Glaucoma Symptoms & Treatment
Glaucoma is a group of eye conditions that cause damage to your optic nerve, which is vital to you for good vision as it supplies images to the brain. Glaucoma damage is generally caused by abnormally high pressure in the eye and unfortunately, many forms of glaucoma have little to no warning signs. The elevated eye pressure is due to a buildup of a fluid, aqueous humor, that flows throughout the inside of your eye. The effect may be so gradual that you may not notice any change in your day to day vision until the condition has become advanced.
What are common glaucoma symptoms?
There are two primary types of glaucoma: open-angle glaucoma and acute angle-closure glaucoma.
Open-angle glaucoma symptoms include:
Because the loss of vision may not be noticeable, if you have a family history of glaucoma or are over the age of 40, it is recommended you have a yearly eye exam with your eye doctor for overall eye health.
Acute angle-closure glaucoma, also known as closed angle glaucoma, can have the following symptoms:
If left untreated, glaucoma can eventually cause blindness and even with treatment many people still experience loss of vision, or even blindness. If you experience symptoms of acute angle-closure glaucoma, you should promptly visit an ophthalmologist or glaucoma doctor, or proceed to the nearest emergency room.
How do you check for glaucoma?
People frequently ask, how do they test for glaucoma? Can an eye test detect glaucoma? How much does a glaucoma eye exam cost? To diagnose glaucoma, an eye doctor will test your vision and examine your eyes through dilated pupils. This is typically part of a complete eye exam, and if you have a family history of glaucoma insurances may cover it. The exam will also focus on the optic nerve, which has a particular appearance with glaucoma. A complete eye exam for glaucoma should typically include the following eye tests for detection:
TONOMETRY
Tonometry is a test that measures the pressure within the eye. During a tonometry test, eye drops are used to numb the surface of the eye. A doctor or technician then measures the inner pressure by using a device to apply a small amount of pressure to the eye or by a warm puff of air. The typical range for normal pressure is 12-21 mm Hg. The higher the pressure reading the higher your risk for glaucoma may be.
OPHTHALMOSCOPY
People frequently ask, what does glaucoma look like in the eye? Ophthalmoscopy helps the doctor examine the optic nerve for glaucoma damage. Eye drops are used to dilate the pupil so the doctor can see through the eye to examine the shape and color of the optic nerve. The doctor then uses a small device with a light on the end to light and magnify the optic nerve. If your intraocular pressure is not within the typical range and/or if the optic nerve looks unusual, your doctor may perform additional exams.
PERIMETRY
Perimetry is a visual field test that produces a map of your complete field of vision. This test will help a doctor determine whether your vision has been affected by glaucoma. During this test, you are asked to look straight ahead and indicate when a moving light passes into your peripheral, or side vision. This helps draw a map of your vision. If glaucoma has been diagnosed, visual field tests are repeated at future appointments to check for any changes in your vision.
NERVE FIBER LAYER MEASUREMENTS
This test, in combination with visual field examinations, is extremely important in detecting progression of glaucoma. Measurements of the optic nerve fiber layer can often help, along with an ophthalmoscopic exam, to detect very early glaucoma at a point prior to when definitive visual field abnormalities are detected. Initiating treatment in appropriate cases prior to demonstrable visual field damage is very desirable for glaucoma patients. Nerve fiber layer measurements and visual fields together give us the best chance of detecting very early progression, thus reducing the risk of progressive damage to vision.
GONIOSCOPY
This part of your exam helps determine whether the angle where the iris meets the cornea is open and wide or narrow and closed. During the exam, eye drops are used to numb the eye. A hand-held contact lens is gently placed on the eye. This contact lens has a mirror that allows the doctor to determine if the angle between the iris and cornea is closed and blocked or wide and open.
PACHYMETRY
Pachymetry is a simple, painless test to measure the thickness of the cornea – the clear, front of the eye. A probe, called a pachymeter, is gently placed on the front of the eye to measure its thickness. Pachymetry aids in diagnosis because corneal thickness has the potential to influence eye pressure readings. With this measurement, the doctor can better understand your intraocular pressure readings and develop a treatment plan.
Glaucoma Treatment Options: How is glaucoma treated?
Glaucoma is typically treated by lowering your eye pressure, or intraocular pressure. Eye nerve damage caused by glaucoma cannot be reversed, but regular checkups and treatment can help to slow or prevent vision loss, especially if you catch the disease in its early stages. Depending on what you are experiencing, your eye doctor may include prescription eye drops, oral medications, laser treatment, surgery or any combination of these. Glaucoma care is typically a team approach. Preventing eye damage only works if the patient follows the treatment plan at home in-between visits to the doctor. The best treatment for glaucoma should be determined by your eye doctor in consultation with you to determine the best plan for your future.
EYE DROPS FOR GLAUCOMA
Eye drops are often the first step in glaucoma treatments to either reduce the formation of fluid in the front of the eye or increase its outflow. It is very important to carefully follow your eye drop regimen to achieve healthy eye pressure and prevent vision loss. There can be side effects, some glaucoma drugs can affect the heart and lungs. Be sure to tell your doctor about all other medications you are currently taking or are allergic to.
Your glaucoma specialist may try various types and combinations of eye drops to treat your glaucoma. He or she may also recommend laser eye surgery for glaucoma or another glaucoma surgery.
GLAUCOMA ORAL MEDICATIONS
Your glaucoma doctor may also prescribe an oral medication if eyedrops are not able to bring your eye pressure to a desired level. Oral medications can work well to lower eye pressure but carry a greater risk for systemic side effects compared with eye drops. These medications are often utilized if you are suffering a pressure spike, which is a more sudden and profound rise in eye pressure. The most common example of one such medication is acetazolamide, which is a diuretic. The purpose of this medication for glaucoma treatment is to decrease the amount of fluid produced in the eye to lower pressure. Simultaneously, the diuretic effect on the kidneys results in increased urination and overall fluid loss. This can make some people more prone to dehydration, cause changes in your normal electrolyte balance, and result in more frequent trips to the bathroom. An oral medication that is given systemically also has a greater potential to interact with other medications you currently take, so it is important to tell your doctor about all your medications and any medication allergies that are known.
GLAUCOMA SURGERY
Other treatment options for glaucoma may include laser therapy or other options such as a trabeculectomy, or the insertion of a drainage tube. If you are treating acute angle-closure glaucoma, or closed angle glaucoma, it is a medical emergency and you’ll need urgent treatment to reduce the pressure in your eye. This generally will require both medication and surgical procedures such as a laser peripheral iridotomy in which your glaucoma surgeon will create a small opening in your iris using a laser. This allows fluid (aqueous humor) to flow through the eye, relieving the eye pressure. You can find more information about glaucoma surgeries here.
Meet the Glaucoma Experts at Wolfe Eye Clinic
Wolfe Eye Clinic has expertise in evaluating and treating all types of glaucoma in Iowa including glaucoma surgery should it be necessary. Wolfe Eye Clinic offers glaucoma treatment services in the Ames, Ankeny, Cedar Falls, Cedar Rapids, Des Moines, Marshalltown, Ottumwa, Pleasant Hill, and Waterloo areas.
Contact Wolfe Eye Clinic at (833) 474-5850 to schedule an appointment, or fill out our form here, to schedule with one of our glaucoma specialists: Dr. Gregory Christiansen, Dr. Benjamin Mason or Dr. Ryan Vincent.