What is Glaucoma?
This is one of the most common questions I am asked by new patients. Glaucoma is a common condition. It affects 1 in 50 Americans over age 40. Glaucoma causes blindness in some patients. However, when diagnosed early and treated appropriately, most patients maintain excellent vision for their lifetime.
Glaucoma is a disease that damages the optic nerve. The optic nerve is the connection between the eye and the brain, the connection that sends whatever the eye sees to the brain so that we can actually perceive what we’re seeing. Without the optic nerve, the eye is blind.
Patients with glaucoma have progressive damage to the optic nerve. As glaucoma develops, the eye develops blind spots. In the early stages of the disease, a patient is not aware of these blind spots. In advanced glaucoma, there are more blind spots and as they come together, patients become aware that parts of their vision are blurred or simply missing. Left untreated, the disease progresses until there is complete loss of vision.
Unfortunately, vision loss from glaucoma is irreversible. The goal of treatment is preventing vision loss from occurring. Diagnosis when glaucoma is mild or before damage occurs is essential and leads to a better long term outcome.
Glaucoma is usually diagnosed during routine eye exams. The intraocular pressure or pressure in the eye may be elevated. The optic nerve may look suspicious for glaucoma. Either of these findings may lead your eye doctor to order additional testing for glaucoma.
We test for glaucoma or optic nerve damage by testing both the function and structure of the optic nerve. The function of the optic nerve is assessed through visual field testing. A computer maps out the sensitivity of points in your visual field. The goal is to look for any areas where there is decreased sensitivity or possible early blind spots.
We test the structure of the optic nerve by measuring the thickness of certain layers of the tissue around the optic nerve. This may be referred to as Optical Coherence Tomography or OCT.
Through both visual field testing and OCT, your eye doctor can then determine if you have glaucoma and how early or advanced it is.
The treatment for glaucoma is to lower intraocular pressure or IOP. Lowering IOP slows and often prevents worsening of glaucoma. We can lower pressure either through drops, laser or surgery. The first line therapy for glaucoma is usually drops or laser. In multiple studies, laser and drops have been shown to be equally as effective with some studies showing that laser may be the more cost-effective option.
Your eye doctor will determine how low your eye pressure needs to be and then work towards getting your pressure down to that level. The goal would be no further glaucoma damage, that is, the goal is to preserve your vision for the rest of your lifetime.
Once the eye pressure is lowered to the goal pressure, the structure and function of the optic nerve must still be monitored. We monitor the health of the optic nerve at regular intervals through both visual field and OCT testing. If no further damage has occurred, then the therapy is continued. If there is more optic nerve damage, then the IOP should be lowered further.
With early diagnosis and appropriate therapy, most glaucoma patients enjoy good vision for their lifetime. Unfortunately, some glaucoma patients still go blind. Often this is when the diagnosis is not made until the disease is already advanced or in patients who are unable to adhere to therapy. However, the majority of glaucoma patients, if diagnosed early and treated appropriately do very well. This is one of the many benefits of an annual routine eye exams.
Market Street At Heath Brook
4414 SW College Road, Ocala, FL 34474
1500 S.E. Magnolia Ext., Suite 106, Ocala, FL 34471
The Villages Office
1950 Laurel Manor Drive, Suite 250
The Villages, FL 32162
200 West Office
8520 S.W. State Road 200, Ocala, FL 34481
Ocala Eye Surgery Center
3330 S.W. 33rd Road, Ocala, FL 34474