| 1. What is glaucoma? |
page top |
Glaucoma is a set of eye diseases – all of which can permanently damage the optic nerve. The optic nerve is similar to a video cable connecting a DVR to a televsion. The optic nerve connects the eye, which sees images, to the brain, which records and interprets them. This helps your brain understand what you have seen with your eye. If the optic nerve is damaged, irreversible, permanent blindness may occur. The damage almost always occurs very slowly and gradually so that you are usually unaware of the damage until it is too late.
|
| |
| 2. How is glaucoma diagnosed? |
page top |
Glaucoma almost always has NO symptoms. You do not know you have it. Glaucoma is usually detected based on a combination of factors including family and medical history, as well as pressure in the eye, dilating the pupil to look at the optic nerve, testing for the loss of peripheral vision and measuring the thickness of the cornea. You usually are unaware of peripheral vision loss as you see with two eyes together so a small change to one eye is not obvious. Both eyes make microscopic movements so that small side vision defects are missed.
|
| |
| 3. What is that 'air puff test'? |
page top |
The air puff test is a screening test measuring the intraocular pressure in your eye. To accurately determine and follow the eye pressures, most doctors use what is called an applanation tonometer. To use this, a numbing agent with a yellowish dye is placed on your eye and a tonometer is placed against the surface of the eye for a more accurate reading of intraocular eye pressure.
|
| |
| 4. What is a 'normal' eye pressure? |
page top |
There is no such thing as a normal eye pressure. This might sound strange, as there are normal values for blood pressure, blood sugar, etc. However eye pressure is similar to weight. Three people could have the same weight with one being too thin, one too heavy and one just right.
|
| |
| 5. How does glaucoma usually advance? |
page top |
When glaucoma advances, the loss of sight is usually first noticed peripherally. In less frequent occurrences, central vision loss may be detected first. The loss is slowly progressive. The rate varies per person and may vary depending upon the stage of the disease.
|
| |
| 6. How does an eye doctor know if I have lost peripheral (side) vision? |
page top |
Your eye doctor will administer a relatively brief and painless test that will have you cover one eye and with the other, look straight ahead at a screen. You will be given a hand-held clicker. Without moving your eye from the center of the chamber, random flashes of light will appear around the chamber, one at a time. These will vary by brightness. You will press your clicker every time you see a flash of light. The machine will measure what it showed you versus what you saw and print out a report for your doctor to review.
|
| |
| 7. How does an eye doctor measure the thickness of my cornea? |
page top |
A device called a pachymeter will painlessly measure the thickness of your cornea in seconds. The eye is first numbed with a drop. The pachymeter is a handheld device that is placed against the eye for a few seconds. A thinner cornea may be indicative of an increased risk for developing glaucoma if your eye pressure is abnormal.
|
| |
| 8. How many types of glaucoma are there? |
page top |
There are many but the most common type in the United States is called Primary Open Angle Glaucoma. If detected early, eye drops usually stop the progression of Primary Open Angle Glaucoma. Less common is Narrow Angle Glaucoma. If you are diagnosed with this type of glaucoma, you will require a laser procedure to provide immediate drainage of building fluid between the back and front of the eye.
|
| |
| 9. My doctor told me I am a 'glaucoma suspect'. What does this mean? |
page top |
When you are labeled a glaucoma suspect, it means you have the potential to develop glaucoma but do not yet have the disease. Reasons to place the “suspect” label on a patient include family history of glaucoma, elevated intraocular pressure and unusual appearing optic nerves, among others. If you have been diagnosed as a glaucoma suspect, it is important to maintain a regular schedule of follow-up visits with your eye doctor to prevent loss of sight in the event that you do develop glaucoma.
|
| |
| 10. I was just diagnosed with primary open angle glaucoma. Am I going blind? |
page top |
Most people who are receiving regular checkups with their eye doctor learn of their glaucoma diagnosis before they have lost any sight. Glaucoma first involves your peripheral vision, and does not involve central vision until later in its course. The disease is often slowly progressive. The goal of glaucoma therapy is to maintain the current visual function. If a patient follows his or her doctor’s instructions, and take the medications as directed there is an excellent chance that you can maintain your vision. If a significant amount of vision is lost before the first visit, the goal is keep the vision that is remaining. Regrettably, vision that is lost due to glaucoma cannot be restored.
