Important Information About Glaucoma You Should Know

Glaucoma, also called the “sneak thief of sight,” is a serious eye disease that can cause permanent blindness if not diagnosed and treated in time. In honor of National Glaucoma Awareness Month every January, we would like to share some very important information about glaucoma that you will benefit from knowing. 

Approximately three million people in the United States have some type of glaucoma eye disease. Based on available data, the National Eye Institute projects this number to climb to approximately 4.2 million people by the year 2030.

This important information about glaucoma is for informational purposes. If you suspect you have any of the symptoms of eye glaucoma, we recommend immediately scheduling an appointment with your trusted eye care provider. Let’s start with some basic facts about glaucoma.

Important Facts About Glaucoma

Photograph showing acute angle-closure glaucoma which is a sudden elevation in intraocular pressure that occurs when the iris blocks the eye’s drainage channel—the trabecular meshwork. Image taken by Jonathan Trobe, M.D.

Some basic facts about glaucoma:

• Only about 50% of the 3 million Americans with glaucoma get diagnosed
• Higher rates among people of African-American, Asian or Latino/Hispanic heritage
• African-Americans are 5x more likely to get glaucoma and 6x more likely to go blind
• Up to 40% of sight can be lost before glaucoma is diagnosed
• If undiagnosed and treated, glaucoma can cause permanent blindness

What are the Causes of Glaucoma?

At the present time, the causes of glaucoma are still a mystery. Although pressure on the optic nerve (also called “ocular hypertension”) is considered to be a significant risk factor, even people whose eye pressure is well within the “normal” range get glaucoma too. 

Genetic disposition might explain the disproportionately high rate of glaucoma in people with East Asian, Central/South American and African-American heritage. However, at this time researchers still cannot say with any certainty.

Glaucoma Risk Factors

Although the exact cause of glaucoma remains a mystery, we have identified several glaucoma risk factors. Glaucoma risk factors include:

• Age (40+)
• Family history
• Previous eye injury
• Far or near-oriented eyesight
• Use of steroid-based medication
• Diabetes, high blood pressure/hypertension, poor circulation

The Symptoms of Eye Glaucoma

There are two primary types of age-related Macular Degeneration: Wet Form and Dry Form. By performing a retinal eye scan, your optometrist can detect both forms.

Normal Field of Vision

Field of Vision with Advanced Glaucoma

The symptoms of Glaucoma range significantly depending on the type of glaucoma someone suffers from. Some people do not experience any of the symptoms of eye glaucoma until significant vision loss occurs. For other people, the symptoms of eye glaucoma are very hard to ignore. These symptoms can include:

• Vision becomes blurry
• The eyes redden permanently 
• Sensitivity to light and/or soreness of the eyes
• Lights appear to have “halos” around them
• Sudden onset of visual disturbance, especially in low light
• Severe eye pain accompanied by nausea and vomiting
• Tunnel vision (toward the later stages of the disease)

It is very important to understand that the symptoms of eye glaucoma can also be caused by other types of diseases and illnesses too. If you have ANY of these symptoms, regardless of severity, we urge you to immediately contact and schedule an appointment with your trusted eye care professional.

The Different Types of Glaucoma Eye Disease

Acute angle closure glaucoma of the right eye (intraocular pressure was 42 in the right eye). Note the mid sized pupil on the left that was not reactive to light and conjunctivitis. Photo taken by James Heilman, MD. 

There are several differing types of glaucoma eye disease:

• Low or Normal Tension Glaucoma is still a mystery
• Open-Angle Glaucoma (most common) occurs when fluid from the eye passes too slowly for too long through the open drainage “channel” where the iris and cornea meet
• Angle-Closure Glaucoma (less common) occurs when the drainage angle closes because part of the iris is blocking it
• Congenital Glaucoma occurs at birth, is generally easily diagnosable, and with surgery children can have a good prognosis for vision health in life
• Pigmentary Glaucoma (rare) is a complication of pigment dispersion syndrome, which occurs when pigment granules from the iris flake off into eye fluid
• Traumatic Glaucoma is the result of injury to the eye by blunt trauma, flying debris and/or bleeding

Additionally, two different types of glaucoma eye disease can occur as the byproduct of associated medical conditions:

• IridoCorneal Endothelial Syndrome (ICE) occurs when cells on the back of the cornea cover drainage tissue in the eye, which blocks canals and causes pressure buildup
• Uveitic Glaucoma is inflammation caused by an obstruction in the uvea, which is located underneath the “white.” Approximately 20% of people suffering from this inflammation develop glaucoma.

