Glaucoma is one of the leading causes of blindness in the United States. Glaucoma is a group of eye conditions characterized by optic nerve damage leading to vision loss. Vision loss occurs peripherally first. If left untreated, glaucoma can therefore result in "tunnel vision". Having routine eye exams is imperative for diagnosing glaucoma because symptoms usually don't appear until advanced stages. Glaucoma is typically manageable with treatment. However, vision loss from glaucoma is irreversible.
Glaucoma is a group of eye conditions and each condition has unique characteristics. Primary open-angle glaucoma and angle-closure glaucoma are the most common. The 'angle' is a structural area within the eye making up the space between the iris and the cornea. The 'angle' is where the fluid inside the eye (aqueous humor) drains. Other versions include normal-tension glaucoma, congenital glaucoma and pigmentary glaucoma.
Open-Angle Glaucoma – The angle is open, however the pressure inside the eye (intraocular) is high. Damage to the optic nerve fibers results if the intraocular pressure is sustained at the higher level.
Angle-Closure Glaucoma – A sudden and severe increase in intraocular pressure secondary to the angle being blocked or closed.
Normal-Tension Glaucoma – Optic nerve damage occurs despite a 'normal' or low intraocular pressure.
Congenital Glaucoma – Optic nerve damage from glaucoma is present in infants and children.
Pigmentary Glaucoma – Pigment granules slough from your iris blocking aqueous humor from adequate drainage from the eye.
Based on the findings after reviewing your medical history and conducting a comprehensive eye exam, Dr. Dold will determine whether or not to the need exists to perform additional tests to confirm a diagnosis of glaucoma. General tests throughout the comprehensive eye exam and other, specific glaucoma tests are used to diagnose glaucoma. Additional tests include:
Tonometry
The initial glaucoma test is a simple, painless procedure that involves numbing your eyes with drops to measure your intraocular pressure. There are other methods of tonometry, such as 'non-contact tonometry', also known as "the air puff" test. Dr. Miller measures the intraocular pressure, but she does not use the "air puff"!
Visual Field Test
A visual field test evaluates your peripheral (side) vision to determine whether your visual field has been affected by glaucoma.
Pachymetry
Measuring the thickness of your corneas indicates the "trueness" of the intraocular pressure reading. A thicker-than-average cornea will give a falsly high intraocular pressure reading. Conversely, a thinner-than-average cornea will give a falsly low intraocular pressure reading.
Retinal Photography
This is a photographic documentation to evaluate structural relationships within the optic nerves.
Nerve Fiber Analysis
The retinal nerve fiber layer is measured by optical coherence tomography (OCT). OCT can detect change to the structure of the optic nerve early, before damage results in vision loss.
Knowing the risks can be helpful in early diagnosis of glaucoma because symptoms are rarely present through the early stages of the disease. If you fall into any of the categories below, Dr. Dold may recommend more frequent eye exams or further diagnostic testing to rule out or to confirm glaucoma.
Age – The older you are, specifically over 40, the higher your risk for developing glaucoma. This risk varies based on your ethnic background. Certain ethnicities such as Mexican Americans and African Americans are at higher risk for developing at a younger age.
Ethnic Background – People of African American, Irish, Russian, Japanese, Hispanic, Inuit and Scandinavian descent are at an increased risk of development.
Family History of Glaucoma - A greater factor of heredity exists in a first generation relative.
Medical Conditions – Diabetes, heart disease, high blood pressure and hypothyroidism may increase your risk. Also, using certain medications may increase your risk of developing glaucoma.
Eye Conditions - Eye tumors, retinal detachment, eye inflammation, eye injuries, and certain eye surgeries may have an affect on the increased risk of developing glaucoma.
Each type of glaucoma has varying symptoms, but they usually only appear in advanced stages of the disease. Routine eye exams allow for early detection. Most often, no symptoms of glaucoma are observed. However, if you experience any of the following glaucoma symptoms, seek urgent medical care, if possible, by an eye care professional:
Vision loss, specifically peripheral
Eye redness
Halos around lights
Tunnel vision
Pain in the eye
Nausea or vomiting (due to pain in the eye)
Glaucoma is a treatable, but not a curable, condition. Damage to the optic nerve caused by glaucoma cannot be repaired. However, further damage can be prevented with close monitoring and with appropriate treatment. Treatment for glaucoma include medicated eye drops, oral medications, and sometimes surgical procedures. All treatment are designed to lower the intraocular pressure in order to protect the optic nerve fibers.
Alternative medicine may be defined as non-standard, unconventional treatments for glaucoma. It must be noted that some of these treatment alternatives have no proven clinical effect.
Follow Dr. Dold's treatment plan to most effectively treat your glaucoma. Glaucoma is a very 'individual' condition. What a 'normal' intraocular pressure for some, may not be for others. Treatments and frequency of evaluation will be tailored to your specific case of glaucoma.