Understanding Glaucoma

What is Glaucoma?

Glaucoma is a disease of the eye that causes a painless peripheral vision loss due to increased pressures inside the eye. No one really knows the exact cause, or etiology, behind glaucoma. We do know that there is a hereditary component to glaucoma, and if left untreated glaucoma can cause irreversible blindness. The frightening thing about glaucoma is that most patients have lost a significant amount of peripheral vision before they realize there is a visual problem.

What are the Symptoms of Glaucoma?

There are two main types of glaucoma, one is called open angle and the other is called closed or narrow angle. Most patients with open angle glaucoma (the most common) have no significant symptoms until a large amount of peripheral vision has been lost. Patients with elevated eye pressure (normal is less than 22) can have some dull pain and associated headaches, but normally there is no pain. Patients that have what is called a closed angle attack of glaucoma usually have severe pain, commonly associated with loss of central vision, nausea and vomiting.

How does Glaucoma damage the eye?

Elevated pressure is believed to be caused by a defect in the filtration system (or the drain) inside the eye ball. The pressure builds up and causes compression of the optic nerve in the back of the eye, leading to death of the neurons that supply the electrical signals from the retina to the brain. The most common area to lose vision first is in the periphery. This peripheral vision loss can be picked up by a special test in our office called the Visual Field Test.

How is Glaucoma treated?

Treatment for glaucoma is solely based on lowering the pressure in the eye. Sometimes that can be done with topical drops. If drops cannot lower the pressure sufficiently, then a laser can sometimes be used to lower the pressure. This laser is called an SLT and is done in the office. If drops or laser does not lower the pressure, then a surgery called a trabeculectomy can be performed by Dr. Stewart.

Dr. Stewart and Glaucoma

Dr. Stewart is fellowship trained by the late Dr. Robert Stewart, a pioneer in glaucoma diagnosis and treatment.