Dealing with Glaucoma

Defining Glaucoma

There are at least 4 million Americans who risk losing their vision with fully half of them suffering form glaucoma, a leading trigger to irreversible blindness. The sad part is that they are not even aware they face the risk until the diagnosis is too late to reverse their condition. Medical experts are one in saying that if you wait for a glaucoma symptom to appear, such as loss of peripheral vision or reduced visual acuity, you’re already in the late stages of the disorder.

Simply put, glaucoma is an eye disorder that disables the optic nerve and causes irreversible blindness.  The condition can be progressive as in the case of open-angle glaucoma where intraocular pressure builds up over time to progressively damage the optic nerve.  This is the more common glaucoma that afflicts 90% of Americans suffering with it.  The other is closed-glaucoma that is a sudden blockage of the eye’s drainage systems to cause intraocular pressure to increase suddenly, damage the optic nerve and cause complete blindness in 24 to 48 hours.

Symptoms to Watch For

While it may be too late to reverse the onset of open-angle glaucoma once symptoms appear, you can still do something to prevent it for getting into a stage of absolute glaucoma or total blindness. There are just two symptoms to look out for.  One is loss of side or peripheral vision. The condition could have started years ago starting with a progressive increase in intraocular pressure that weakens the optic nerve.   On the other hand, closed angle glaucoma manifests in a pained, swollen and reddened eye that often comes with nausea, decreased vision with halos around lights. This is considered a medical emergency and you have no time to lose in getting to a hospital or your doctor. 

Diagnosing the Condition

A diagnosis will subject the affected eye to a thorough eye dilation exam or ophthalmoscopy to determine the degree of damage to the optic nerve.  The doctor or ophthalmologist places a few drops on your affected eye to dilate your pupils through which the condition of the optic never can be seen with the aid of special instruments. In addition, a tonometer, most commonly an applanation tonometer, will gauge the fluid pressure in your eye. 

A more recent test is pachymetry which measures the thickness of the cornea after the eye surface is numbed with anesthetic drops.  Studies have shown a causal link between intraocular pressures and corneal thickness.  Thin corneas can increase the risk of glaucoma.  In addition, an anesthetized eyeball can also lend to a Gonisocopy where a special contact lens with mirrors that penetrate the eye that allows the doctor to examine the fluid drainage angle and are of the eye. It also determines the presence of blocked blood vessel that block the drainage of aqueous fluid from exiting the eye.

Patients will also be checked with a computerized visual field testing that maps out the visual fields to determine signs and degree of glaucomatous damage to the optic nerve by gauging peripheral vision losses, unless central vision has already been affected. 

The doctor may also check your medical background as some people are more at risk for glaucoma than others. Diabetics and those undergoing prolonged steroid and cyclosporine medication are known to have high risk to secondary glaucomas.  It is also interesting to note that  African Americans are 3-4 times for susceptible to it starting at 45 and older, Hispanics 65 and older.  In addition, patients with a family history of glaucoma also are at risk.

Medicating Glaucoma

While optic nerve damage in glaucoma cannot be revered, the progress can be halted in its tracks and controlled. Patients are generally administered with prescriptive medication, surgery or both. Medication is commonly in the form of glaucoma drops meant to reduce aqueous fluid production or increase drainage to lower intraocular pressure. There are various drops and each has its own benefits and potential side effects and your doctor can prescribe the right one for you.

There are several forms of conventional and laser surgical procedures meant to drain out the eye fluids by widening the drainage system or creating new vents through which the aqueous humour can escape. The most common is trabeculectormy which can be done with lasers or traditional method to remove a clogged trabecular meshwork in the eye to crate an opening or drainage pathway. There’s also laser iridotomy and laser trabeculoplasty. Laser cyclo-ablation is one form of laser surgery reserved to patients with severe glaucoma or when other traditional solutions have failed.  It involves laser burns to freeze the ciliary body that produces aqueous fluid.

Regardless of the stage at which glaucoma is determined, careful management of the condition is imperative to save whatever is left in one’s visual ability.