Glaucoma Treatment

Glaucoma is a leading cause of blindness, affecting more than three million Americans. Often called the “sneak thief” of sight, glaucoma includes more than 30 different eye diseases that damage the optic nerve, often silently.T

Many patients do not notice symptoms until significant vision loss has occurred. Early diagnosis is crucial, as timely treatment can control the disease and prevent permanent vision loss.

What Causes Glaucoma?

Glaucoma usually occurs when intraocular pressure (IOP)—the pressure inside the eye—rises. Normally, aqueous humor fluid flows in and out of the eye to maintain healthy pressure. When drainage is blocked or reduced, fluid builds up, damaging the optic nerve, which transmits visual signals from the eye to the brain. The specific cause and progression depend on the type of glaucoma.

Symptoms of Glaucoma

Most forms of glaucoma are asymptomatic, meaning there are no noticeable warning signs. By the time vision changes occur, the disease may already be advanced.

Chronic Glaucoma: Develops slowly; peripheral vision loss often goes unnoticed.
Acute Glaucoma (Acute Angle Closure): Rapid pressure increase can cause:
Blurred vision, especially at night
Halos or rainbows around lights
Severe headaches or eye pain
Nausea

Because early symptoms are rare, regular eye exams every 1–2 years are essential, particularly for high-risk individuals.

Common Types of Glaucoma

Acute Angle Closure Glaucoma: Sudden blockage of the eye’s drainage angle, causing rapid pressure increase.
Primary Angle Closure Glaucoma: Slow obstruction of the drainage angle by the iris.
Primary Open Angle Glaucoma: Drainage angle is open, but fluid drains inefficiently for unknown reasons.
Pseudoexfoliation Glaucoma: Fibrillary deposits block fluid outflow.
Pigmentary Glaucoma: Pigment from the iris obstructs drainage structures.
Angle Recession Glaucoma: Trauma-induced scarring blocks fluid outflow.
Neovascular Glaucoma: Abnormal blood vessel growth obstructs drainage.
Normal Tension Glaucoma: Optic nerve damage occurs despite normal eye pressure.
Childhood or Pediatric Glaucoma: Congenital forms affecting infants and young children.

Risk Factors

While most common in adults over 40, glaucoma risk is influenced by genetics, ethnicity, and other health factors:

Age over 60
Family history of glaucoma or elevated eye pressure
African-American over 40
Diabetes or hypertension
Severe nearsightedness or farsightedness
Use of steroids
Eye injuries
Asian or Hispanic (over 60)

Early Detection at Bascom Palmer Eye Institute

Early diagnosis is key to preventing vision loss. Bascom Palmer specialists use comprehensive, non-invasive testing, including:

Tonometry: Measures intraocular pressure.
Visual Field Testing: Detects peripheral vision loss.
Spectral Domain OCT: High-resolution imaging of the retinal nerve fiber layer to monitor optic nerve health.
Pachymetry: Measures corneal thickness, which can influence eye pressure readings.
Gonioscopy: Examines the drainage angle in the eye.

Glaucoma Treatments

Medications

Eye Drops: Reduce eye pressure by decreasing fluid production or increasing outflow. Classes include beta-blockers, prostaglandin analogues, alpha-adrenergic agonists, miotics, Rho kinase inhibitors, and carbonic anhydrase inhibitors.
Oral Medications: Also reduce intraocular pressure when drops are insufficient.

Laser Therapy

Opens clogged drainage channels using a focused laser beam. Outpatient procedure with rapid recovery.

Surgery

Filtering Surgery: Creates a new fluid drainage pathway for cases uncontrolled by medication or laser therapy.
Implant Surgery: Tiny drainage devices (“aqueous shunts”) help maintain surgical openings.
MIGS (Minimally Invasive Glaucoma Surgery): Uses microscopic equipment to lower eye pressure with smaller incisions and faster recovery. Indicated for certain glaucoma types.

Bascom Palmer Eye Institute combines advanced diagnostics, cutting-edge treatments, and expert care to preserve vision and improve quality of life for patients with glaucoma.

FAQ

What exactly is glaucoma, and why is it called the 'silent thief of sight'?

Glaucoma is a group of eye conditions that damage the optic nerve, often due to high pressure inside the eye, leading to gradual vision loss. It’s ‘silent’ because it has no early symptoms—peripheral (side) vision fades first without pain. Risk factors include age over 60, family history, or diabetes, affecting millions worldwide.

How is glaucoma diagnosed?

Diagnosis involves a comprehensive eye exam with tonometry (pressure check), visual field testing (to map side vision), and optic nerve imaging like OCT scans. It’s quick and painless, often during routine visits. Early detection is key since damage is irreversible, but treatment can halt progression.

What are the main treatment options for glaucoma?

Treatments aim to lower eye pressure: eye drops (most common, daily use to improve fluid drainage), laser therapy (like trabeculoplasty to open drain channels), or surgery (trabeculectomy creates a new drainage pathway). Your doctor tailors based on type—open-angle (slow) or angle-closure (sudden emergency).

Do glaucoma treatments have side effects?

Eye drops might cause stinging, blurred vision, or lash growth; lasers are quick with minimal downtime but rare inflammation; surgery risks include infection or temporary pressure spikes. Most side effects are mild and manageable—sticking to your regimen prevents vision loss, which is the biggest risk of untreated glaucoma.

Can lifestyle changes help manage glaucoma?

Yes, while meds are essential, eating a heart-healthy diet (leafy greens for antioxidants), exercising moderately (to lower pressure), and avoiding heavy caffeine or steroids help. Regular check-ups, even if pressure is controlled, monitor nerve health. Quitting smoking also reduces risk.