Glaucoma

Glaucoma is one of the leading causes of blindness in North America. In glaucoma, the optic nerve (the nerve carrying information from the eye to the brain) is damaged by a build-up of fluid in the eyeball. There are two types of glaucoma, called open-angle glaucoma and closed-angle glaucoma.

The front of the eye is filled with a clear liquid that supplies the eye with oxygen and nutrients and keeps it inflated. A gland behind the upper eyelid produces a steady supply of this liquid, and it normally drains out through a mesh of tiny holes behind the lower eyelid. In glaucoma, the liquid is produced normally, but it cannot drain out of the eye. This causes pressure to build up in the eye, pressing on the optic nerve. The nerve cells slowly lose their blood supply, eventually dying. The outer nerves fail first, so vision loss tends to start at the edges, progressing to "tunnel vision" and blindness. Many people don't notice this at first, and there's usually no pain, so glaucoma is often quite advanced before it's detected. The only exception is a severe acute form of angle closure glaucoma, which is characterized by nausea, vomiting, a dull pain around the eye, and decreased vision.

The good news is that with early treatment, vision loss can be minimized or prevented. Because glaucoma isn't obvious, it's vital to get your eyes checked regularly, especially if you have any of these risk factors:

• family history of glaucoma
• African descent
• advancing age
• nearsightedness
• previous eye injury
• high blood pressure
• diabetes
• long-term use of prednisone, cortisone, or other steroids

Adults should have their eyes checked every one to two years up to the age of 65, and every year after that. But if you have any of these risk factors, you should go as often as your eye care professional recommends. At the check-up, the optometrist will measure the pressure in your eye, look at the optic nerve for signs of damage, and check your peripheral vision. If glaucoma is suspected, you will probably be referred to an ophthalmologist (a physician specializing in eye disorders) for treatment. Glaucoma is usually treated with eye drops that lower the pressure in the eye. In some cases, surgery may be needed.

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