Glaucoma and Vision Loss: What You Need to Know

by | Jan 31, 2023

What is glaucoma? 

Glaucoma is a group of eye disorders that can lead to permanent vision loss and blindness. 

It is caused by an increase in pressure inside the eye which leads to damage to the optic nerve, which is the bundle of nerve fibers that carries visual information from the eye to the brain. 

It is also called the “silent thief of sight” because it often has no early symptoms and can go undetected until significant vision loss has occurred. 

Symptoms of glaucoma

The symptoms of glaucoma depend on the type that you have. In many cases, glaucoma has no noticeable symptoms in the early stages.  However, these symptoms may not appear until the disease is in an advanced stage.

Which includes

  • Gradual loss of peripheral vision
  • Difficulty adjusting to low light levels
  • Seeing halos around lights
  • Severe eye pain or headache

Risk factors for glaucoma

Risk factors for glaucoma include:

Age:

The risk of glaucoma increases as you get older. It’s highly prevalent in people 65 years and above.

Family history:

Your risk of glaucoma is higher if a parent or sibling has the disease.

High intraocular pressure:

High pressure inside your eye can increase your risk of glaucoma.

Ethnicity:

Africans, African Americans, Hispanic, and people of Asian descent are at a higher risk of glaucoma.

Medical conditions:

Diabetes, high blood pressure, and certain heart conditions can increase your risk of glaucoma.

Eye injuries or disorders:

certain eye conditions, such as nearsightedness or farsightedness, or previous eye injuries can increase the risk of glaucoma.

Certain medications:

Taking certain medications such as corticosteroids for long-term use.

History of eye surgery:

People who have had cataract surgery or other eye surgeries are also at a higher risk of developing a type of glaucoma.

 

Types of glaucoma.

There are two main types of glaucoma:

Open-angle glaucoma:

This is the most common type of glaucoma. It occurs when the eye’s drainage canals become gradually blocked over time. This type of glaucoma usually has no symptoms in the early stages and progresses slowly, causing peripheral vision loss.

Angle-closure glaucoma:

This type of glaucoma occurs when the angle between the iris and the cornea becomes too narrow. This can cause a sudden increase in eye pressure, resulting in severe eye pain, nausea, headaches, and eventual rapid loss of vision. It’s a medical emergency and requires prompt treatment.

Other types of glaucoma include

Normal-tension glaucoma:

It’s a form of glaucoma that occurs when the eye pressure is normal, but the optic nerve is damaged.

Pigmentary glaucoma:

It’s a rare type of glaucoma that occurs when small bits of pigment from the iris build up in the drainage canals, blocking the flow of fluid.

There are also other types of secondary glaucoma such as Congenital Glaucoma, Trauma-induced Glaucoma, and Neovascular Glaucoma, which are due to other underlying medical conditions or as a side effect of certain medications.

interior of the eye free of glaucoma

How is glaucoma diagnosed?

Glaucoma is typically diagnosed through routine comprehensive eye exams. During the exam, your eye doctor will perform several tests to check for signs of the disease, including

Tonometry: This test measures the pressure inside your eye. High intraocular pressure is a sign of glaucoma.

Dilated fundoscopy or ophthalmoscopy: Your eye doctor will dilate your eyes, using a special instrument to look at the back of your eye and check for signs of damage to the optic nerve.

Perimetry or visual field analysis: This test measures your peripheral vision to check for any loss of vision.

Pachymetry: This test measures the thickness of your cornea.

Gonioscopy: This test checks for any blockages in the drainage canals of your eye.

Additionally, your doctor may also take a scan of your eye called optical coherence tomography (OCT) or Heidelberg retinal tomography (HRT) to check for any damage to the retina or the optic nerve.

The main goal of treating glaucoma is to lower the pressure inside the eye (intraocular pressure) to prevent further damage to the optic nerve. Treatment options for glaucoma include:

  • Medications: Eye drops and pills or a combination of both are the most common form of treatment for glaucoma. These medications help lower the pressure inside the eye by increasing the outflow of fluid or decreasing the amount of fluid produced in the eye.
  • Laser therapy: This procedure uses a laser to create a small opening in the eye to improve the outflow of fluid, which can lower the pressure inside the eye.
  • Surgery: In more advanced cases, surgery may be needed to create a new drainage channel for fluid to leave the eye, or to remove part of the iris.
  • Monitoring: Some cases of glaucoma may not require treatment if the intraocular pressure is mild, but regular check-ups are needed to monitor the condition.

