Glaucoma is a progressive eye disease that can cause vision loss. Currently affecting around 2% of the U.S. population, glaucoma is the leading cause of blindness among African Americans and the third leading cause among Caucasians. Glaucoma in its various forms causes higher than normal intraocular pressure, created by the intraocular fluid (also known as aqueous humor) filling the inside of the eye. The body continuously produces this fluid essential to eye function and health, while the eye’s natural drainage system normally removes any excess fluid buildup at about an equal rate. If the eye’s natural drains become blocked, however, the buildup of excess fluid leads to an increase in pressure that could over time permanently damage the optic nerve.
TYPES OF GLAUCOMA
There are different types of glaucoma. The most common is open angle glaucoma, usually related to an inherited trait in which the eye’s drainage canals tend to become clogged. Patients with open angle glaucoma usually have little to no symptoms in the early stages of the disease. As it advances, though, a patient may begin noticing vision problems, beginning first with restricted sight in their peripheral or “side” field, a halo effect around bright lights, and a mild aching around the eyes. Another type is acute angle closure glaucoma, caused by structural flaws within the eye (such as a shorter eye length that leaves less space between the iris and the drainage canal) or from the development of cataracts. In these cases the iris or other structures can become pressed against a drain and block it off. Unlike open angle glaucoma, this type of glaucoma can result in a very rapid pressure increase that often causes severe pain. In addition, there are secondary forms of glaucoma caused by other health conditions like diabetes or eye inflammation. Injury to the eye could also damage the natural drainage structures.
Any glaucoma-related vision loss is permanent, so it’s critical to detect elevated intraocular pressure early and take measures to control it for the remainder of a person’s life. Although a patient may not know they have elevated eye pressure, an ophthalmologist or optometrist can perform a simple test during a regular eye exam to detect it.
We recommend everyone over the age of 35 undergo an annual eye exam not only for overall vision health but to detect elevated eye pressure if present. We also encourage exams at any age for patients at high risk for glaucoma, including those with diabetes, extreme near-sightedness, a family history of glaucoma, or who are of African descent.
TREATING AND MANAGING GLAUCOMA
Managing glaucoma requires keeping intraocular pressure at a normal level for the rest of a patient’s life. The most common way and often the first treatment choice is with medicated drops a patient applies to their eyes daily. Depending on the active ingredients, these drops either help the eye drain excess fluid or decrease fluid production.
Eye drops are non-invasive, easy to use and can effectively control pressure for many years. Some patients, however, can develop allergies to the medication, or the drops become less effective over time, leading us to consider other procedures to lower eye pressure. One such common procedure is a trabeculectomy or filter surgery. During this procedure the surgeon removes tissue in the eye interfering with drainage, including part of the eye’s drainage system called the trabecular meshwork, to improve fluid removal. More recently we’ve seen the emergence of minimally (or micro) invasive glaucoma surgeries (MIGS). This new group of procedures include microscopic surgical techniques and specialized medical devices (like iStent®) that help increase fluid drainage, while running a lower risk of scar tissue development than a traditional trabeculectomy. Another new procedure in glaucoma treatment is selective laser trabeculoplasty (SLT) in which an eye surgeon directs laser energy at the eye’s drainage system. Although the exact mechanism isn’t fully understood, it’s believed the quick beam stimulates the release of enzymes to that area of the eye that subsequently improves drainage.
Although glaucoma is incurable, we can minimize its effects and the risks of vision loss with early diagnosis and effective pressure management. To set up a glaucoma screening eye exam, or to learn more about treatment, visit Contact Us or call us at 1-800-624-8254 if you have a specific question. You can also use either method to request an appointment with an HEC professional at one of our convenient Mississippi locations in Hattiesburg, Columbia or Laurel.