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What is glaucoma?
Glaucoma is a group of diseases that can damage the eye's optic nerve
and result in vision loss and blindness. However, with early treatment, you
can often protect your eyes against serious vision loss.
What is the optic nerve?
The optic nerve is a bundle of more than 1 million nerve fibers. It connects
the retina to the brain. (See diagram below.) The retina is the light-sensitive
tissue at the back of the eye. A healthy optic nerve is necessary for good
vision.
How does open-angle glaucoma damage the optic nerve?
Glaucoma is a group of diseases that can damage the eye's optic nerve
and result in vision loss and blindness. However, with early treatment, you
can often protect your eyes against serious vision loss.
What is the optic nerve?
The optic nerve is a bundle of more than 1 million nerve fibers. It connects
the retina to the brain. (See diagram below.) The retina is the light-sensitive
tissue at the back of the eye. A healthy optic nerve is necessary for good
vision.
How does open-angle glaucoma damage the optic nerve?
In the front of the eye
is a space called the
anterior chamber. A
clear fluid flows
continuously in and out
of the chamber and
nourishes nearby
tissues. The fluid
leaves the chamber at
the open angle where
the cornea and iris
meet. (See movie
below.) When the fluid
reaches the angle, it
flows through a spongy
meshwork, like a drain,
and leaves the eye.
is a space called the
anterior chamber. A
clear fluid flows
continuously in and out
of the chamber and
nourishes nearby
tissues. The fluid
leaves the chamber at
the open angle where
the cornea and iris
meet. (See movie
below.) When the fluid
reaches the angle, it
flows through a spongy
meshwork, like a drain,
and leaves the eye.
Illustration by JirehDesign.com
Sometimes, when the
fluid reaches the
angle, it passes too
slowly through the
meshwork drain. As
the fluid builds up, the
pressure inside the
eye rises to a level
that may damage the
optic nerve. When the
optic nerve is
damaged from
increased pressure,
open-angle
glaucoma--and vision
loss--may result.
That's why controlling
pressure inside the
eye is important.
fluid reaches the
angle, it passes too
slowly through the
meshwork drain. As
the fluid builds up, the
pressure inside the
eye rises to a level
that may damage the
optic nerve. When the
optic nerve is
damaged from
increased pressure,
open-angle
glaucoma--and vision
loss--may result.
That's why controlling
pressure inside the
eye is important.
Illustration by JirehDesign.com
Does increased eye pressure mean that I have glaucoma?
Not necessarily. Increased eye pressure means you are at risk for
glaucoma, but does not mean you have the disease. A person has
glaucoma only if the optic nerve is damaged. If you have increased eye
pressure but no damage to the optic nerve, you do not have glaucoma.
However, you are at risk. Follow the advice of your eye care professional.
Can I develop glaucoma if I have increased eye pressure?
Not necessarily. Not every person with increased eye pressure will
develop glaucoma. Some people can tolerate higher eye pressure better
than others. Also, a certain level of eye pressure may be high for one
person but normal for another.
Whether you develop glaucoma depends on the level of pressure your
optic nerve can tolerate without being damaged. This level is different for
each person. That's why a comprehensive dilated eye exam is very
important. It can help your eye care professional determine what level of eye
pressure is normal for you.
Can I develop glaucoma without an increase in my eye
pressure?
Yes. Glaucoma can develop without increased eye pressure. This form of
glaucoma is called low-tension or normal-tension glaucoma. It is not as
common as open-angle glaucoma.
Who is at risk for open-angle glaucoma?
Anyone can develop glaucoma. Some people are at higher risk than
others. They include:
A comprehensive dilated eye exam can reveal more risk factors, such as
high eye pressure, thinness of the cornea, and abnormal optic nerve
anatomy. In some people with certain combinations of these high-risk
factors, medicines in the form of eyedrops reduce the risk of developing
glaucoma by about half.
What are the symptoms of glaucoma?
At first, open-angle glaucoma has no symptoms. It causes no pain. Vision
stays normal.
As glaucoma remains untreated, people may miss objects to the side and
out of the corner of their eye. Without treatment, people with glaucoma will
slowly lose their peripheral (side) vision. They seem to be looking through a
tunnel. Over time, straight-ahead vision may decrease until no visual acuity
remains.
