Glaucoma

with Dr. Raphael Rosenbaum

Glaucoma

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What is glaucoma?

Glaucoma is a constellation of diseases that lead to optic nerve damage progressive vision loss and blindness. Glaucoma occurs when the normal eye pressure rises above normal physiologic levels. However, with early intervention one can often prevent severe vision loss.

What is the optic nerve?

The optic nerve made up of over 1 million individual nerve fibers. It serves as a rely between the the retina and the brain. The retina absorbs the external light waves and transmits them via the optic nerve to the brain.

What are the different forms of glaucoma?

The most common form of glaucoma is open-angle glaucoma.  However there are other types including low tension glaucoma, angle closure glaucoma, congenital glaucoma, and the broad catagory of secondary glaucomas.  Secondary glaucoma includes pigmentary glaucoma, neovascular glaucoma and steroid induced glaucoma.

How does open-angle glaucoma damage the optic nerve?

Patients with open angle glaucoma have no clear pathology to explain why there pressure is elevated.  There production tissue appears normal and there drainage canal seems intact.  Despite this there eye pressure is to high.  Elevated eye pressure leads to compression of the optic nerve and resultant loss of nerve fiber tissue.

Does increased eye pressure mean that I have glaucoma?

Glaucoma is defined as the presence of elevated eye pressure, optic nerve damage and concomitant visual field loss. However many practitioners may recommend close follow up and early initiation of therapy based on the overall clinical picture in an effort to prevent vision loss.

Can I develop glaucoma if I have increased eye pressure?

Not every person with elevated eye pressure will develop glaucoma. There are some people who may be able to tolerate elevated eye pressure better than others.  However there is no way to know in advance where you will fall in this spectrum.  As a result a comprehensive eye exam with ancillary testing is always needed when suspicion for glaucoma is high.

Can I develop glaucoma without an increase in my eye pressure?

Unfortunately yes.  Just like some people develop heart disease without any clear risk factors like elevated cholesterol, pressure etc. patients can also develop glaucomatous damage with normal eye pressure. This is often referred to as normal tension glaucoma or low pressure glaucoma.

Who is at risk for glaucoma?

Anyone can develop glaucoma, however there are some identifiable risk factors. Risk factors include being African Americans heritage, people with a family history of glaucoma diabetes, uveitis or steroid induced elevated eye pressure.

What are the symptoms of glaucoma?

Glaucoma is often referred to as the sneak thief of vision as the earliest stages of glaucoma are often aymptomatic. Why is that?  It is primarily a result of the nature of the disease.  Glaucomatous visual loss usually begins in the periphery as a result the visual loss is often not noted until it is too late.

Can glaucoma be treated?

Yes first line treatment is typically with pressure lowering drops.  There are numerous types of drops and depending on the type of glaucoma your physician may prescribe different drops.  If pressure lowering drops are unable to control your pressure laser therapy or surgical options exist that can better control your eye pressure.