Glaucoma Treatment By St. George Eye Doctor, Dr. Fife

What is glaucoma?
Glaucoma is a group of eye disorders leading to progressive damage of the optic nerve, and is characterized by loss of nerve tissue resulting in loss of vision. The optic nerve is the nerve that connects the eye to the brain.

What are the risk factors for glaucoma?
People with a family history of glaucoma, African Americans, and those who are very nearsighted or diabetic are at a higher risk of developing the disease. It most often occurs in people over age 40.

What symptoms will I notice if I have glaucoma?
Unfortunately glaucoma, known as the ‘Silent Thief of Sight’, usually does not have any symptoms until the disease is in the end stage. This makes it important to have your eyes examined regularly and tested as directed by your doctor. Although there typically are no noticeable symptoms, that may depend on the type of glaucoma. There are several types of glaucoma.

The most common type, open angle glaucoma, develops gradually and painlessly, without symptoms. The pressure inside the eye becomes too great and slowly crushes the optic nerve which leads to a loss of peripheral (side) vision.

In normal tension glaucoma, eye pressure may be normal, yet damage still occurs to the optic nerve. We’re not quite sure why this occurs, but it is thought that it may be due to poor perfusion pressure or inadequate nutrients reaching the optic nerve from the blood supply. A recent study has shown that if you subtract your diastolic pressure from your eye pressure and the number totals less than 50, you may be at a higher risk of glaucoma progression. Additionally, breathing disorders such as sleep apnea may be a risk factor for this type of glaucoma.

A rarer type, closed angle glaucoma, occurs rapidly and its symptoms may include blurred vision, loss of side vision, seeing colored rings around lights and pain or redness in the eyes.

End stage glaucoma, regardless of the cause, has symptoms of significantly decreased peripheral (side) vision which may lead to complete loss of vision.

What will happen if I have glaucoma and don’t know?
Untreated glaucoma can cause complete and irreversible blindness. This makes glaucoma a serious eye disease and is the second leading cause of blindness in the U.S. Glaucoma cannot be prevented, but if diagnosed and treated early, it can be controlled. Vision lost to glaucoma cannot be restored. That is why the American Optometric Association recommends annual eye examinations for people at risk for glaucoma. Dr. Fife will discuss his findings with you and partner with you in monitoring and treating as needed. Depending on your condition, he may recommend more frequent examinations.

How is glaucoma diagnosed?
Even in the early stages, glaucoma can be detected during a thorough eye exam. A comprehensive optometric examination will include taking a thorough medical and family history, measuring the pressure of the fluid inside the eye, direct visual examination of the optic nerve with a special microscope and lens, and assessment of central and side vision.

What if the doctor suspects I have glaucoma?
Additional testing may be ordered when suspicious findings are noted during an eye examination. These tests often include:

  • OCT – this instrument scans the optic nerve for loss of nerve fiber. Nerve fiber loss is one of the earliest signs of glaucoma

  • Retinal Photo – taking an image of the optic nerve and the surrounding nerve fiber layer can aid in initial documentation as well as monitoring for progression

  • Pachymetry – measurement of the thickness of the cornea (the front surface of the eye). Cornea thickness affects measurement of pressure inside the eye, so it is important to know corneal thickness to accurately monitor intraocular pressure

  • Visual Field Testing – measurement and mapping of the peripheral (side) vision. Glaucoma has very characteristic patterns of side vision loss. Visual field testing can pick up these losses very early, even when they are not apparent to you.

  • Gonioscopy – measurement of the anterior chamber angle. This is the area inside the eye where the fluid drains back into the body’s circulatory system.

How do you treat glaucoma?
Glaucoma is treated by trying to decrease the pressure inside the eye. Prescription eye drops are usually very effective and often only have to be administered once or twice a day. However some cases of glaucoma require surgical intervention.

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