Glaucoma can develop in one or both eyes.
How is glaucoma detected?
Glaucoma is detected through a comprehensive eye exam that includes:
Visual acuity test. This eye chart test measures how well you see at
various distances.
Dilated eye exam. Drops are placed in your eyes to widen, or dilate, the
pupils. Your eye care professional uses a special magnifying lens to
examine your retina and optic nerve for signs of damage and other eye
problems. After the exam, your close-up vision may remain blurred for
several hours.
Tonometry. An instrument (right) measures the pressure inside the eye.
Numbing drops may be applied to your eye for this test.
Pachymetry. A numbing drop is applied to your eye. Your eye care
professional uses an ultrasonic wave instrument to measure the thickness
of your cornea.
Can glaucoma be cured?
No. There is no cure for glaucoma. Vision lost from the disease cannot be
restored.
Can glaucoma be treated?
Yes. Immediate treatment for early stage, open-angle glaucoma can delay
progression of the disease. That's why early diagnosis is very important.
Glaucoma treatments include medicines, laser trabeculoplasty,
conventional surgery, or a combination of any of these. While these
treatments may save remaining vision, they do not improve sight already
lost from glaucoma.
Medicines. Medicines, in the form of eyedrops or pills, are the most
common early treatment for glaucoma. Some medicines cause the eye to
make less fluid. Others lower pressure by helping fluid drain from the eye.
Before you begin glaucoma treatment, tell your eye care professional
about other medicines you may be taking. Sometimes the drops can
interfere with the way other medicines work.
Glaucoma medicines may be taken several times a day. Most people
have no problems. However, some medicines can cause headaches or
other side effects. For example, drops may cause stinging, burning, and
redness in the eyes.
Many drugs are available to treat glaucoma. If you have problems with one
medicine, tell your eye care professional. Treatment with a different dose or
a new drug may be possible.
Because glaucoma often has no symptoms, people may be tempted to
stop taking, or may forget to take, their medicine. You need to use the drops
or pills as long as they help control your eye pressure. Regular use is very
important.
Make sure your eye care professional shows you how to put the drops into
your eye. See tips on using your glaucoma eyedrops.
Laser trabeculoplasty. Laser trabeculoplasty helps fluid drain out of the
eye. Your doctor may suggest this step at any time. In many cases, you
need to keep taking glaucoma drugs after this procedure.
Laser trabeculoplasty is performed in your doctor's office or eye clinic.
Before the surgery, numbing drops will be applied to your eye. As you sit
facing the laser machine, your doctor will hold a special lens to your eye. A
high-intensity beam of light is aimed at the lens and reflected onto the
meshwork inside your eye. You may see flashes of bright green or red light.
The laser makes several evenly spaced burns that stretch the drainage
holes in the meshwork. This allows the fluid to drain better.
Like any surgery, laser surgery can cause side effects, such as
inflammation. Your doctor may give you some drops to take home for any
soreness or inflammation inside the eye. You need to make several
followup visits to have your eye pressure monitored.
If you have glaucoma in both eyes, only one eye will be treated at a time.
Laser treatments for each eye will be scheduled several days to several
weeks apart.
Studies show that laser surgery is very good at reducing the pressure in
some patients. However, its effects can wear off over time. Your doctor may
suggest further treatment.
Conventional surgery. Conventional surgery makes a new opening for the
fluid to leave the eye. (See diagram.) Your doctor may suggest this
treatment at any time. Conventional surgery often is done after medicines
and laser surgery have failed to control pressure.
Conventional surgery is performed in an eye clinic or hospital. Before the
surgery, you will be given medicine to help you relax. Your doctor will make
small injections around the eye to numb it. A small piece of tissue is
removed to create a new channel for the fluid to drain from the eye.
For several weeks after the surgery, you must put drops in the eye to fight
infection and inflammation. These drops will be different from those you
may have been using before surgery.
As with laser surgery, conventional surgery is performed on one eye at a
time. Usually the operations are four to six weeks apart.
Conventional surgery is about 60 to 80 percent effective at lowering eye
pressure. If the new drainage opening narrows, a second operation may be
needed. Conventional surgery works best if you have not had previous eye
surgery, such as a cataract operation.
