"I hadn't noticed any problems with my vision, so I wasn't worried when my optometrist suspected glaucoma. I was shocked when glaucoma was diagnosed!" It is a common misconception that no symptoms of a vision problem means there is no problem. In developed countries over half of people with glaucoma don't know that they have it, and this number is probably considerably higher in underdeveloped countries. There is no cure for glaucoma and vision lost cannot be restored, but if detected and treated early the progression can be slowed and sometimes even stopped. Regular eye examinations are the key!
Glaucoma is a group of eye diseases that cause progressive damage of the optic nerve at the point where it leaves the eye to carry visual information to the brain. If left untreated, most types of glaucoma progress without warning nor obvious symptoms towards gradually worsening visual damage and may lead to blindness. This is the reason that glaucoma is described as the "sneak thief of sight". Vision loss usually affects peripheral vision first. Later, it will affect central vision, which is necessary for seeing objects clearly and for common daily tasks like reading and driving.
The eyes constantly produce aqueous humor, a clear fluid which circulates in the front part of the eyes. As new aqueous flows into the eyes, the same amount should drain out through an area called the drainage angle. This process keeps intraocular pressure (IOP) in the eyes stable. But if the drainage angle is not functioning effectively, fluid builds up and pressure inside the eye rises, damaging the optic nerve. As nerve fibers degenerate, blind spots develop in the vision. These blind spots may not be noticed until the disease has progressed and a significant amount of vision has been lost.
There are several types of glaucoma. Some may occur as a complication of other visual disorders, "secondary" glaucoma, but the vast majority is "primary". Primary open-angle glaucoma is the most common type and is typically due to inadequate drainage of fluid resulting in increased intraocular pressure. With this type of glaucoma there are no obvious symptoms or changes to vision at first. As it progresses, visual symptoms may include needing more light, blurry vision, sensitivity to glare, difficulty differentiating contrast and colours, and reduced peripheral vision. One person described it as "looking through dirty glasses".
Angle-closure glaucoma (also called closed-angle glaucoma or narrow-angle glaucoma) is an acute condition which occurs when the drainage angle becomes completely blocked and eye pressure rises very rapidly. Symptoms include sudden decreased or blurred vision, severe eye pain, eye redness, headache, nausea and halos around lights. This is a medical emergency and needs immediate treatment.
People with ocular hypertension have no signs of optic nerve damage but have higher than normal eye pressure. They are considered "glaucoma suspects" and have an increased risk of eventually developing glaucoma. Some people are considered glaucoma suspects even if their eye pressure is normal, because they may show signs such as blind spots or optic nerve damage that could indicate glaucoma. Like a person who has been diagnosed with glaucoma, a glaucoma suspect needs to be regularly monitored for visual changes over time.
Congenital glaucoma is a rare condition that develops in infants or young children or can be present at birth. As with the other types of glaucoma, the earlier it is detected and treated, the better the prognosis and less devastating the effects will be.
Anyone can develop glaucoma, but certain people have a higher risk. These include adults over the age of 40, certain ethnic groups, a high degree of shortsightedness or farsightedness, diabetes, long-term use of steroid medications and eye trauma. Family history is a risk factor that should prompt people to schedule an eye examination. "In my case glaucoma was hereditary. My mother had it, her mother had it and so did my great-grandmother. Knowing the risk, I wish I had seen my optometrist earlier than I did."
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The only sure way to diagnose glaucoma is with a complete eye examination. The earlier it is diagnosed and treatment begins, the better the prognosis. Glaucoma damage is permanent, it cannot be reversed, but treatment generally helps to slow down or stop further damage. Most types of glaucoma are chronic, which means long-term life-long treatment is prescribed. It may be treated with eye drops, oral medicine or surgery, or a combination. Used every day, the eye drops lower eye pressure. Some do this by reducing the amount of aqueous fluid the eye produces, while others reduce pressure by helping fluid flow better through the drainage angle. If eye drops or oral medication are unsuccessful, surgery may be performed to help lower the pressure in the eyes. |
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"I knew I had a lifetime of treatment and medication, but I realised my attitude would make a difference." Treating glaucoma successfully is a team effort between patient and doctor. Your ophthalmologist will prescribe your glaucoma treatment. It is up to you to be part of the treatment process. Use your eye drops as prescribed and be responsible about scheduling appointments with your optometrist to monitor your eye health. "I haven't overcome glaucoma yet, but nor has it overcome me - nor will it. My one great hope is that through scientific research someone will find a lasting cure for this malignant condition." |