What is glaucoma?

Glaucoma is a disease of the eye’s optic nerve. The optic nerve is the cable connecting the eye where light is converted to electric signals and sent to your brain where images are created. Glaucoma is usually a slow process of destruction of the nerve fibers in the optic nerve causing a gradual decease in vision.

What causes Glaucoma?

There are numerous risk factors that can lead to glaucoma. One of the most important is high eye pressure. The pressure in your eye can be high without causing any symptoms. For this reason, glaucoma is best to be diagnosed before it starts causing symptoms of decreased vision. By then, it would be very advanced. The only way to do this is to have routine eye exams every year or two. Occasionally the pressure can rise quickly as in angle closure glaucoma causing pain. Without immediate laser treatment or surgery, this can rapidly lead to blindness. Sometimes the pressure does not need to be very high to cause glaucoma. This is what is called normal pressure glaucoma and I see this in about 30% of all glaucoma cases. Other factors also play a role such as family history, race, increased cupping of the optic nerve, and thin corneas. The cornea is the clear structure, like a watch crystal, over the colored part of the eye. There is no correlation between high eye pressure and high blood pressure. It is very possible to have glaucoma and normal blood pressure. In fact, abnormally low blood pressure may even be a risk factor for glaucoma.

How is glaucoma diagnosed?

Aside from measuring the eye pressure, the are several specialized tests used to determine if you have glaucoma. These include computerized visual field testing, optical coherence tomography (OCT) of the nerve fiber layer, ultrasound thickness measurements of the cornea, and analysis of the filtering area of the eye where fluid is filtered out of the eye. These tests are all performed in my office. I will use my training and experience in interpreting these tests to decide if you have glaucoma.

Sometimes patients may have some risks factors but no true evidence of glaucoma. Most of these patients will be closely followed without treatment. But if the eye pressure becomes significantly high, treatment would be recommended before visual loss occurs’

What is the treatment of glaucoma?

The mainstay of treatment is the reduction of pressure in the eye. This can usually be accomplished with the use of drops. The use of drops can be augmented and sometimes replaced with the use of specialized laser treatments. For certain types of glaucoma, laser treatment is used as the initial treatment. I will discuss these treatment modalities with you. I have had great success in treating about 98-99% of glaucoma with just drops and laser. In 1-2% of patients, eye surgery is necessary. If there is a cataract obscuring vision, the cataract surgery itself will help reduce the eye pressure.