In some instances, your vision may not be as good as it was before
conventional surgery. Conventional surgery can cause side effects,
including cataract, problems with the cornea, and inflammation or infection
inside the eye. The buildup of fluid in the back of the eye may cause some
patients to see shadows in their vision. If you have any of these problems,
tell your doctor so a treatment plan can be developed.
What are some other forms of glaucoma?
Open-angle glaucoma is the most common form. Some people have
other types of the disease.
In low-tension or normal-tension glaucoma, optic nerve damage and
narrowed side vision occur in people with normal eye pressure. Lowering
eye pressure at least 30 percent through medicines slows the disease in
some people. Glaucoma may worsen in others despite low pressures.
A comprehensive medical history is important in identifying other potential
risk factors, such as low blood pressure, that contribute to low-tension
glaucoma. If no risk factors are identified, the treatment options for low-
tension glaucoma are the same as for open-angle glaucoma.
In angle-closure glaucoma, the fluid at the front of the eye cannot reach
the angle and leave the eye. The angle gets blocked by part of the iris.
People with this type of glaucoma have a sudden increase in eye pressure.
Symptoms include severe pain and nausea, as well as redness of the eye
and blurred vision. If you have these symptoms, you need to seek treatment
immediately. This is a medical emergency. If your doctor is unavailable, go
to the nearest hospital or clinic. Without treatment to improve the flow of
fluid, the eye can become blind in as few as one or two days. Usually,
prompt laser surgery and medicines can clear the blockage and protect
sight.
In congenital glaucoma, children are born with a defect in the angle of the
eye that slows the normal drainage of fluid. These children usually have
obvious symptoms, such as cloudy eyes, sensitivity to light, and excessive
tearing. Conventional surgery typically is the suggested treatment, because
medicines may have unknown effects in infants and be difficult to
administer. Surgery is safe and effective. If surgery is done promptly, these
children usually have an excellent chance of having good vision.
Secondary glaucomas can develop as complications of other medical
conditions. These types of glaucomas are sometimes associated with eye
surgery or advanced cataracts, eye injuries, certain eye tumors, or uveitis
(eye inflammation). Pigmentary glaucoma occurs when pigment from the
iris flakes off and blocks the meshwork, slowing fluid drainage. A severe
form, called neovascular glaucoma, is linked to diabetes. Corticosteroid
drugs used to treat eye inflammations and other diseases can trigger
glaucoma in some people. Treatment includes medicines, laser surgery, or
conventional surgery.
What can I do if I already have lost some vision from
glaucoma?
If you have lost some sight from glaucoma, ask your eye care professional
about low vision services and devices that may help you make the most of
your remaining vision. Ask for a referral to a specialist in low vision. Many
community organizations and agencies offer information about low vision
counseling, training, and other special services for people with visual
impairments. A nearby school of medicine or optometry may provide low
vision services.
What research is being done?
Through studies in the laboratory and with patients, the National Eye
Institute is seeking better ways to detect, treat, and prevent vision loss in
people with glaucoma. For example, researchers have discovered genes
that could help explain how glaucoma damages the eye.
The NEI also is supporting studies to learn more about who is likely to get
glaucoma, when to treat people with increased pressure, and which
treatment to use first.
What can I do to protect my vision?
If you are being treated for glaucoma, be sure to take your glaucoma
medicine every day. See your eye care professional regularly.
You also can help protect the vision of family members and friends who
may be at high risk for glaucoma--African Americans over age 40; everyone
over age 60, especially Mexican Americans; and people with a family history
of the disease. Encourage them to have a comprehensive dilated eye exam
at least once every two years. Remember: Lowering eye pressure in
glaucoma's early stages slows progression of the disease and helps save
vision.
Medicare covers an annual comprehensive dilated eye exam for some
people at high risk for glaucoma. These people include those with
diabetes, those with a family history of glaucoma, and African Americans
age 50 and older.
What should I ask my eye care professional?
You can protect yourself against vision loss by working in partnership with
your eye care professional. Ask questions and get the information you need
to take care of yourself and your family.
What are some questions to ask?
