Glaucoma - Diagnosis, Treatment, and Prevention

What is Glaucoma?

Glaucoma is a disease that damages your eye’s optic nerve. It usually happens when fluid builds up in the front part of your eye. That extra fluid increases the pressure in your eye, damaging the optic nerve. It’s the most common form of optic nerve damage leading to vision loss.

How is Glaucoma Diagnosed?

Regular eye examination is important to detect glaucoma or other eye problems as it is possible to have glaucoma and not know it. Eye exams can assess optic health and vision loss. To check for glaucoma, an eye doctor may conduct one or more of these painless tests:

1. Dilated eye exam

This test is done to widen pupils and view your optic nerve at the back of your eyes.

2. Gonioscopy

This test is done to examine the angle where your iris and cornea meet.

3. Optical Coherence Tomography (OCT)

This test is done to look for changes in your optic nerve that may indicate glaucoma.

4. Ocular Pressure Test

Also known as tonometry, this test is done to measure eye pressure.

5. Pachymetry

This is done to measure corneal thickness.

6. Slit-lamp exam

This is done to examine the inside of your eye with a special microscope called a slit lamp.

7. Visual Acuity Test

This is to check for vision loss using eye charts.

8. Visual Field Test

This is done to check for changes in peripheral vision i.e. your ability to see things off to the side.

Management & Treatment

If left untreated, glaucoma can lead to faster development of permanent vision loss or blindness. Though available treatments can’t restore lost vision, it can slow down additional vision loss. It’s important to see an eye doctor right away if you have eye pain, severe headaches or vision problems.

1. Eye drops

There are many types of eye drops available which your doctor can prescribe to treat glaucoma. Some decrease fluids and increase drainage to improve eye pressure. Because glaucoma is a lifelong condition, you may need to use daily eye drops for life. You may have to apply them more than once a day.

2. Oral Medications to treat Glaucoma

Your doctor might also prescribe oral medication. These drugs can improve drainage or slow the creation of fluid in your eye.

3. Laser Therapy

Your doctor may suggest laser as a first-line therapy instead of drops or in addition to eye drops. This is because a strong beam of light can help to improve fluid drainage from your eye by either increasing the flow of fluid from your eye or it can stop fluid blockage. The results from laser treatments vary but can last for years in some cases. Procedures include:

• Trabeculoplasty: This helps to open the drainage area.

• Iridotomy: This makes a tiny hole in your iris to let fluid flow more freely.

• Cyclophotocoagulation: This treats areas of the middle layer of your eye to lower fluid production.

4. Surgery

This is another way to help reduce eye pressure. While this method is more invasive, it can also achieve better eye pressure control faster than drops or lasers. Surgery can help slow down vision loss, but it can’t restore lost vision or cure glaucoma. There are many types of surgeries for glaucoma, so your doctor may choose depending on specific type and severity.
For instance, there is traditional surgery which involves cutting your eye and then there is minimally invasive glaucoma surgery (MIGS). There are many types of MIGS procedure available, including different types of stents or devices used to improve the outflow of fluid from your eye. These procedures typically take less time to perform and have a faster recovery time with potentially fewer risks involved than traditional surgeries.

Glaucoma Risk Factors

Glaucoma mostly affects adults older than 40 years, but young adults, children, and even infants can have it.  You’re more likely to get it if you have family history, are older than 40 years, have poor vision or are near-sighted or far-sighted.

Prevention of glaucoma

You can’t prevent glaucoma. But if you find it early, you can lower your risk of eye damage. These steps may help protect your vision:

1. If you’re older than 40 years, visit an ophthalmologist every 1 to 2 years and get a complete eye exam.

2. Check for family history with glaucoma.

3. Follow your doctor’s instructions.

4. Do moderate physical activity such as walking or jogging at least 3 times a week.

5. Use protective eyewear when playing outdoor activities.