Glaucoma

Description

Glaucoma is a common eye condition in which vision is lost because of damage to the optic nerve. The optic nerve carries information about vision from the eye to the brain. In most cases, the optic nerve is damaged when the pressure of fluid inside the front part of the eye rises. However, glaucoma-related eye damage can occur even when the fluid pressure is normal.
In the most common form of glaucoma, called primary open angle glaucoma, fluid circulates freely in the eye and the pressure tends to rise slowly over time. Gradual loss of vision is usually the only symptom.

Glaucoma is one of the leading causes of blindness for people over the age of 60. It can occur at any age but is more common in older adults.
Most people with glaucoma have no early symptoms or pain. Visit your eye doctor regularly so they can diagnose and treat glaucoma before you have long-term vision loss.
If you lose vision, it can’t be brought back. But lowering eye pressure can help you keep the sight you have. Most people with glaucoma who follow their treatment plan and have regular eye exams are able to keep their vision.

Many forms of glaucoma have no warning signs. The effect is so gradual that you may not notice a change in vision until the condition is at an advanced stage.
Because vision loss due to glaucoma can’t be recovered, it’s important to have regular eye exams that include measurements of your eye pressure so a diagnosis can be made in its early stages and treated appropriately. If glaucoma is recognized early, vision loss can be slowed or prevented. If you have the condition, you’ll generally need treatment for the rest of your life.
Types
There are many different types of glaucoma, but the most common type in the United States is called open-angle glaucoma — that’s what most people mean when they talk about glaucoma. Other types of glaucoma are less common, like angle-closure glaucoma and congenital glaucoma.
Symptoms
The signs and symptoms of glaucoma vary depending on the type and stage of your condition. For example:
Open-angle glaucoma
• Patchy blind spots in your side (peripheral) or central vision, frequently in both eyes
• Tunnel vision in the advanced stages
Acute angle-closure glaucoma
• Severe headache
• Eye pain
• Nausea and vomiting
• Blurred vision
• Halos around lights
• Eye redness
Causes
Scientists aren’t sure what causes the most common types of glaucoma, but many people with glaucoma have high eye pressure (intraocular pressure) — and treatments that lower eye pressure help to slow the disease.
Less-common causes of glaucoma include a blunt or chemical injury to your eye, severe eye infection, blocked blood vessels inside your eye, and inflammatory conditions. It’s rare, but eye surgery to correct another condition can sometimes bring it on. It usually affects both eyes, but it may be worse in one than the other.
Diagnosis
Eye doctors can check for glaucoma as part of a comprehensive dilated eye exam. The exam is simple and painless — your doctor will give you some eye drops to dilate (widen) your pupil and then check your eyes for glaucoma and other eye problems. The exam includes a visual field test to check your peripheral (side) vision.

Your doctor will review your medical history and conduct a comprehensive eye examination. He or she may perform several tests, including:
• Measuring intraocular pressure (tonometry)
• Testing for optic nerve damage with a dilated eye examination and imaging tests
• Checking for areas of vision loss (visual field test)
• Measuring corneal thickness (pachymetry)
• Inspecting the drainage angle (gonioscopy)

Treatment

Doctors use a few different types of treatment for glaucoma, including medicines (usually eye drops), laser treatment, and surgery.
If you have glaucoma, it’s important to start treatment right away. While it won’t undo any damage to your vision, treatment can stop it from getting worse
Medicines. Prescription eye drops are the most common treatment. They lower the pressure in your eye and prevent damage to your optic nerve.
Laser treatment. To lower pressure in your eye, doctors can use lasers to help the fluid drain out of your eye. It’s a simple procedure that your doctor can do in the office.
Surgery. If medicines and laser treatment don’t work, your doctor might suggest surgery. There are several different types of surgery that can help the fluid drain out of your eye.

Prevention
These self-care steps can help you detect glaucoma in its early stages, which is important in preventing vision loss or slowing its progress.
• Get regular dilated eye examinations. Regular comprehensive eye exams can help detect glaucoma in its early stages, before significant damage occurs. As a general rule, the American Academy of Ophthalmology recommends having a comprehensive eye exam every five to 10 years if you’re under 40 years old; every two to four years if you’re 40 to 54 years old; every one to three years if you’re 55 to 64 years old; and every one to two years if you’re older than 65. If you’re at risk of glaucoma, you’ll need more frequent screening. Ask your doctor to recommend the right screening schedule for you.
• Know your family’s eye health history. Glaucoma tends to run in families. If you’re at increased risk, you may need more frequent screening.
• Exercise safely. Regular, moderate exercise may help prevent glaucoma by reducing eye pressure. Talk with your doctor about an appropriate exercise program.
• Sip fluids frequently. Drink only moderate amounts of fluids at any given time during the course of a day. Drinking a quart or more of any liquid within a short time may temporarily increase eye pressure.
• Sleep with your head elevated. Using a wedge pillow that keeps your head slightly raised, about 20 degrees, has been shown to reduce intraocular pressure while you sleep.
• Take prescribed medicine. Using your eyedrops or other medications as prescribed can help you get the best possible result from your treatment. Be sure to use the drops exactly as prescribed. Otherwise, your optic nerve damage could

worsen.

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