Learing All About Glaucoma
It is one of the more well-known eye diseases, affecting more than 3 million people in America. It’s a disease that has no cure, but can be prevented and treated to slow and stop further progression. It’s the leading cause of irreversible blindness in the world. And because January is a month dedicated to spreading awareness about this disease, what better way is there for us to explain what it is, how it affects us, and how it is treated. Let’s talk about Glaucoma.
Glaucoma is a buildup of pressure in the front part of your eye. Our eyes usually produce aqueous humor just behind the iris (in the ciliary body). This liquid helps regulate and stabilize the pressure in our eyes. Glaucoma is a disease of profusion, meaning if the pressure in the eye is higher than the pressure in the arteries of the eye, this can halt the nutrient delivery to the cells causing them to die off. While medication and surgery can help treat and prevent extensive damage and vision loss, there is no present cure for the disease.
There are many types of glaucoma, but the two primary types are open-angle glaucoma and angle-closure glaucoma. Open-angle glaucoma is more common, and happens gradually. Over time, the eye will begin to not drain fluid as well as it should, and the buildup causes pressure. This is painless and impossible to self-diagnose, since it doesn’t cause any vision changes until it has advanced into the late stages. Primary Open Angle Glaucoma is often called the “silent thief of sight.” Angle-closure glaucoma occurs when the space between the cornea and iris is narrower than normal to the drainage angle of the eye. The iris’ proximity to the drainage angle can end up blocking it, causing pressure to rapidly build. This is known as an acute attack. This type of rapid pressure build up is a medical emergency and you should contact your doctor or go directly to the emergency department immediately if it occurs.
Unlike open-angle glaucoma that happens gradually without symptoms, angle-closure has some very noticeable symptoms like sudden blurry vision, severe eye pain, seeing halos around lights, headaches, and nausea. If treated immediately the damage to the optic nerve can be minimized. This is a rare, but serious condition. Patients who are at risk will likely be referred to an ophthalmologist for an out-patient laser procedure to reduce the risk of an acute attack ever happening.
Though there is no cure for Primary Open Angle Glaucoma, there are plenty of treatment options and preventative measures available. The best way to make sure glaucoma isn’t present or doesn’t advance: regular comprehensive eye exams. If caught early on, glaucoma can be treated and prevent further harm and vision loss.
While glaucoma can occur in anyone at any age, it tends to be hereditary and statistically affect individuals of African and Hispanic descent. It also has a tendency to occur as we age, occurring more often in people over the age of 60. If you have a family member or family history of glaucoma, it’s even more important to get a comprehensive eye exam on a regular basis to make sure you are not at risk of developing glaucoma.
Since glaucoma increases pressure on the optic nerve, medication and treatment focuses on lowering the pressure and keeping it at a safe level.
Usually, treatment is as easy as a prescribed eye drop medication that lowers the eye pressure. These eye drops can either reduce the amount of aqueous fluid the eye produces or help fluid flow better through the eye’s drainage angle. Other relatively non-invasive treatment options include simple laser procedures, which can be done in the ophthalmologist’s office. There are two main types of laser surgery for open-angle glaucoma, Argon laser trabeculoplasty (ALT) and Selective laser trabeculoplasty (SLT). Trabeculoplasty uses a laser to make the drainage angle work more effectively letting fluid drain properly and reduce eye pressure.
There are also more invasive procedures that can be done in an operating room. These procedures focus on creating a new drainage channel for the aqueous fluid to leave the eye, in the event that the fluid is unable to naturally drain. This includes trabeculectomy, which creates a new drainage channel. Drainage implants can also be strategically placed within the drainage system to help promote outflow, but many may only be performed at the same time as cataract surgery.
Another way to help potentially reduce risk for glaucoma and other eye diseases: eating healthy! You’ve heard us say it time and time again, healthy eating can help keep your eyes healthy in a variety of different ways. From dairy, leafy greens and essential oils, healthy eating has potential to reduce the risk for glaucoma according to research coming from Harvard Medical School. While research has not definitively found leafy greens to ward off glaucoma there are ample benefits relating to macular degeneration, as well as general health, and therefore very little downside to incorporating them into your diet. For a refresher course on what to eat for your eye health, check out our thanksgiving blog!
Of course, when glaucoma is talked about, marijuana usually comes up in conversation as an alternative form of treatment. Marijuana has been a hotbed for debate across the nation in recent years, and while it’s recreationally legal here in Nevada, there’s also some medical facts you should know.
Yes, it’s true: marijuana can lower eye pressure. THC, the active ingredient in marijuana, has been found to be responsible for lowering eye pressure when used safely. However, it’s no longer considered efficient when compared to traditional medicine. Glaucoma is a constant, 24-hour condition, needing treatment that can continually relieve pressure and prevent advancement. Because the effects of marijuana wear off after a couple of hours, the medical relief is just as short lasting, which means its properties of lowering eye pressure only lasts for a couple of hours at a time. Keeping on top of treating glaucoma is important in order to prevent blindness and advancement of the disease, which means reverting back to more traditional – but more efficient – kinds of treatment.
Glaucoma is a serious and potentially blinding disease and for some lucky patients management means only one or two visits to the eye doctor yearly. The more rare or serious cases can have a patient in the doctor’s office every couple of months. Detection is the key, so don’t skip those annual exams just because your vision is good. Think about it like this: you may not know you have termites until your house comes crashing down around you. 2020 is the year of the eye and we want you all to “Think about your eyes!” And because Janurary is Glaucoma Awareness Month, check out this quick breakdown of Glaucoma by the Numbers from the AOA's latest issue of AOA Focus.