Glaucoma refers to a group of eye disorders leading to damage of the eye’s nerve fibers. (Millions of these nerve fibers transmit visual information from the retina to the brain.) Damage to the nerve fibers is often associated with an increase in internal eye pressure. But damage can also occur even if your eye pressure is normal (for example, if you are genetically predisposed and have weak nerve fibers, or have a vascular problem such as diabetes).
Early glaucoma can cause decreased visual sensitivity at the edges of your vision (peripheral vision). Unfortunately, many people with glaucoma don’t notice this decreased sensitivity in their vision. In fact, it is estimated that 2 million Americans have glaucoma but don’t even realize it. Untreated or uncontrolled glaucoma eventually leads to progressive vision loss and can then lead to complete blindness.
In fact, glaucoma is the second leading cause of blindness (cataracts being the first). Unlike cataracts, however, vision loss from glaucoma is irreversible. That’s why it is so important to detect glaucoma early. At Frontier Eye Care, we use the latest technology such as OCT (optical coherence tomography) to detect early damage to the nerve fibers before usable vision is lost.
Symptoms of Glaucoma
Glaucoma often is called the “silent thief of sight,” because most types of glaucoma don’t cause any pain, and vision loss is usually not noticeable at first.
One type of glaucoma – acute angle-closure glaucoma – does lead to sudden, intense eye pain, as well as blurry vision, halos around lights, nausea and vomiting. If you have these symptoms, come see us at Frontier Eye Care or visit the emergency room immediately so steps can be taken to prevent permanent vision loss.
Diagnosis, Screening and Tests for Glaucoma
During every comprehensive eye examination at Frontier Eye Care, we measure your intraocular pressure, or IOP. Most people are familiar with the “air puff” test, which is a traditional way to measure eye pressure. Sometimes, eye pressure is measured with an applanation tonometer, which uses a small probe to push against the front of your eye after it is numbed with eye drops. However, for most patients, we use new technology at Frontier Eye Care which allows us to measure your pressure without the air puff or drops! This new test is quicker and much more comfortable.
An abnormally high pressure reading indicates a problem with the amount of fluid in the eye. Either the eye is producing too much fluid, or it’s not draining properly. But high eye pressure is just one risk factor for glaucoma. You can develop glaucoma even if your pressure readings are normal. We also routinely screen every patient for early visual field loss, and carefully examine the appearance of your optic nerve fibers.
If we determine that you are at risk for glaucoma (if you have high eye pressure, a family history, or suspicious nerve fibers, for example), we will first discuss and explain our findings with you. We can then use additional methods to determine whether treatment is necessary and monitor your glaucoma.
Sophisticated imaging technology – such as digital retinal imaging and optical coherence tomography (OCT) – allow us to create baseline images and measurements of the eye’s nerve fibers and internal structures. Then, at specified intervals, additional images and measurements are taken to make sure no changes have occurred over time that might indicate progressive glaucoma damage.
Gonioscopy also may be performed to make sure the fluid in your eye (aqueous humor) can drain properly from your eye. In gonioscopy, special lenses are used with a biomicroscope to enable Dr. Alden to see the structure inside the eye that controls the outflow of aqueous.
Although eye pressure is only one risk factor in glaucoma, it is something we can control. Treatment aimed at lowering eye pressure can involve medicated eye drops, laser treatment, or glaucoma surgery depending on the severity. Usually, eye drops are tried first.
Unfortunately, many patients may become careless about using their eye drops. In fact, non-compliance with eye drops for glaucoma is the primary reason for blindness caused by glaucoma. If you find that the eye drops you are using for glaucoma are uncomfortable or inconvenient, consult with Dr. Alden about a possible alternative therapy.
There is no cure for glaucoma, but if detected early and treated accordingly, patients will have the opportunity to outlive their condition and limit the amount of vision that may be lost due to glaucoma.
If you would like to discuss glaucoma with Dr. Alden, simply ask during your appointment To schedule an examination, call our Casper office at (307) 472-2020.