to preserve sight for someone with glaucoma. 

Different Types of Glaucoma

There are several different types of glaucoma; the main two types are open-angle glaucoma and angle-closure glaucoma. While these two types are the most prevalent forms of glaucoma, there are other types including:

• Secondary glaucoma
• Normal-tension glaucoma
• Pigmentary glaucoma
• Congenital glaucoma 

Let’s look at each one to understand better how they are caused and the differences in how they present themselves. 

Open-Angle (Chronic) Glaucoma

Open-angle glaucoma (OAG) is the most common type of glaucoma, affecting 9 out of 10 Americans who suffer from glaucoma. Open-angle glaucoma occurs when small deposits collect in the eye’s drainage canals over time. In the early stages, the drainage canals will appear unaffected, but the drainage canals become slowly clogged as time passes. Fluid builds up inside the eye, which puts pressure on the optic nerve. The slow and gradual nature of open-angle glaucoma means that individuals who suffer from the disease might not show any symptoms for years.  

Acute Narrow-Angle Glaucoma (NAG)

Unlike open-angle glaucoma, acute narrow angle glaucoma often comes on suddenly. While it might not be as prevalent in the United States, acute narrow angle glaucoma (NAG) makes up for about 50% of glaucoma worldwide. Acute narrow angle glaucoma occurs when the angle between the cornea and the iris becomes too narrow. This causes the drainage canals to become blocked. As a result, the aqueous fluid can’t leave the eye, and this causes a sudden increase in eye pressure. Acute narrow angle glaucoma is more prevalent in women than men and tends to affect Asian and Inuit people the most. An acute angle narrow glaucoma attack is often brought on when the eyes dilate too quickly. This can happen when you walk into a dark room or get excited or stressed. The symptoms of acute narrow angle glaucoma present themselves suddenly and are often painful and severe.

Secondary Glaucoma

When glaucoma is classed as secondary, it means that the glaucoma is often the result of an existing eye condition or injury such as cataracts. Certain medicines, such as corticosteroids can also cause secondary glaucoma. Secondary glaucoma can either be open-angle or angle-closure. 

Normal-Tension Glaucoma

Normal-tension glaucoma is a type of open-angle glaucoma. However, the key distinction is that there is no notable increase in eye pressure. There have been several identified potential causes for normal tension glaucoma including:

• Migraine
• Nocturnal systemic hypotension
• Low vascular perfusion
• Raynaud’s Phenomenon

It is most prevalent among Asians and Asian Americans, but there is still some uncertainty around what causes this type of glaucoma. 

Congenital Glaucoma

Congenital glaucoma is also known as pediatric, childhood, or infantile glaucoma. It occurs when the drainage canals don’t form properly when the child is in the womb. It is possible to identify a baby’s glaucoma symptoms at birth. Congenital glaucoma is often hereditary, and children born with it have a defect in the angle of their eye. This prevents normal fluid drainage and results in a build of pressure inside the eye. 

Symptoms of Glaucoma

Unfortunately, many individuals with open-angle glaucoma will not notice any early symptoms as the onset is slow and gradual, which is why it is important to have regular eye examinations with our Newsom Eye team. 

Closed-angle glaucoma presents severe symptoms that come on suddenly. Any of the following symptoms could be an indication of glaucoma. Individuals who suffer from any of these symptoms should make an appointment for a glaucoma eye examination.

Blind Spots

The earliest stages of vision loss associated with glaucoma often present themselves as blind spots. If you are suffering from blind spots in your peripheral or central vision, it could be a sign. Glaucoma can also cause diminishing and blurry vision. Open-angle rarely presents any symptoms in the early stages, but the main tell-tale sign is a loss of peripheral vision. 

Eye Redness and Discomfort

Acute narrow angle glaucoma often causes redness, pain in the eye, headaches, nausea, or vomiting. This can also be brought on by infections or injuries. These symptoms can also present themselves in the later stages of open-angle glaucoma. 

Light Sensitivity and Halos

As glaucoma develops, you might notice that you become increasingly sensitive to light. You may also see rainbow-colored halos around bright lights, such as street lights and car headlights.  

Diagnosing Glaucoma

As it is possible to have glaucoma and not know it, it is essential to have regular eye exams. One or more of the following painless tests will be carried out to check for glaucoma:

• Dilated eye exam – widens the pupils to view the optic nerve at the back of the eyes
• Gonioscopy – examines the angle where the cornea and iris meet
• Optical coherence tomography (OCT) – looks for changes in the optic nerve that may be a sign of glaucoma
• Ocular pressure test (tonometry) – measures eye pressure
• Pachymetry – measures corneal thickness
• Slit-lamp exam – examines the inside of the eye
• Visual acuity test – checks for vision loss
• Visual field test – checks for changes in peripheral vision

If glaucoma is detected, restoring any vision that has already been lost is impossible. However, there are several treatments to reduce additional loss.

Treatment for Glaucoma

Several treatments for glaucoma are available to help slow down any additional vision loss. Most ophthalmologists will start with eye drops or oral medication. Early surgery or laser treatment may be more beneficial in some cases.

Medication/Eyedrops

Prescription eye drops for glaucoma can help to decrease fluid creation and increase fluid drainage out of the eye. This helps to alleviate eye pressure. Glaucoma is a lifelong condition, so these eye drops often need to be used daily for life. However, our Newsom Eye team of glaucoma specialists offer the latest options in glaucoma treatment including Durysta. Durysta is a tiny, dissolvable implant that our team places in your eye to decrease pressure from glaucoma. This FDA approved implant allows you to reduce your dependence on drops for the management of glaucoma. 

Oral medications such as carbonic anhydrase inhibitors and beta blockers can also help decrease fluid creation and increase drainage. Doctors will often prescribe a combination of oral medication and eye drops. 

Laser Treatment

Laser treatments for glaucoma include laser trabeculoplasty and SLT (Selective Laser Trabeculoplasty). These treatments can help to improve fluid drainage from the eye and reduce eye pressure. In some cases, the results from laser treatments might last up to five years, and some of them can be repeated. 

Surgery

There are several different types of surgery for glaucoma. While surgery is more invasive than the above treatment options, it can allow for eye pressure to be controlled much quicker than medication or laser treatment. The severity and type of glaucoma will determine which solution is best for you.   

Glaucoma Treatment at Newsom Eye

Many of the symptoms associated with glaucoma develop overtime so regular eye exams help detect glaucoma early and minimize vision loss by promptly starting treatment.

Our Board Certified experts at Newsom Eye are here to help you enjoy your best vision. Schedule an appointment with our Newsom Eye team today so you can live life with NEWSOM EYES!