Glaucoma Eye Exams
Glaucoma is a leading cause of preventable vision loss and blindness in older individuals in the United States and Canada and the second leading cause of blindness in the World, even more than macular degeneration.
What is Glaucoma?
Glaucoma is not a single disease. It is actually a group of eye diseases that cause damage to the optic nerve due to an increase in pressure inside the eye, which is called intraocular pressure (IOP). When detected in the early stages, glaucoma can often be controlled, preventing severe vision loss and blindness. However, symptoms of noticeable vision loss often only occur once the disease has progressed. This is why glaucoma is called “the sneak thief of sight”. Unfortunately, once vision is lost from the disease, it usually can’t be restored.
Treatments include medication or surgery that can regulate the IOP and slow down the progression of the disease to prevent further vision loss. The type of treatment depends on the type and the cause of glaucoma.
Prevention is possible only with early detection and treatment. Since symptoms are often absent, regular eye exams which include a glaucoma screening are essential, particularly for individuals at risk of the disease. While anyone can get glaucoma, the following traits put you at a higher risk:
- Age over 60
- Hispanic or Latino descent, Asian descent
- African Americans over the age of 40 (glaucoma is the leading cause of blindness in African Americans, 6-8 times more common than in Caucasians.)
- Family history of glaucoma
- People with severe nearsightedness
- Certain medications (e.g. steroids)
- Significant eye injury (even if it occurred in childhood)
Signs and Symptoms of Glaucoma: Due to a buildup of pressure in the eye, glaucoma causes damage to the optic nerve which is responsible for transmitting visual information from the eye to the brain. How does glaucoma affect your vision?
Types of Glaucoma: There are a number of types of glaucoma, some more acute than others. Learn about the common types of glaucoma and the differences between them.
Diagnosis and Treatment of Glaucoma: Early detection and treatment of glaucoma are essential to stopping or slowing the disease progression and saving vision. Treatment can include medicated eye drops, pills, laser procedures and minor surgical procedures depending on the type and stage of glaucoma.
Signs and Symptoms of Glaucoma
The intraocular pressure caused by glaucoma can slowly damage the optic nerve, causing a gradual loss of vision. Vision loss begins with peripheral (side) vision, resulting in limited tunnel vision. Over time if left untreated, central vision will also be affected which will increase until it eventually causes total blindness. Unfortunately, any vision that is lost from the optic nerve damage cannot be restored.
What are the Symptoms?
Typically, glaucoma sets in without any symptoms. At the early onset of the most common type of glaucoma “open angle” glaucoma, vision remains normal and there is no pain or discomfort. This is why the disease is nicknamed the “sneak thief of sight”.
An acute type of glaucoma, called angle-closure glaucoma, can present sudden symptoms such as foggy, blurred vision, halos around lights, eye pain, headache and even nausea. This is a medical emergency and should be assessed immediately as the intraocular pressure can become extremely high and cause permanent damage within hours.
Types of Glaucoma
The primary forms of glaucoma are open-angle and narrow-angle, with open-angle being the most common type.
Primary open-angle glaucoma (POAG)
POAG gradually progresses without pain or noticeable vision loss initially affecting peripheral vision. By the time visual symptoms appear, irreparable damage has usually occurred, however, the sooner treatment starts the more vision loss can be prevented. When untreated, vision loss will eventually result in total loss of side vision (or tunnel vision) and eventually total vision loss.
Normal-tension glaucoma or low-tension glaucoma
This is another form of open-angle glaucoma in which the intraocular pressure remains within the normal level. The cause of this form of glaucoma is not known, but it is believed to have something to do with insufficient blood flow to the optic nerve, causing damage. Individuals of Japanese descent, women and those with a history of vascular disease or low blood pressure are at higher risk.
Acute angle-closure glaucoma is marked by a sudden increase in eye pressure, which can cause severe pain, blurred vision, halos, nausea, and headaches. The pressure is caused by a blockage in the fluid at the front of the eye which is a medical emergency and should be treated immediately. Without prompt treatment to clear the blockage vision can be permanently lost.
The inherited form of the disease that is present at birth. In these cases, babies are born with a defect that slows the normal drainage of fluid out of the eye; they are usually diagnosed by the time they turn one. There are typically some noticeable symptoms such as excessive tearing, cloudiness or haziness of the eyes, large or protruding eyes or light sensitivity. Surgery is usually performed, with a very high success rate, to restore full vision.
Glaucoma can develop as a complication of eye surgeries, injuries or other medical conditions such as cataracts, tumors, or a condition called uveitis which causes inflammation. Uncontrolled high blood pressure or diabetes can result in another serious form called neovascular glaucoma.
A rare form of glaucoma, this occurs when pigment from the iris sheds and clogs the drainage of fluid from the eye resulting in inflammation and damage to the eye and drainage system.
Treatment of glaucoma is dependent upon the severity and type of glaucoma present.
Glaucoma Diagnosis and Treatment
During all routine eye examinations Drs. Cauchi and Peters will perform a test called tonometry which allows us to measure the pressure inside the eye, a screening visual field test and directly view the optic nerve in each eye to check for damage from glaucoma. If these test reveal a suspicion that you may have early glaucoma, we will schedule a follow up examination to perform additional additional tests. These tests include the use of sophisticated imaging technology, such as optical coherence tomography (OCT), digital retinal stereo photos, and threshold visual field testing. If these tests confirm a diagnosis of glaucoma, you will be referred for treatment.
Dr. Peters is licensed by the State of California to manage and treat glaucoma. If the diagnosis of glaucoma in confirmed, she will establish baseline images and measurements of the eye’s optic nerve and internal structures and function. Then she will begin treatment by prescribing eye drops to lower the eye’s pressure. At specified intervals, additional images and measurements will be taken to make sure no changes have occurred over time that might indicate progressive glaucoma damage. Further treatment can involve referral for glaucoma surgery depending on the severity.
Because glaucoma often is painless, people may become careless about strict use of eye drops that can control eye pressure and help prevent permanent eye damage. In fact, non-compliance with a program of prescribed glaucoma medication is a major reason for blindness caused by glaucoma. Most glaucoma can be controlled over a person’s lifetime in order to prevent an end result of blindness.
Can you reduce your risk for glaucoma? First of all, don’t smoke. If you do, quit! We think that the chemicals in cigarettes can be toxic to the delicate structures in the optic nerve. Engage in regular exercise that increases your heart rate. According to a recent European study, exercise increases cardiovascular health which may lower your risk. Maintaining a healthy weight, and eating a varied and healthy diet can also lower your risk.
Vision Solutions has the experience and equipment necessary to diagnose and often treat glaucoma. For more information please schedule an appointment with your eye care provider, and we will be in touch with you shortly.