What is Glaucoma?
Glaucoma is a complex disease in which damage to the optic nerve leads to progressive, irreversible vision loss. Glaucoma is the second leading cause of blindness.
What causes Glaucoma?
It’s the result of an intrinsic deterioration of the optic nerve, which leads to high fluid pressure on the front part of the eye.
Normally, the fluid, called aqueous humor, flows out of your eye through a mesh-like channel. If this channel gets blocked, the liquid builds up. The reason for the blockage is unknown, but doctors do know it can be inherited, meaning it’s passed from parents to children.
Less common causes include a blunt or chemical injury to your eye, severe eye infection, blocked blood vessels inside the eye, and inflammatory conditions. It’s rare, but sometimes eye surgery to correct another condition can bring it on. It usually affects both eyes, but it may be worse in one than the other.
How is Glaucoma treated?
Your doctor may use prescription eye drops, laser surgery, or microsurgery to lower pressure in the eye.
Eye drops. These either reduce the formation of fluid in the eye or increase its outflow, thereby lowering eye pressure. Side effects may include allergies, redness, stinging, blurred vision, and irritated eyes. Some glaucoma drugs may affect your heart and lungs. Be sure to tell your doctor about any other medications you’re taking or are allergic to.
Laser surgery. This procedure can slightly increase the flow of the fluid from the eye for people with open-angle glaucoma. It can stop fluid blockage if you have angle-closure glaucoma. Procedures include:
- Trabeculoplasty: Opens the drainage area
- Iridotomy: Makes a tiny hole in the iris to let fluid flow more freely
- Cyclophotocoagulation: Treats areas of the middle layer of your eye to reduce fluid production
Microsurgery. In a procedure called a trabeculectomy, the doctor creates a new channel to drain the fluid and ease eye pressure. Sometimes this form of glaucoma surgery fails and has to be redone. Your doctor might implant a tube to help drain fluid. Surgery can cause temporary or permanent vision loss, as well as bleeding or infection.
Open-angle glaucoma is most often treated with various combinations of eye drops, laser trabeculoplasty, and microsurgery. Doctors in the U.S. tend to start with medications, but there’s evidence that early laser surgery or microsurgery could work better for some people.
Infant or congenital glaucoma -- meaning you are born with it -- is primarily treated with surgery, because the cause of the problem is a very distorted drainage system.
Talk to your eye doctor to find out which glaucoma treatment is right for you.
When should surgery be done?
Surgery involves either laser treatment or making a cut in the eye to reduce the intraocular pressure. The type of surgery your doctor recommends will depend on the type and severity of your glaucoma and the general health of your eye.
Surgery can help lower pressure when medication is not sufficient. However, it cannot reverse vision loss.
