Glaucoma

What is glaucoma?

Glaucoma is a disease of the optic nerve. The optic nerve is a cable that exits the back of the eye and goes to the brain. It carries visual information to the brain. Glaucoma is sometimes, but not always increase of intraocular pressure or pressure within the eye. Over time it can lead to a progressive loss of the peripheral field of vision.

What are some of the warning signs associated with glaucoma?

Unfortunately, there aren’t a whole lot of warning signs or symptoms associated with glaucoma. Some people have called it a sneak-thief of sight for that reason. It’s often detected just with a routine screening exam. Those screening exams become very important. Even if you feel like you have healthy eyes, you should have examinations every two to four years starting at age 40, steadily increasing as you age so individuals over age 60 should complete an eye exam probably every year, even if they feel that their eyes are healthy, to pick up diseases such as glaucoma.

Who is at risk for glaucoma?

There are groups that are at increased risk compared to others for glaucoma, and that includes people who have a first degree family member who has glaucoma, e.g. a mother, father, brother, or sister, and certain ethnic groups. African Americans, Hispanics, or Asians can be at higher risk for glaucoma.

What are the latest treatments offered for glaucoma?

Current treatments for glaucoma first start with medications or drops given to the eye to lower the eye pressure and decrease the risk of damage to the optic nerve. There are also laser treatments that can be done in the clinic to accomplish the same goal.

Traditionally, there’s been a gap after medical and laser treatments where we’re not entirely comfortable with how patients are doing but we’re not quite ready to lower the eye pressure through surgery. There have been good surgeries for decades to lower the eye pressure but they have a certain recovery period that’s involved, a lot of follow-up visits, and we still do those with regularity to help protect people’s vision.

There is a newer category of surgery for glaucoma called minimally invasive glaucoma surgery or micro basil glaucoma surgery. The goal of the surgery is to fill in the gap where someone’s not doing quite so well on drops or laser therapies but are not quite ready to go into one of the more invasive surgeries yet. These are sometimes combined with cataract surgery aiming to optimize or increase the eye’s own natural drainage pathway to lower the pressure. They tend to have less recovery time and in many cases, less potential for serious side effects.

What do you recommend for those who feel they are at high risk for glaucoma?

The most important first step is to have an eye exam. It doesn’t even have to be with a glaucoma specialist. It could be with your local eye care provider. What they might do to look at one’s risk for glaucoma is checking the eye pressure during the appointment.

They may perform a test at the peripheral field of vision. This is the form of the vision that is preferentially affected by glaucoma but we don’t exactly notice in our life because its way out there at the edges.

They may perform a test to look at the function, check the thickness of the clear front window of your eye or the cornea, which can affect our risk for glaucoma. They’ll examine the optic nerve before taking some pictures of the optic nerve to look at its appearance. Whether it appears healthy and relaxed or thin in certain areas can be signs of glaucoma.    

Last reviewed: 
October 2020

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