Glaucoma is one of the leading causes of blindness in the U.S.--Almost 80,000 Americans are blind from glaucoma, and at least another 2 million currently have the disease. Half of those with glaucoma don't know it. There are over a dozen types of glaucoma--some hereditary, some from trauma, and some caused by medications.

Glaucoma is often called the "sneak thief" of sight because the most common type causes no symptoms until vision is already damaged. Vision lost to glaucoma cannot be regained, and there is no "cure" for the condition. Vision loss can be stopped, however, if the disease is caught and treated in time. The best way to prevent vision loss from glaucoma is to see your eye doctor at regular intervals for a complete eye examination.


What Is Glaucoma?

Simply put, glaucoma is a disease in which the pressure inside the eye is too high for that particular eye to withstand. This is because either too much fluid is being produced within the eye, or too little is drained. Some people with normal intraocular pressure can experience vision loss from glaucoma; so-called "normotensive glaucoma". Others with high intraocular pressure never develop the optic nerve damage of glaucoma. These are the exceptions. In general, elevated eye pressure is still considered the major risk factor for glaucoma, because studies have shown that the higher the pressure is, the more likely optic nerve damage is to occur.

Glaucoma causes damage to the optic nerve, which enters the back of the eye. The optic nerve carries the images we see to the brain. The optic nerve is like an electric cable containing about 1.2 million wires. Glaucoma can damage these nerve fibers, causing blind spots to develop.


Examination for Glaucoma

Because most individuals with glaucoma experience no noticeable symptoms, the eye examination which includes testing for glaucoma is the single most important tool in preventing vision loss from the disease.

Glaucoma can be diagnosed only through a series of tests administered by trained personnel and interpreted by an eye doctor.

An examination for glaucoma may include:

Some of these tests may not be necessary for every patient, but more tests may be added, or repeated more frequently if glaucoma is suspected or if glaucoma damage increases over time.

Everyone should have regular eye examinations, but those at risk for glaucoma need to have more frequent exams.

Remember that vision lost to glaucoma can't be regained, however early detection and treatment can prevent further damage.


Treatment for Glaucoma

There is no "cure" for glaucoma, but it can be controlled. Even when treatment is effective, individuals with glaucoma need to have their eyes checked regularly, and often need to continue treatment for the rest of their lives. This may seem like a burden, but is preferable to losing one's sight.

Treatment for glaucoma focuses on lowering intraocular pressure (IOP) to a level the doctor thinks is unlikely to cause further optic nerve damage. That level differs from individual to individual, and one person's "target pressure" may change during the course of his or her lifetime.



Therapy for open-angle glaucoma (the most common type) usually begins with medicated eye drops to lower the intraocular pressure (IOP). Medications may be topical, such as eye drops or eye ointments, or oral, such as pills or tablets.

Any medication, including eye drops, may have side effects. Some side effects of glaucoma medications include:


It is very important that people with glaucoma carefully follow their optometrist or ophthalmologist's recommended treatments--any side effects of medication should be discussed with the doctor. If they become serious or intolerable, the patient and the doctor may decide to change treatment.

In some cases, eye drops, eye ointments and oral medications do not adequately reduce or control intraocular pressure. Your eye doctor may then recommend laser treatment or surgery. Laser treatment allows fluid within the eye to more easily drain, which lowers the pressure. Occasionally, surgery is used, usually as a last resort.

A patient's age, eye structure, type of glaucoma, and other medical conditions are all taken into consideration when deciding how to treat his or her glaucoma. The eye doctor, in partnership with the patient, is best able to make the appropriate treatment decisions.