Glaucoma is a range of eye diseases affecting the optic nerve and cause progressive, permanent vision loss. It is the second leading cause of blindness and is typically painless. People of all ages are at risk of glaucoma, but people of older ages are at a higher risk. Vision loss typically begins with the peripheral or side vision, and develops gradually so that patients with glaucoma might not notice any vision loss until only very little remains.
Glaucoma is typically caused by high eye pressure or intraocular pressure (IOP) from the fluid in the inside of the eye. We measure this at each exam using an eye drop with a yellow dye and anesthetic as well as a probe that gets close to the eye. Some offices use the “air puff” test. Average IOP is between 10-21 millimeters of mercury. Readings of 21 and over are considered elevated and suspect for glaucoma. These elevated readings may require treatment depending on the patient’s risk factors.
The key to glaucoma treatment is early detection. Glaucoma is typically diagnosed after a series of exams in order to monitor the IOP fluctuations, changes to the peripheral and central vision, as well as changes to the optic nerve. Treatment initially consists of eye drops to lower the IOP. If this fails to sufficiently lower the IOP, surgical and laser procedures can be performed to also assist in lowering IOP. Unfortunately there is no cure for glaucoma and the vision loss is permanent. While treatment aims to slow down or stop the loss of additional vision, about 10% of those under proper treatment will continue to progress and lose vision.
Due to the chronic nature of the condition, frequent eye exams are important to monitor the eye pressure, peripheral vision and optic nerve, and must be monitored for life.
Additional resources can be found at the National Eye Institute website:
Introduction to glaucoma