About my eye disease or disorder
About my treatment
About my tests...
Other suggestions
Today, patients take an active role in their health care. Be an active patient
about your eye care.
Not necessarily. Increased eye pressure means you are at risk for
glaucoma, but does not mean you have the disease. A person has
glaucoma only if the optic nerve is damaged. If you have increased eye
pressure but no damage to the optic nerve, you do not have glaucoma.
However, you are at risk. Follow the advice of your eye care professional.
Can I develop glaucoma if I have increased eye pressure?
Not necessarily. Not every person with increased eye pressure will
develop glaucoma. Some people can tolerate higher eye pressure better
than others. Also, a certain level of eye pressure may be high for one
person but normal for another.
Whether you develop glaucoma depends on the level of pressure your
optic nerve can tolerate without being damaged. This level is different for
each person. That's why a comprehensive dilated eye exam is very
important. It can help your eye care professional determine what level of eye
pressure is normal for you.
Can I develop glaucoma without an increase in my eye
pressure?
Yes. Glaucoma can develop without increased eye pressure. This form of
glaucoma is called low-tension or normal-tension glaucoma. It is not as
common as open-angle glaucoma.
Who is at risk for open-angle glaucoma?
Anyone can develop glaucoma. Some people are at higher risk than
others. They include:
- African Americans over age 40.
- Everyone over age 60, especially Mexican Americans.
- People with a family history of glaucoma.
A comprehensive dilated eye exam can reveal more risk factors, such as
high eye pressure, thinness of the cornea, and abnormal optic nerve
anatomy. In some people with certain combinations of these high-risk
factors, medicines in the form of eyedrops reduce the risk of developing
glaucoma by about half.
What are the symptoms of glaucoma?
At first, open-angle glaucoma has no symptoms. It causes no pain. Vision
stays normal.
As glaucoma remains untreated, people may miss objects to the side and
out of the corner of their eye. Without treatment, people with glaucoma will
slowly lose their peripheral (side) vision. They seem to be looking through a
tunnel. Over time, straight-ahead vision may decrease until no visual acuity
remains.
Glaucoma can develop in one or both eyes.
How is glaucoma detected?
Glaucoma is detected through a comprehensive eye exam that includes:
Visual acuity test. This eye chart test measures how well you see at
various distances.
Dilated eye exam. Drops are placed in your eyes to widen, or dilate, the
pupils. Your eye care professional uses a special magnifying lens to
examine your retina and optic nerve for signs of damage and other eye
problems. After the exam, your close-up vision may remain blurred for
several hours.
Tonometry. An instrument (right) measures the pressure inside the eye.
Numbing drops may be applied to your eye for this test.
Pachymetry. A numbing drop is applied to your eye. Your eye care
professional uses an ultrasonic wave instrument to measure the thickness
of your cornea.
Can glaucoma be cured?
No. There is no cure for glaucoma. Vision lost from the disease cannot be
restored.
Can glaucoma be treated?
Yes. Immediate treatment for early stage, open-angle glaucoma can delay
progression of the disease. That's why early diagnosis is very important.
Glaucoma treatments include medicines, laser trabeculoplasty,
conventional surgery, or a combination of any of these. While these
treatments may save remaining vision, they do not improve sight already
lost from glaucoma.
Medicines. Medicines, in the form of eyedrops or pills, are the most
common early treatment for glaucoma. Some medicines cause the eye to
make less fluid. Others lower pressure by helping fluid drain from the eye.
Before you begin glaucoma treatment, tell your eye care professional
about other medicines you may be taking. Sometimes the drops can
interfere with the way other medicines work.
Glaucoma medicines may be taken several times a day. Most people
have no problems. However, some medicines can cause headaches or
other side effects. For example, drops may cause stinging, burning, and
redness in the eyes.
Many drugs are available to treat glaucoma. If you have problems with one
medicine, tell your eye care professional. Treatment with a different dose or
a new drug may be possible.
Because glaucoma often has no symptoms, people may be tempted to
stop taking, or may forget to take, their medicine. You need to use the drops
or pills as long as they help control your eye pressure. Regular use is very
important.
Make sure your eye care professional shows you how to put the drops into
your eye. See tips on using your glaucoma eyedrops.
