Glaucoma: The Silent Disease

Eyes with and without glaucomaSpring is in the air, the sun is shining, flowers are blooming and the world is a beautiful place. No one is thinking their vision or that of a loved one could be slowly slipping away. Our world is unique, with beautiful sights to behold. Dr. Khemsara spends many hours diagnosing and treating patients to preserve the precious gift of sight that allows us to enjoy children at play, the ocean waves rolling onto the beach, or a mountain view, and so much more.

It is estimated that three million Americans have deteriorating vision due to glaucoma which will eventually prevent them from beholding such sights. Only about half of them know that they have glaucoma. How can this happen? Glaucoma is a disease that can cause blindness without any symptoms, and by progressing very slowly. This is why it is known as the “Silent Disease.” Blindness from glaucoma can often be prevented with early detection, yearly eye exams, and treatment. Treatment often comes in the form of ophthalmic eye drops, laser treatments and/or surgery for more advanced stages.

In a healthy eye, excess fluid leaves the eye through the drainage angle, keeping pressure stable.

In the healthy eye, there is a clear fluid called aqueous humor which circulates inside the front portion of your eye through a pathway called the trabecular meshwork. If you have glaucoma, the aqueous humor does not flow out of the eye properly. As this happens, your eye pressure, called intraocular pressure (IOP), rises.   Measuring your IOP is the first step in determining if you may get glaucoma or if, in fact, you already have this disease.

The second step is to determine if your eye pressure has caused damage to the optic nerve fibers. The optic nerve is connected to the retina — a layer of light-sensitive tissue lining the inside of the eye — and is made up of many nerve fibers, like an electric cable is made up of many wires. The optic nerve sends signals from your retina to your brain, where these signals are interpreted as the images you see.

Raised eye pressure leads to damage of the optic nerve. Damage to the optic nerve can occur at different eye pressures in different patients. There is not one ‘right’ eye pressure that is the same for everyone. Your eye care provider establishes a target eye pressure for you that he or she predicts will protect your optic nerve from further damage.

The most common form of glaucoma is called primary open-angle glaucoma. It occurs when the trabecular meshwork of the eye gradually becomes less efficient at draining fluid. If the eye pressure is too high for you, the optic nerve becomes more damaged, and blank spots will begin to appear in your field of vision. You usually won’t notice these blank spots in your day-to-day activities until the optic nerve is significantly damaged and these spots become large.

Eye pressure is not always the same – it rises and falls from day to day and hour to hour. In addition to routine eye pressure testing, it is essential that the optic nerve be examined by an eye care professional for proper diagnosis.

Another type of glaucoma is angle-closure glaucoma. This develops when the patient’s iris is very close to the drainage angle in their eye. The iris can end up blocking the drainage angle. You can think of it like a piece of paper sliding over a sink drain. When the drainage angle gets completely blocked, eye pressure rises very quickly. This is called an acute attack. It is a true eye emergency, and you should call your ophthalmologist right away or you might go blind. Unfortunately, people at risk for developing closed-angle glaucoma often have few or no symptons before the attack. People of Asian descent and those with hyperopia (farsightedness) tend to be more at risk for developing this form of glaucoma. People at risk for closed-angle glaucoma can be diagnosed and treated with a preventive laser procedure. Again, this can only be diagnosed if routine eye exams are scheduled with a trained professional. Symptoms of an acute attack include blurry vision, severe eye pain, headache, nausea, vomiting and rainbow colored rings or halos around lights.

If you have not had an eye exam, please schedule your appointment and encourage others to do the same. Summit Eye Care is in the business of fighting the “Silent Disease.” Let us assist you in preserving vision wherever possible.

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