Glaucoma Risk Factors

Risk factors for glaucoma include:

● Age 45 or older
● Family history of glaucoma
● History of injury to the eye
● African American
● History of steroid use, either in the eye (drops) or systemically (orally or injected)
● Diabetes
● Nearsighted (myopic)
● Farsighted (hyperopic)
● History of elevated intraocular pressure

A series of tests can be performed to determine if you have glaucoma. If you are diagnosed with glaucoma and are being treated, these tests can determine if it is being adequately controlled. If glaucoma is detected in a comprehensive eye exam, the doctor will design a treatment plan especially for you. We will go over the treatment options available and make recommendations for which treatment or combinations of treatments are best for your specific condition.

Causes and Symptoms

When talking about glaucoma, the terms “open-angle” and “closed-angle” are often used. The angle refers to the area in the eye where fluid drains out into the bloodstream, which is critical to maintaining normal pressure in the eye. When fluid cannot drain out of the eye properly, the intraocular pressure (IOP) gets too high.

Angle narrowing progresses over time as the eye changes with age. Because of this, all closed-angle glaucoma patients begin with an open angle that can progress to a narrow angle and then to a closed angle. 

Open-angle glaucoma is the most common form of glaucoma in the United States and has no initial symptoms, developing slowly over time. The disease begins when the drainage canals in the angle of the eye become clogged with age, which elevates that internal pressure of the eye.  This increase in pressure damages the optic nerve, and you generally will not experience any changes in vision until severe eye damage has already occurred. The two major symptoms of open-angle glaucoma are an altering of peripheral vision and tunnel vision (in advanced stages).

Closed-angle glaucoma occurs because of changes in the shape of the eye and in the thickness of the lens inside the eye, which can occur in some people. There can be gradual progression of a  narrow angle to the point where the eye’s internal fluid cannot get out of the eye through the drainage area because it is too narrow. There are two types of closed-angle glaucoma, chronic and acute. Chronic closed-angle glaucoma occurs when the eye’s drainage angle narrows gradually, and slowly restricts the ability of fluid to drain from the eye. The progression of this is often the same as open angle glaucoma. Acute closed-angle glaucoma occurs when sudden changes in the eye cause the drainage area to close completely. This results in the iris not being as wide and open as it should be, leading to a sudden increase in intraocular pressure.  Symptoms include severe headaches, nausea, vomiting, and blurred vision/ halos around lights.  These symptoms are intense and noticeable, and you must get medical attention immediately. At the time of your comprehensive eye exam, the doctor will
let you know if you are at risk for this type of problem.

Diagnosis

At our office, we can perform several tests to diagnose glaucoma. Most glaucoma is diagnosed through a routine pressure check and an optic nerve evaluation which are parts of a comprehensive eye exam. The doctor will check for optic nerve damage by looking directly through the pupil at the back of your eye to examine the shape and color of the optic nerve. A visual field test, corneal thickness measurement, and other tests can also help determine if you have glaucoma.

Treatment and Procedures

Damage to the optic nerve is irreversible, so there is no cure for glaucoma. This means it is imperative to have regular checkups and take prescribed medication as directed. The goal of treatment is to reduce intraocular pressure and slow down the effects of glaucoma. 

Treatments include:

● Medications
● Laser treatments
● Traditional surgical treatments
● Minimally invasive glaucoma surgeries