Laser trabeculoplasty. Laser trabeculoplasty helps fluid drain out of the
eye. Your doctor may suggest this step at any time. In many cases, you
need to keep taking glaucoma drugs after this procedure.
Laser trabeculoplasty is performed in your doctor's office or eye clinic.
Before the surgery, numbing drops will be applied to your eye. As you sit
facing the laser machine, your doctor will hold a special lens to your eye. A
high-intensity beam of light is aimed at the lens and reflected onto the
meshwork inside your eye. You may see flashes of bright green or red light.
The laser makes several evenly spaced burns that stretch the drainage
holes in the meshwork. This allows the fluid to drain better.
Like any surgery, laser surgery can cause side effects, such as
inflammation. Your doctor may give you some drops to take home for any
soreness or inflammation inside the eye. You need to make several
followup visits to have your eye pressure monitored.
If you have glaucoma in both eyes, only one eye will be treated at a time.
Laser treatments for each eye will be scheduled several days to several
weeks apart.
Studies show that laser surgery is very good at reducing the pressure in
some patients. However, its effects can wear off over time. Your doctor may
suggest further treatment.
Conventional surgery. Conventional surgery makes a new opening for the
fluid to leave the eye. (See diagram.) Your doctor may suggest this
treatment at any time. Conventional surgery often is done after medicines
and laser surgery have failed to control pressure.
Conventional surgery is performed in an eye clinic or hospital. Before the
surgery, you will be given medicine to help you relax. Your doctor will make
small injections around the eye to numb it. A small piece of tissue is
removed to create a new channel for the fluid to drain from the eye.
For several weeks after the surgery, you must put drops in the eye to fight
infection and inflammation. These drops will be different from those you
may have been using before surgery.
As with laser surgery, conventional surgery is performed on one eye at a
time. Usually the operations are four to six weeks apart.
Conventional surgery is about 60 to 80 percent effective at lowering eye
pressure. If the new drainage opening narrows, a second operation may be
needed. Conventional surgery works best if you have not had previous eye
surgery, such as a cataract operation.
In some instances, your vision may not be as good as it was before
conventional surgery. Conventional surgery can cause side effects,
including cataract, problems with the cornea, and inflammation or infection
inside the eye. The buildup of fluid in the back of the eye may cause some
patients to see shadows in their vision. If you have any of these problems,
tell your doctor so a treatment plan can be developed.
What are some other forms of glaucoma?
Open-angle glaucoma is the most common form. Some people have
other types of the disease.
In low-tension or normal-tension glaucoma, optic nerve damage and
narrowed side vision occur in people with normal eye pressure. Lowering
eye pressure at least 30 percent through medicines slows the disease in
some people. Glaucoma may worsen in others despite low pressures.
A comprehensive medical history is important in identifying other potential
risk factors, such as low blood pressure, that contribute to low-tension
glaucoma. If no risk factors are identified, the treatment options for low-
tension glaucoma are the same as for open-angle glaucoma.
In angle-closure glaucoma, the fluid at the front of the eye cannot reach
the angle and leave the eye. The angle gets blocked by part of the iris.
People with this type of glaucoma have a sudden increase in eye pressure.
Symptoms include severe pain and nausea, as well as redness of the eye
and blurred vision. If you have these symptoms, you need to seek treatment
immediately. This is a medical emergency. If your doctor is unavailable, go
to the nearest hospital or clinic. Without treatment to improve the flow of
fluid, the eye can become blind in as few as one or two days. Usually,
prompt laser surgery and medicines can clear the blockage and protect
sight.
In congenital glaucoma, children are born with a defect in the angle of the
eye that slows the normal drainage of fluid. These children usually have
obvious symptoms, such as cloudy eyes, sensitivity to light, and excessive
tearing. Conventional surgery typically is the suggested treatment, because
medicines may have unknown effects in infants and be difficult to
administer. Surgery is safe and effective. If surgery is done promptly, these
children usually have an excellent chance of having good vision.
