Glaucoma

Glaucoma is a leading cause of vision loss and blindness in the United States. It is a group of eye diseases that cause damage to the optic nerve because of increased pressure from fluid that builds up inside the eye. Because glaucoma has no symptoms in its early stages, and vision that is lost cannot be restored, it is imperative that everyone has a comprehensive dilated eye exam annually. If detected early, glaucoma can usually be controlled and severe vision loss can often be prevented.

Anyone can get glaucoma, but those at higher risk include:

  • African Americans over age 40
  • Everyone over age 60 (especially Hispanics/Latinos)
  • People with a family history of the disease
  • People with past eye injuries
  • People who take steroids.

Glaucoma can impact one or both eyes; it affects peripheral vision, narrowing the field of vision and left untreated, it can cause total vision loss.

Glaucoma diseases are usually classified into two groups – open angle glaucoma (chronic glaucoma) and closed-angle glaucoma (acute glaucoma).

Either set of conditions can cause permanent damage to vision in the affected eye(s). Unfortunately, chronic glaucoma, the most common form of the disease, is largely asymptomatic until the disease has reached a significant stage.

There are a few signs one may watch out for, which may signal its onset. If the symptoms mentioned below are noticed, investigated and treated in time, it is possible to slow down and sometimes quell the progression of the disease.

Intense Pain

Severe pain in the affected eye is a typical symptom of acute closed-angle glaucoma. The affected eye begins to ache suddenly and the level of pain can be incapacitating. The eye pain is described as a heaviness/throbbing behind the eyes; the outer surface of the eye also aches at times. Most people will attempt to rub the eye or clutch it tightly when an attack occurs but this may only irritate the eye further.

Redness in Eye

Acute glaucoma eyes tend to get red and become discolored. Usually the redness is present in only one eye which distinguishes it from redress produced by other causes such as fatigue or substance abuse. With glaucoma, even the rim of the eyelid becomes red, swollen and encrusted.

Hazy vision

Those with glaucoma will often develop unclear vision with a misty haze that impedes proper sight. This usually occurs suddenly and rubbing or washing the eye is unlikely to provide much relief. In most cases, the mistiness may last anywhere between a few minutes to a couple of hours. Once experienced, these bouts of misty vision may become more and more frequent and longer. This reflects rapid deterioration of condition and calls for an immediate visit to the doctor.

Seeing Halos

A lot of people with glaucoma complain of seeing “rainbow-like” halos when looking directly at light sources. Some describe it as seeing spots or having double vision. Sources of light are not visible clearly and have halos surrounding them. Unfortunately, seeing halos around light is not something people take seriously because they think it is fairly normal. The more frequently such bouts of non-vision occur, the more eyesight is at risk. If you see halo rings around lights, you should see a doctor as soon as possible.

Onset of Visual Disturbance

Many people with glaucoma also suffer from visual disturbance, especially in low light. They may not be able to see objects exactly as they are, with lines and edges appearing wavy or distorted. The tendency when this happens is to pass off the disturbance as some random error of sight but as the disease progresses, this nature of visual disturbance becomes hard to ignore. It is recommended that an ophthalmologist be consulted on the earliest incidence of this problem.

Various Kinds of Eye Irritability

Those with glaucoma face a lot of discomfort in their eyes in ways unrelated to vision. For instance, apart from pain in their eye(s), the area surrounding the eye also tends to get tender and achy . The eyes may get watery often with excessive tearing, especially when eyes are under strain (like when reading, watching TV, etc.). Alternately, the eye may feel dry and gritty, causing the urge to rub and itch.

Unusual Response to Light-Based Stimuli

People with glaucoma react very unusually to light-based stimuli, especially in the later stages of the condition. They may have problems in adjusting to a dark or dim room and may also have difficulties in lighted spaces or sources of glare.

Headaches

Severe headaches accompanied by eye pain and blurred vision are also typical warning signs of closed-angle glaucoma. An attack of this kind should be handled in the emergency room.

Glaucoma Treatment

Glaucoma can be treated with eye drops, pills, laser surgery, traditional surgery or a combination of these methods. The goal of any treatment is to prevent loss of vision. The good news is that glaucoma can be managed if detected early, and that with medical and/or surgical treatment, most people with glaucoma will not lose their sight.

If you have glaucoma, it is important to take your medications regularly and exactly as prescribed in order to control your eye pressure. Your eye doctor may prescribe eye drops as treatment. Since eye drops are absorbed into the bloodstream, it is important to tell your doctor about other medications you are currently taking. Ask your doctor and/or pharmacist if the medications you are taking together are safe. Some drugs can be dangerous when mixed with other medications. To minimize absorption into the bloodstream and maximize the amount of drug absorbed in the eye, close your eye for one to two minutes after administering the drops and press your index finger lightly against the inside corner of your eyelid to close the tear duct which drains into the nose. While almost all eye drops may cause an uncomfortable burning or stinging sensation at first, the discomfort should last for only a few seconds.

Sometimes, when eye drops don’t sufficiently control your eye pressure , pills may be prescribed in addition to drops. These pills, which have more systemic side effects than drops, also serve to turn down the eye’s faucet and lessen the production of fluid. These medications are usually taken from two to four times daily. It is important to share this information with all your other doctors so they can prescribe medications for you which will not cause potentially dangerous interactions.

When medications do not achieve the desired results, or have intolerable side effects, your ophthalmologist may suggest surgery.

This month is Glaucoma Awareness Month. If you suffer from glaucoma, stay informed about the latest research on the disease and its treatment through the Glaucoma Research Foundation at glaucoma.org.

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