Catching the ‘sneak thief’ of sight

Glaucoma is one of the leading causes of blindness in the United States. Some research predicts that by the year 2040 glaucoma will become the leading cause of functional blindness in the U.S. Glaucoma is a family of many different diseases that usually causes an increase in the pressure within the eye, damaging the optic nerve. When pressure inside the eye increases over time the optic nerve is damaged. Blind spots in peripheral areas of vision may occur and eventually begin to affect the central vision. Often called the “sneak thief” of sight, most forms of glaucoma do not produce symptoms until vision is already severely damaged and may take many years to do so. However, if caught early, the disease can usually be controlled and permanent vision loss can be prevented.

Intermountain Eye Centers are fully committed to state-of-the-art clinical care of patients with glaucoma. Glaucoma has become a much more complex disease as medical knowledge has advanced and individualized care for patients has become much more important. Recent research has changed many of the aspects of the diagnosis and treatment of different forms of glaucoma and the staff members at Intermountain Eye Centers are in the forefront in development and incorporation of these improvements into the management of glaucoma.  We offer the latest in glaucoma diagnosis and treatment, including Selective Laser Trabeculoplasty (SLT), Minimally Invasive Glaucoma Surgery (MIGS), including iStent and canaloplasty and micropulse cyclo-ablative procedures.

Surgery to create a new passage for fluid drainage.

Surgery to create a new passage for fluid drainage.

 

Intermountain Eye Centers are currently involved in two surgical glaucoma clinical trials.  One involves a MIGS-type implant that may be an improvement on trabeculectomy. The second involves implanting intraocular pressure-lowering medications in the eye as an alternative to eye drops for medical treatment of glaucoma.

FAQs

Can blindness due to glaucoma be prevented?
Regular and appropriate diagnostic examinations by an ophthalmologist are the key to preventing loss of vision due to glaucoma. Ophthalmologists are medical doctors who are specialists in eye care that are trained to examine and treat eye diseases. Although there is currently no way to reverse optic nerve damage, if glaucoma is diagnosed and treated early blindness is almost always preventable. The most important issue in preventing blindness from glaucoma is early detection before the vision is seriously threatened. Appropriate treatment can then prevent further damage.
What are the symptoms of glaucoma?
Over 50 percent of the people who have the disease in the United States do not know they have it. In most cases, glaucoma is asymptomatic and the patient is unaware of a problem. By the time an individual experiences noticeable decreased vision the disease is frequently in its latter stages. Since early warning signs of glaucoma are rare, it is important, especially for those at increased risk, to have medical eye examinations at the appropriate intervals.

Symptoms depend on the type of glaucoma the individual has. Patients who have chronic glaucoma may not be aware of any symptoms because the disease usually develops so slowly that patients rarely notice loss of peripheral vision even though it may, in fact, be significant. This is quite different from the symptoms of cataract or macular degeneration, which affect the central vision first (which makes the patient aware fairly early on of a vision problem). 
An interesting exception to these generalizations of most forms of glaucoma is acute angle closure glaucoma. Even before a full blown acute angle closure attack, patients often experience intermittent symptoms of an impending serious problem.

What are the symptoms of early acute angle closure glaucoma?
Patients experience blurry vision when it starts to get dark or after an emotional upset.
 They see halos around lights and may get headaches around the eye or on the brow accompanied by blurry vision and halos.
 Nausea may accompany the above symptoms.

These symptoms are often mistaken for a migraine headache or another non-glaucoma related vision problem. They can also be precipitated by certain medications a patient is taking. Some ingredients in many over-the-counter cold-relief medications and prescription medications for various conditions can make a susceptible patient more likely to suffer acute angle closure glaucoma. Patients with these symptoms need a careful evaluation of the drainage angle of their eyes to determine if they are at risk for angle closure glaucoma.

How does glaucoma affect the eye?
The eye has an internal pressure created by production of a clear fluid called aqueous humor. This fluid is necessary to maintain the shape of the eye and it acts to maintain the function of the optically clear parts of the eye, including the lens and cornea. This fluid circulates through the eye and exits through the anterior chamber angle and ultimately drains into the bloodstream through blood vessels outside of the eye. In most forms of glaucoma, the aqueous humor outflow is obstructed, resulting in increased eye pressure and, eventually, optic nerve damage. However, glaucoma is not a disease of high pressure in the eye alone. Glaucoma is an optic nerve disease and high pressure within the eye is one of the major risk factors. The vision loss from glaucoma is the result of the death of the structures making up the optic nerve that convey the visual information gathered from the eye to the brain, which is interpreted as vision. The characteristic pattern of damage to the nerve fiber layer in glaucoma produces the patterns of visual field defects that are characteristic of the disease.