Understanding Glaucoma and Your Risk Factors

Glaucoma is the leading cause of blindness for people older than 60 – but it can often be prevented with early awareness and treatment. Glaucoma damages the eye’s optic nerve when fluid builds up in the front part of the eye. The extra fluid adds pressure in the eye, damaging the optic nerve. According to the Centers for Disease Control (CDC), about 3 million Americans have glaucoma, and it’s the second leading cause of blindness worldwide. Glaucoma can also occur in one or both eyes.

What Are the Types of Glaucoma?

With glaucoma, there are two major types: primary open-angle glaucoma and angle-closure or closed-angle glaucoma. Open-angle glaucoma is the most common form, and results in increased eye pressure. There are often no early symptoms, according to the CDC, leading to estimates that about 50 percent of people with glaucoma don’t know they have the disease.

• Primary open-angle glaucoma: This type happens gradually, when the eye does not drain its fluid efficiently. Eye pressure builds up and begins damaging the optic nerve. It is painless and at first there are no changes in vision. Routine eye exams are critical in helping to find early signs of optic nerve damage.
• Angle-closure glaucoma: This occurs when the iris (the colored part of your eye) is very close to the eye’s drainage angle. The iris can block the drainage angle. When it becomes completely blocked, eye pressure increases quickly in what is called an acute attack. This is an eye emergency and you should call your ophthalmologist. Signs of an acute angle-closure attack include suddenly blurry vision, severe eye pain, nausea, headache and seeing rainbow-colored rings or halos around lights. Angle-closure glaucoma can cause blindness if not treated right away. There is also slow, or chronic angle-closure glaucoma, which happens more slowly and may not include symptoms.

What are the symptoms of glaucoma?

According to the National Institutes of Health, glaucoma usually doesn’t have any symptoms. A person may slowly lose vision over time, usually starting with peripheral vision. As the disease worsens, you may not be able to see things to your side anymore.

Who is at risk for Glaucoma?

Though anyone can get glaucoma, there are a few types of people who have a higher risk. These include African Americans older than 40, all people older than 60, people who have a family history of glaucoma and diabetic people. African Americans, according to the CDC, are 6-to-8 times more likely to be diagnosed with glaucoma than white people. And diabetic people are more than 2 times likely to get glaucoma.

Additionally, you may have a higher risk of diagnosis if:

• You have had an eye injury
• You are farsighted or nearsighted
• Use long-term steroid medication
• Have high eye pressure
• Have corneas that are thin in the center
• Have migraines, high blood pressure, poor blood circulation or other whole-body health problems.

How does my eye doctor check for glaucoma?

Eye doctors can check for glaucomaas part of a comprehensive dilated eye exam. The exam is simple and painless —your doctor will give you some eye drops to dilate, or widen, your pupil and then check your eyes for glaucoma and other eye problems. The exam includes a visual field test to check your peripheral vision.

How is Glaucoma Treated?

When glaucoma begins to cause vision loss, it usually occurs in the peripheral vision first. This is the area you can see to the side of your head when you are looking forward. Later, the disease may impact your central vision. Your eye doctor will typically prescribe eye drops, oral medicine or surgery to reduce the pressure in your eye. These efforts are to try to prevent permanent vision loss.

Is There a Cure for Glaucoma?

There is no cure for glaucoma and if you lose your vision, it cannot be regained. It is possible to halt further loss of vision with medication or surgery.

If you are concerned about whether you have glaucoma, or are experiencing problems with your eyesight, it may be time to visit your eye doctor. It may help you to have a list of questions to ask when you have your appointment, so you get the most comprehensive information available. You may want to ask:

• What type do I have?
• How often do I need to get a checkup for glaucoma?
• What are my treatment options?
• What will happen if I don’t get treated?
• What are the possible side effects of treatment?
• What can I do to help with my glaucoma and protect my vision?
• What will happen to my vision in the future?
• What should I avoid doing after I’ve been diagnosed with glaucoma?

For more information about glaucoma, see www.nei.nih.gov