Glaucoma is actually a category of eye disorders involving an increase of intraocular (internal) eye pressure. Pressure builds because the eye is producing too much fluid or the fluid is not adequately draining. This pressure damages the eye’s optic nerve (structure that transmits visual information from the eye to the brain).

Glaucoma is the second leading cause of blindness in the United States.  Cases of the disease are expected to increase due to an aging population.

Often called the silent thief of sight, most glaucoma sufferers are unaware that they have the condition. Glaucoma can be painless and develop over time. Loss of peripheral vision can be the only noticeable symptom. Unfortunately, permanent damage usually occurs before symptoms are noticed.

Types of Glaucoma

The two major categories of glaucoma are chronic and acute. Chronic glaucoma is referred to as primary open-angle glaucoma and acute is referred to as angle-closure glaucoma.

Angle (referenced in both conditions) pertains to the structure inside the eye that is responsible for fluid drainage.

Primary Open-Angle Glaucoma (POAG)

With POAG, normal or low tension or pressure is present and pain and damage to the optic nerves is not experienced until the end phase of the condition. A gradual loss of peripheral vision is usually the only symptom noticed with POAG.  If internal eye pressure is allowed to remain high, the optic nerve is so destroyed that only limited tunnel vision remains.

Acute Angle-Closure Glaucoma

Angle-closure or narrow angle glaucoma produces a sudden onset of symptoms including eye pain, headaches, nausea, vomiting, ghost or halos vision, dilated pupils, red eyes and even vision loss. Symptoms may last for hours, subside and then reappear. Each attack causes significant damage to the optical nerve and some loss of vision

While chronic and acute glaucoma are the most common, the disorder can be due to other conditions including:

Congenital glaucoma

This is a congenital defect in the eye’s drainage system that is present at birth and usually diagnosed by age one. Because children cannot communicate any associated problems, you should take note of clouding in the eye or enlargement or protrusions of the eyes. Early eye exams will help detect this condition.

Pigmentary Glaucoma

When pigment from the iris gets in the angles of the eye, it blocks the drainage and causes inflammation. Symptoms include mild pain and blurred vision especially after physical activity. This type of glaucoma is rare.

Secondary Glaucoma

Secondary glaucoma develops after an eye trauma, infection, inflammation, tumor or enlarged cataract.  Pay attention to subtle symptoms experienced after such events and seek medical care as necessary.

Causes of Glaucoma

Generally, glaucoma is due to pressure in fluid buildup caused by a lack of balance between the amount of fluid needed to sustain vision health and the amount of fluid that must be released.  Poor blood flow to the optic nerve is a suspected cause of normal-tension glaucoma. Additional causes include:

  • Eye trauma
  • Eye infections
  • Blocked fluid drainage
  • Birth defects
  • Inherited risks of elevated intraocular pressure
  • Advanced age
  • Abnormalities in the optic nerve

Signs and Symptoms

Your symptoms will be related to the type of glaucoma that you have. Because POAG must progress to a destructive point to be apparent, regular eye exams are critical to avoid vision loss due to the disorder. You should also seek a consultation or immediate care if you experience any of the following:

  • Loss of or decreased peripheral vision
  • Changes in peripheral vision especially with eye pain or headaches
  • Eye pain accompanied by headaches, migraines, nausea or vomiting
  • Ghost or halos vision
  • Dilated pupils, red eyes or blurred vision accompanied by headaches, migraines, nausea or vomiting

If you suffer an angle closure attack as described above, contact our office immediately or go to your nearest emergency hospital.

Treatment Options

Glaucoma can be detected during an eye exam.  Because your symptoms may not be noticeable until significant damage is done or because they may come on suddenly, your best protection is routine eye exams.

Treatment for glaucoma is dependent on its severity and can include:

  • Medicated eye drops to lower pressure in the eye
  • Certain medications to lower pressure
  • Surgery (either convention or laser) to decrease production of the intraocular fluid and/or increase fluid drainage
  • Laser surgery
  • Combination of the above treatments

Early diagnosis is key to prevent glaucoma related vision loss. If you have missed your routine eye exam, are experiencing changes in your peripheral vision or other vision problems, call our office at 425.822.825 to schedule an appointment.