Secondary glaucomas can develop as complications of other medical
conditions. These types of glaucomas are sometimes associated with eye
surgery or advanced cataracts, eye injuries, certain eye tumors, or uveitis
(eye inflammation). Pigmentary glaucoma occurs when pigment from the
iris flakes off and blocks the meshwork, slowing fluid drainage. A severe
form, called neovascular glaucoma, is linked to diabetes. Corticosteroid
drugs used to treat eye inflammations and other diseases can trigger
glaucoma in some people. Treatment includes medicines, laser surgery, or
conventional surgery.
What can I do if I already have lost some vision from
glaucoma?
If you have lost some sight from glaucoma, ask your eye care professional
about low vision services and devices that may help you make the most of
your remaining vision. Ask for a referral to a specialist in low vision. Many
community organizations and agencies offer information about low vision
counseling, training, and other special services for people with visual
impairments. A nearby school of medicine or optometry may provide low
vision services.
What research is being done?
Through studies in the laboratory and with patients, the National Eye
Institute is seeking better ways to detect, treat, and prevent vision loss in
people with glaucoma. For example, researchers have discovered genes
that could help explain how glaucoma damages the eye.
The NEI also is supporting studies to learn more about who is likely to get
glaucoma, when to treat people with increased pressure, and which
treatment to use first.
What can I do to protect my vision?
If you are being treated for glaucoma, be sure to take your glaucoma
medicine every day. See your eye care professional regularly.
You also can help protect the vision of family members and friends who
may be at high risk for glaucoma--African Americans over age 40; everyone
over age 60, especially Mexican Americans; and people with a family history
of the disease. Encourage them to have a comprehensive dilated eye exam
at least once every two years. Remember: Lowering eye pressure in
glaucoma's early stages slows progression of the disease and helps save
vision.
Medicare covers an annual comprehensive dilated eye exam for some
people at high risk for glaucoma. These people include those with
diabetes, those with a family history of glaucoma, and African Americans
age 50 and older.
What should I ask my eye care professional?
You can protect yourself against vision loss by working in partnership with
your eye care professional. Ask questions and get the information you need
to take care of yourself and your family.
What are some questions to ask?
About my eye disease or disorder
- What is my diagnosis?
- What caused my condition?
- Can my condition be treated?
- How will this condition affect my vision now and in the future?
- Should I watch for any particular symptoms and notify you if they
occur? - Should I make any lifestyle changes?
About my treatment
- What is the treatment for my condition?
- When will the treatment start and how long will it last?
- What are the benefits of this treatment and how successful is it?
- What are the risks and side effects associated with this treatment?
- Are there foods, drugs, or activities I should avoid while I'm on this
treatment? - If my treatment includes taking medicine, what should I do if I miss a
dose? - Are other treatments available?
About my tests...
- What kinds of tests will I have?
- What can I expect to find out from these tests?
- When will I know the results?
- Do I have to do anything special to prepare for any of the tests?
- Do these tests have any side effects or risks?
- Will I need more tests later?
Other suggestions
- If you don't understand your eye care professional's responses, ask
questions until you do understand. - Take notes or get a friend or family member to take notes for you. Or,
bring a tape recorder to help you remember the discussion. - Ask your eye care professional to write down his or her instructions
to you. - Ask your eye care professional for printed material about your
condition. - If you still have trouble understanding your eye care professional's
answers, ask where you can go for more information. - Other members of your health care team, such as nurses and
pharmacists, can be good sources of information. Talk to them, too.
Today, patients take an active role in their health care. Be an active patient
about your eye care.
| How should I use my glaucoma eyedrops? If eyedrops have been prescribed for treating your glaucoma, you need to use them properly and as instructed by your eye care professional. Proper use of your glaucoma medication can improve the medicine's effectiveness and reduce your risk of side effects. To properly apply your eyedrops, follow these steps:
|
"You'll 'See' - We Care."
Community Eye Care of Indiana
Normal vision |
| Same scene as viewed by a person with glaucoma |
A tonometer
measures
pressure inside
the eye to detect
glaucoma.
measures
pressure inside
the eye to detect
glaucoma.
Visual field test.
This test measures
your side (peripheral)
vision. It helps your
eye care professional
tell if you have lost
side vision, a sign of
glaucoma.
This test measures
your side (peripheral)
vision. It helps your
eye care professional
tell if you have lost
side vision, a sign of
glaucoma.