The problem with glaucoma is that it usually has no symptoms and that the progression is so slow that most individuals have no idea it is progressing. Patients therefore tend to not be as compliant with their medications as they should be because they do not notice any differences in their vision.
Maintaining a regular schedule of follow up visits to your eye doctor and taking medications at proper intervals will help preserve your sight. In fact, most people who follow doctor’s instructions maintain full visual activity for the remainder of their lifetime.
|
| |
| 11. If I have glaucoma, will I be able to continue driving? |
page top |
If you have not yet lost your central vision and your peripheral vision is sufficient, continued adherence to your therapy should keep you able to drive, from a visual perspective.
|
| |
| 12. I have glaucoma. What happens if I forget to take my eye drops? |
page top |
The purpose of the drops you take for glaucoma is to lower your eye pressure. If you take a twice-daily drop, each drop works for twelve hours. If you take a once-daily drop, the medication works for approximately 24 hours. If you don’t take your medications, the pressure is not lowered. Therefore, in this period of time, your glaucoma could continue to slowly progress. Just as with high blood pressure, the glaucoma medication is critical regardless of whether you are experiencing symptoms. Preservation of sight is dependent upon maintaining a regular regimen of medication as prescribed by your doctor. While missing a single occasional dose will not cause you to go blind, you should make every attempt to get yourself into a routine that promotes taking your drops every day at the same time. If you are traveling or are out for the evening, plan ahead. If you miss one dose of a once-daily medication per week, you will miss 52 doses (almost 2 months worth!) per year.
|
| |
| 13. I have trouble with eye drops. Is there another treatment path for my glaucoma? |
page top |
Eye drops are not easy to administer! Not only is it difficult for many people to get a drop in their eye, but also it is difficult to make sure that only one drop is squeezed at a time and that the dropper does not touch the eye lid. Only about 30% of people can place a drop on their eye correctly!
Most likely, your doctor will want you to get comfortable taking the drops. Other treatment paths, such as lasers and conventional surgery, are used in the event that you cannot use drops or that drops do not work. Your doctor’s office will likely have video instruction on how to properly insert eye drops. Alternatively, the doctor’s office may have staff that can work with you to improve your technique. If that fails, you may wish to seek the help of a friend or family member to assist you.
|
| |
| 14. Is glaucoma hereditary? |
page top |
Yes, glaucoma tends to run in families. It is not uncommon for glaucoma to skip a generation. If a family member related to you by blood has glaucoma, you may be between four and eight times more likely to get glaucoma than someone else. This is why your doctor will want to know if anyone in your family has/had glaucoma, even back to your grandparents’ generation. If you have glaucoma, it is important to educate members of younger generations so that they may be screened regularly for glaucoma.
|
| |
| 15. Does glaucoma cause problems with night vision? |
page top |
Many glaucoma patients report that night vision is not as good as it once was. Glaucoma can decrease contrast sensitivity, however, night vision loss is usually not directly related to glaucoma.
|
| |
| 16. Does glaucoma affect the ability to distinguish colors? |
page top |
Some glaucoma patients report difficulty distinguishing colors. Color vision loss may be one of the first things to become diminished. However this is usually very subtle. Color vision testing is not used to diagnose glaucoma as there are many things that can cause color vision loss.
|
| |
| 17. What type of laser surgery am I facing if eye drops fail to control my glaucoma? |
page top |
If you have open angle glaucoma, a procedure called laser trabeculoplasty is often used to help lower the pressure. Risks to this procedure are very minimal. The procedure takes a matter of minutes, can be done in your doctor’s office, and can result in a 25% decrease in your eye’s pressure lasting months or years. The procedure does not hurt and does not disable you. You can go about your daily activities after leaving your doctor’s office without any restrictions.
|
| |
| 18. Can a glaucoma patient have laser surgery for corrective vision? |
page top |
Most likely, the answer to this question will be no. The procedure for corrective vision repair can alter the thickness of your cornea. This actually alters the way doctors read the pressure in your eye making the determination of adequate eye pressure reduction much more difficult.
|
| |
Glaucoma FAQ's
