What causes glaucoma?
Often the cause of glaucoma is unknown. Glaucoma occurs in a seemingly normal eye without evidence of other conditions. Elevated eye pressure can be caused by trauma, eye tumors or abnormal blood vessel growth.
It does not appear that any specific foods or activities cause glaucoma, though some studies have shown that certain exercises can lead to slightly lower eye pressures, slowing progression or risk for the disease. There is no clear science indicating any direct relationship between other medical illnesses such as high blood pressure and glaucoma.
How is glaucoma diagnosed?
Only a qualified eye care professional can diagnose glaucoma during a comprehensive dilated eye exam. Patients do not experience any pain or other symptoms until permanent visual loss is present.
If necessary, the ophthalmologist will have you take a visual field test, which measures your peripheral vision. The ophthalmologist will also thoroughly examine the back of your eye for any changes that might indicate nerve damage from glaucoma.
Having your eyes checked regularly by an optometrist or an ophthalmologist can detect changes in eye pressure before vision loss occurs. The American Academy of Ophthalmology recommends glaucoma screening:
- Every four years beginning at age 40 if you do not have glaucoma risk factors
- Every two years if you are at high risk or over 65
What are the risk factors for glaucoma?
The following factors increase risk:
- A family history of glaucoma
- 35 years of age or older
- African American of any age
- History of severe eye inflammation or infection
- History of eye trauma
- Previous eye surgery
- Steroid use (oral or inhaled)
Many medications increase the risk of glaucoma and/or increase eye pressure. It is important to bring a current list of all of your prescriptions and over-the-counter medications to your ophthalmology appointments.
How is glaucoma treated?
There has been a lot of innovation treating glaucoma and researchers continue to improve upon these treatments. The ultimate goal of treating glaucoma is sight preservation. Fortunately, we now have the ability to treat earlier glaucoma earlier to retain as much vision as possible. Treatments can include:
Eye drops are the first line defense against glaucoma. There are several different types, which work separately or in conjunction with one another. If you have problems while using your glaucoma drops, notify your doctor immediately so that other options can be prescribed. Do not discontinue medications of any kind without notifying your doctor.
If eye drops are not an option, or are no longer working, your doctor may consider a laser procedure to lower the pressure in your eyes. There are a few types of laser treatments for glaucoma; your doctor will discuss which is best for you.
When medications and laser treatments do not lower eye pressure enough, the doctor may recommend a surgical procedure called a trabeculectomy, sometimes called conventional surgery.
Minimally Invasive Glaucoma Surgery
Minimally invasive glaucoma surgery procedures are less invasive. These procedures enhance the eye’s existing outflow system. They are recommended for patients who have early to moderate glaucoma and who are interested in decreasing the number of glaucoma medications they are currently using. Current techniques available:
- These are patients who have early to moderate open angle glaucoma and would like to reduce or possibly eliminate their glaucoma drop usage. The iStent is a titanium stent. It is placed in the drainage angle during cataract surgery to enhance outflow. Most iStent patients have early to moderate open angle glaucoma and would like to reduce or eliminate glaucoma drop usage.
- This microsurgical device removes the trabecular meshwork which is believed to be the site of resistance of the outflow system in the eye. This can be a stand-alone procedure or can easily be done at the time of cataract surgery.
- This technique can be performed at the time of cataract surgery or after a patient has had cataract surgery to reduce the production of fluid within the eye. By affecting the inflow, the intraocular pressure is reduced. A laser probe with a camera is introduced into the eye to apply laser to the ciliary processes, which is the part of the eye that creates the fluid in the eye.