It’s important to note that in many cases, more than one treatment option may be used in combination, and treatment plans may vary depending on the type, stage, and progression of the disease.

What are the causes of glaucoma?

The prognosis of glaucoma depends on the type and stage of the disease, on presentation as well as the individual patient’s response to treatment. In general, early detection and treatment of glaucoma can slow or prevent further vision loss. However, once vision is lost to glaucoma, it cannot be restored.

Open-angle glaucoma, which is the most common type of glaucoma, usually progresses slowly and without noticeable symptoms in the early stages, so regular eye exams are essential for the early detection and management of the disease. With appropriate treatment, many people with open-angle glaucoma are able to maintain their vision for many years.

Angle-closure glaucoma, on the other hand, is considered a medical emergency and if not treated promptly it can cause severe vision loss or blindness in one or both eyes.

It’s important to note that even with treatment, some people with glaucoma will still experience vision loss. However, with regular eye exams, appropriate treatment, and good compliance, the progression of the disease can be slowed and vision loss can be minimized.

It’s also important to mention that patients with glaucoma should be monitored. regularly, as the disease may progress over time and require adjustments to treatment.

 

Living with Glaucoma

Living with glaucoma can be challenging, but with proper management and care, it is possible to maintain good vision and quality of life.  Here are some tips for coping with glaucoma:

Follow your treatment plan:

Take your medications as prescribed and attend regular follow-up appointments with an optometrist.

Monitor your vision:

Be aware of any changes in your vision and report them to your doctor immediately.

Protect your eyes:

Wear sunglasses and a wide-brimmed hat when you are outdoors to protect your eyes from harmful UV rays.

Keep a healthy lifestyle:

Eating a healthy diet, getting regular exercise, and controlling any underlying medical conditions can help lower your risk of vision loss.

Practice safety:

If you have limited peripheral vision, it is important to take extra precautions when walking, cooking, or driving.

Learn to adjust to vision loss:

If vision loss occurs, learning to adapt to it can help maintain independence and improve quality of life. This can include learning to use adaptive devices such as magnifiers or talking books, or learning new ways to navigate your environment.

Emotional support:

Living with a chronic condition can be challenging, and it’s important to have a support system in place. Talking with a therapist or counselor can help you cope with the emotional aspects of living with glaucoma also Joining a support group can be helpful for those living with glaucoma, as it allows individuals to share their experiences and learn from others who are going through similar experiences.

optometrist-performing-an-eye-test

How can I Prevent Glaucoma? 

Preventing glaucoma can be challenging, as the exact cause of the disease is not fully understood. However, there are some steps you can take to lower your risk of developing glaucoma or slowing its progression:

Regular eye exams: 

This is one of the most important things you can do to prevent glaucoma. Regular eye exams can detect the early signs of glaucoma and allow for early treatment.

Control other systemic health conditions: 

Medical conditions such as diabetes and high blood pressure can increase your risk of glaucoma. By controlling these conditions, you can also lower your risk of developing glaucoma.

Eye injuries prevention: 

Try to avoid eye injuries by wearing protective eyewear when playing sports or working with hazardous or flying materials and machinery. 

Maintain a healthy lifestyle: 

Eating a healthy diet, exercising and maintaining a healthy weight, and not smoking can help reduce your risk of developing glaucoma.

Avoiding the long-term use of corticosteroids: 

Long-term use of corticosteroids can increase the risk of glaucoma, so it is important to use them only as prescribed and under the guidance of a healthcare professional.

Limit exposure to UV light: 

excessive exposure to UV light can damage the eyes and increase the risk of developing glaucoma. Wearing sunglasses that block UV rays can help protect your eyes. 

Consider your family history: 

always be aware of the diseases that run in your family. If you have a family history of glaucoma, it is important to tell your optometrist. 

It’s also important to keep in mind that some risk factors like age, race, or ethnicity can’t be modified, so regular eye exams are even more important for these individuals.

 

In summary, 

Glaucoma is a serious eye condition that can lead to permanent vision loss and blindness if not treated early. Regular eye exams, early detection, and proper treatment are crucial for managing and preventing the disease. Individuals should also take preventive measures such as controlling blood pressure, maintaining a healthy diet, exercising regularly, and not smoking to lower the risk of developing glaucoma. 

It’s important to consult an optometrist if you have any concerns about your vision or think you may be at risk for glaucoma.

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