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Glaucoma

Learn about glaucoma, risk factors, why it is important to manage pressure in the eye, vision damage that can be caused by glaucoma and how Lehigh Valley Health Network eye care professionals can help.

Glaucoma is a potentially blinding disease that typically causes too much pressure in the eyeball. There are no early symptoms, but if detected early, glaucoma can be controlled. Age, race, family history and some medications may increase your risk for developing glaucoma. Higher-risk populations include African Americans older than 40 and Mexican Americans older than 60. Glaucoma is the leading cause of blindness for African Americans.

There are five types of glaucoma, the most common is open-angle glaucoma. In this type, the fluid that normally flows through the pupil into the anterior chamber of the eye cannot get through the filtration area to the drainage canals, causing pressure buildup in the eye. Nearly three million Americans – half of whom do not know they have the disease – are affected by open-angle glaucoma each year.

Other types of glaucoma include:

  • Angle-closure glaucoma – sudden increase in pressure and is a medical emergency.
  • Childhood glaucoma – develops in infancy, early childhood or adolescence
  • Congenital glaucoma – Occurs in children born with defects in the angle of the eye that slows the normal drainage of fluid
  • Secondary glaucoma – Develops as a complication of another medical condition or injury.

Most people who have glaucoma do not notice any symptoms until they begin to lose some vision. As glaucoma damages the optic nerve fibers, small blind spots may begin to develop, usually in the side or peripheral vision. Many people do not notice the blind spots until significant optic nerve damage has already occurred. If the entire nerve is destroyed, blindness results.

It's crucial to see an optometrist or an ophthalmologist every year for an eye examination. The types of vision tests you may have for diabetic retinopathy diagnosis include:

  • Visual acuity test – The common eye chart test, which measures vision ability at various distances
  • Pupil dilation – The pupil is widened with eye drops to allow a close-up examination of the retina.
  • Visual field – Measures side or peripheral vision. Lost peripheral vision may be an indication of glaucoma.
  • Tonometry – In this standard test that measures the pressure inside of the eyes, a machine blows a small amount of air into the eye. The test may feel unusual, but it does not cause pain.

Treatment and next steps

Regular eye exams are the key to detecting glaucoma early enough for successful treatment. It is best to have routine eye checkups every two to four years after age 40 and every one to two years after age 65. Because African Americans have a much higher risk for glaucoma, screening should begin every three to five years from age 20 to 29 and every two to four years after age 30.

While glaucoma cannot be cured, early treatment often can control it. Treatment may include:

  • Prescription eye drops – This is often the first line of treatment to reduce intraocular (in the eye) pressure. Using eye drops as prescribed is very important.
  • Oral medications – If eye drops alone do not bring the intraocular pressure down to the desired level, your doctor may also prescribe oral medications.
  • Surgery – Surgery creates a new opening for fluid to leave the eye.
  • Laser surgery – Several types of surgical procedures can be performed with a laser to treat glaucoma
  • Tube shunt – This is an implantable drainage device that creates an artificial pathway in the eye.
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