Glaucoma

The cause of glaucoma is often unknown. It can happen in a seemingly healthy eye without evidence of other conditions. Elevated eye pressure can be caused by trauma, eye tumors or abnormal blood vessels.

It does not appear that certain foods or activities cause glaucoma. But some studies show that certain exercises can lower eye pressure slightly. This helps slow the progression of the disease or the chances of getting it in the first place. 

No evidence shows a direct relationship between glaucoma and other medical conditions, such as high blood pressure.

A qualified eye care professional can diagnose glaucoma during a dilated eye exam. You will not have pain or other symptoms until permanent vision loss occurs.

If necessary, the eye doctor will do a visual field test, which measures peripheral vision. He or she will also examine the back of your eye for any changes that might show nerve damage from glaucoma.

Having your eyes checked regularly by an optometrist or an ophthalmologist can help detect changes in eye pressure before vision loss occurs. The American Academy of Ophthalmology recommends glaucoma screening:

• Every four years starting at age 40 if you don’t have risk factors for glaucoma
• Every two years if you are at high risk or over age 65

Many medications increase eye pressure and/or the risk of glaucoma. For this reason, please bring a current list of all of your prescriptions and over-the-counter medications to your appointments.  

The following factors increase risk:

• A family history of glaucoma
• Age 60 or older*
• Race: Black or Latino and over age 40*
• History of severe eye inflammation or infection
• History of eye trauma
• Previous eye surgery
• Diabetes
• Arthritis
• Steroid use (oral or inhaled)

*National Eye Institute. Glaucoma. Last reviewed July 28, 2020. Accessed September 10, 2020. 

Many advances continue to be made in treating glaucoma. The even better news is that glaucoma can now be treated earlier, helping keep as much vision as possible. Treatments include:

• Eye drops are the first line of defense against glaucoma. There are several types of drops, which work together or alone. If you have problems using drops, tell your doctor. Don’t stop taking medications of any kind without telling your doctor.
• A laser procedure is an option if eye drops don’t work for you. It can lower the pressure in your eyes. There are a few types of laser treatments for glaucoma. Your doctor will advise as to which is best for you.
• A trabeculectomy is a traditional surgery to lower pressure inside the eye. It is often used if medications and laser treatments aren’t effective. 
• Minimally invasive glaucoma surgery helps improve the eye’s existing outflow system. It is recommended for patients who have early to moderate glaucoma and want to lower the number of glaucoma medications they take. Procedures include:
  • iStent is a titanium stent placed in the drainage angle of the eye. This helps the fluid in the eye to drain. 
  • A trabectome removes the tissue that keeps fluid from draining from the eye. This procedure can be done at the time of cataract surgery or by itself. 
  • Endocyclophotocoagulation is a laser technique that reduces fluid production in the eye. It can be done at the time of cataract surgery or after surgery. The goal is to reduce eye pressure. 

Cataracts are diagnosed by an eye care professional during an exam. Simple, painless tests may be done to see if you have cataracts and how they affect your vision. These include tests for sharpness of vision, contrast (similar shades of colors) and night vision.

A change in your eyeglass prescription may improve vision for a while. There are no eye drops or medications that will make cataracts go away. Cataracts can only be removed with surgery. 

After cataracts start to interfere with your ability to do normal things, you might want to consider surgical options. Talk with your doctor to come up with a plan that’s right for you.

An anesthetic is used to make the operation painless. No shots are needed and no stitches are used. And you don’t have to worry about keeping your eyes open or closed.

During the procedure, you may see light or movement, but you will not see the surgery while it’s being done. The cataract is removed through a small, tunnel-like incision made with a tiny probe.

There is minimal pain during the procedure and only minor irritation afterward. Your vision may be a little blurry for a few days. But most patients notice an immediate improvement in their vision.  

Cataract surgery usually involves putting artificial lenses in the eyes. After surgery, most patients need only mild correction and/or reading glasses.