Glaucoma

What is glaucoma?

Glaucoma is an eye disease that causes damage to the optic nerve and results in vision loss or blindness if left untreated. The optic nerve is responsible for transmitting visual information from the eye to the brain, and damage to this nerve can lead to a variety of visual problems.

The most common type of glaucoma is primary open-angle glaucoma (POAG), which accounts for about 70-90% of all cases of glaucoma. POAG is a chronic and progressive disease that often develops slowly and without any noticeable symptoms until significant vision loss has occurred. The other less common types of glaucoma are angle-closure glaucoma, and normal-tension glaucoma.

What causes POAG?

POAG occurs when the trabecular meshwork, which is responsible for draining aqueous humor (the fluid that maintains the pressure inside the eye), becomes less efficient and causes an increase in intraocular pressure (IOP). The increased pressure can damage the optic nerve over time, leading to irreversible vision loss.

What are the risk factors for POAG?

POAG is more common in people over the age of 60, as well as in people with a family history of the disease, those with certain medical conditions (such as diabetes and hypertension), those who use of certain medications like corticosteroids, smoke, lead a sedentary lifestyles and individuals of African descent.

What are the symptoms of POAG?

In the early stages, primary open-angle glaucoma (POAG) often does not cause noticeable symptoms. As the disease progresses, however, vision loss can occur. Symptoms may include:

1. Gradual loss of peripheral vision (also known as tunnel vision)
2. Blurred vision or halos around lights
3. Difficulty adjusting to darkness
4. Difficulty with tasks that require good vision in low light, such as driving at night
5. Increased sensitivity to glare
6. Eye pain or discomfort
7. Redness in the eye
8. Nausea or vomiting (in severe cases)

Symptoms may not be noticeable until the disease has progressed significantly, and symptoms can also be caused by other eye conditions, so it is essential to have regular eye exams with an ophthalmologist to detect vision problems early. Early detection and treatment can prevent further vision loss but cannot restore lost vision.

What are the treatment options for POAG?

The treatment options for primary open-angle glaucoma (POAG) aim to lower intraocular pressure (IOP) and prevent further damage to the optic nerve. Treatment options may include:

1. Eye drops: Medications in the form of eye drops can be used to reduce IOP by increasing the outflow of aqueous humor or reducing the production of aqueous humor.
2. Oral medications: In some cases, oral medications may be prescribed to lower IOP. These medications work by reducing the production of aqueous humor or increasing its outflow.
3. Laser therapy: Laser trabeculoplasty is a type of laser therapy that can be used to improve the drainage of aqueous humor from the eye, reducing IOP. This treatment is typically used when eye drops are not effective or well-tolerated. This procedure may need to be repeated over time to maintain its effectiveness.
4. Surgery: Trabeculectomy is a surgical procedure that involves creating a small flap in the sclera (the white part of the eye) to allow aqueous humor to drain out of the eye, lowering IOP. This procedure may need to be repeated over time to maintain its effectiveness.
5. Minimally invasive glaucoma surgery (MIGS) may also be used to lower IOP and preserve vision. These procedures are less invasive than traditional glaucoma surgeries, such as trabeculectomy, and are typically associated with fewer complications and a shorter recovery time. MIGS are typically reserved for people with moderate glaucoma who have not responded to other treatments like eye drops or laser therapy.

Regular eye exams, including measurement of IOP, can help with early detection and treatment of POAG. There is no cure for POAG. POAG requires lifelong, ongoing monitoring and management to prevent further vision loss. Regular eye exams are essential to monitor IOP, assess the progression of the disease and adjust treatments.

Coastal Skin & Eye Institute specializes in the diagnosis and treatment of glaucoma for patients in Carmel Valley, Encinitas, and Grossmont. Our ophthalmologists offer comprehensive care, including advanced treatments to manage and prevent vision loss. Rely on our expertise in ophthalmology for effective glaucoma management.