Glaucoma is defined as a build up of fluid pressure inside the eye. The intraocular pressure–IOP–causes damage to the optic nerve. If left untreated for several years, permanent blindness can be the result. Once any vision loss occurs from glaucoma, it cannot be reversed. If the condition is diagnosed and treated early, however, vision loss can be slowed or prevented. Because it usually presents no symptoms in the early stages, the increase in eye pressure is only found when an eye doctor performs a painless pressure test. A yearly eye examination is very important, especially as an individual ages, so that an increase in fluid pressure can be treated before it causes damage and loss of vision.
At present, doctors do not know what causes a blockage of fluid and pressure build-up. Researchers have learned the tendency is often an inherited condition, however, and a family history of glaucoma is considered a risk factor. Other risk factors are aging, diabetes, poor vision, especially nearsightedness, smoking and taking prednisone or other steroid medications.
Three Types of Treatment
Glaucoma is treated by prescription medication in the form of eye drops, microsurgery or laser surgery. The doctor may first try prescription eye drops to determine if eye pressure can be lowered sufficiently to reduce or eliminate damage. If after a period of time the drops do not lower the pressure enough, laser surgery may be used to increase the flow of fluid in open-angle glaucoma or to open the blockage in narrow-angle glaucoma.
In laser surgery, the patient’s chin is placed in a chinrest the same as for an eye exam, and he or she is asked to stare straight ahead for a few seconds while the laser flashes into the eye. It is a relatively painless procedure and eye drops will be prescribed to speed healing and reduce the mild irritation felt by some patients after surgery. The results of lowered pressure usually last one or two years and can be repeated several times.
If laser surgery is not successful or ceases to work, a trabeculectomy can be performed. This is microsurgery that creates a new channel for the fluid to drain from the eye, reducing the intraocular pressure. The patient will be sedated and will generally feel no pain during the short operation. A patch and an eye guard will be worn after surgery and eye drops that affect healing rate and prevent infection will be prescribed.