How is Glaucoma Diagnosed?

Optic nerve in advanced glaucoma disease by (image courtesy Snoop at German Wikimedia Commons)

The American Association of Ophthalmology recommendation is that every person gets (at least) a basic eye exam by the time they are 40 years old. If you have any eye disease risk factors, like diabetes or high blood pressure, we recommend having eye exams performed regularly and/or beginning at a younger age. You can also get glaucoma diagnosed through one of the following testing methods:

• Tonometry measures pressure inside the eye
• Gonioscopy examines the eye’s drainage angle
• Perimetry measures peripheral and central vision
• Visual field test (applicable in later stages)

The Best Treatment for Glaucoma

Unfortunately, nerve and vision damage caused by glaucoma are irreversible. But hope does exist to treat this very serious eye disease. The best treatment for glaucoma eye disease depends on the severity of the condition when it is diagnosed. Your doctor will determine the best treatment for glaucoma based on your symptoms, and the disease’s progression. Treatments for glaucoma can include:

• Eye drops to help lower pressure by helping drain fluid buildup or reduce amount
• Argon laser trabeculoplasty (ALT) is a surgical procedure that can temporarily treat open angle glaucoma 
• A Canaloplasty uses a microcatheter to open the eye canal to allow for temporary drainage and pressure relief
• Trabeculectomy is conventional surgery that makes a partial flap in the scleral wall of the eye for temporary drainage and pressure relief
• Glaucoma drainage implants use flow tubes and plates inserted in the eye’s anterior chamber for drainage and pressure relief
• Non-Penetrating Deep Sclerectomy (NPDS), which is similar to a trabeculectomy but has fewer side effects

If you are diagnosed, your doctor will discuss the best treatment option for glaucoma eye disease with you. We strongly recommend asking questions and taking notes during the consultation so that you are fully aware of your diagnosis and treatment options.

The Best Natural Treatment for Glaucoma

Many of our patients are just as health conscious about their eyes as they are about the rest of their bodies. We love that! As a result, we often field questions about the best natural treatment for glaucoma. According to the Mayo Clinic in Scottsdale, there are several ways you can help control high eye pressure and promote overall vision health everyday:

• Eating a healthy, balanced diet, including the intake of vitamins and minerals associated with eye health: Zinc, copper, selenium and vitamins A, E and C
• Regular exercise may reduce the eye pressure associated with open-angle glaucoma
• Refraining from caffeine and other stimulants that may increase eye pressure
• Drinking moderate amounts of fluid (versus large amounts) to keep eye pressure lower
• Using a wedge pillow to sleep with an elevated head to reduce intraocular pressure

Although the internet is full of herbal remedies and other forms of alternative medical advice, we strongly recommend consulting your trusted eye care professional before adding any type of alternative protocol to your treatment plan.

The Difference Between Cataracts and Glaucoma

A Cataract Covering an Iris

We often get asked to explain the difference between cataracts and glaucoma, because some of their symptoms are similar. The difference between cataracts and glaucoma is:

• Cataracts occur due to changes in the lens of the eye, resulting in a cloudy film developing over the iris. This can cause vision loss and even blindness if not treated. Surgery can cure cataracts and even improve vision.
• Glaucoma occurs due to a buildup of pressure that damages the optic nerve. This can cause blindness because the optic nerve processes visual information. At this time, treatments may relieve symptoms, but there is no cure for glaucoma.

Finally, it is important to understand that dry eye syndrome can coexist with glaucoma. In fact, approximately 50 – 60% of all glaucoma sufferers also suffer from dry eye syndrome. If you have chronic dry eyes, or any symptoms we’ve discussed, please contact your trusted eye care professional immediately. 

January: National Glaucoma Awareness Month at Tatum Eyecare

Every January is National Glaucoma Awareness Month. On behalf of our friends at Prevent Blindness, we would like to close this article by sharing a few hints people with glaucoma can use to make their doctor’s visits as productive and helpful as possible:

1. Bring a detailed list of any questions you think of in advance, and be sure to take detailed notes
2. Talk to your doctor about how the medications you are taking are making you feel
3. Don’t be afraid to ask for clarification, or for more time to take notes, or to share your fears and/or concerns with your doctor

There are many ways you can live your life to the fullest with a glaucoma diagnosis. If you have any questions, want to get more information about glaucoma eye disease any time of the year, or would like to schedule an eye exam with one of our family optometrists, we welcome you to contact us.