Glaucoma is a disease of the optic nerve – the part of the eye that carries the images we see to the brain. The optic nerve is made up of many nerve fibers, like an electric cable containing numerous wires. When damage to the optic nerve fibers occurs, blind spots develop. These blind spots usually go undetected until the optic nerve is significantly damaged. If the entire nerve is destroyed, blindness results.
Early detection and treatment by your ophthalmologist are the keys to preventing optic nerve damage and blindness from glaucoma.
Glaucoma is a leading cause of blindness in the United States, especially for older people. But loss of sight from glaucoma can often be prevented with early treatment. If you live in the Berkeley or Oakland area and would like to schedule a comprehensive and personalized eye exam with Dr. Breaux, contact us today in Pinole at (510) 724-8100 or in Oakland at (510) 655-6626.
Clear liquid called aqueous humor circulates inside the front portion of the eye. To maintain a healthy level of pressure within the eye, a small amount of this fluid is produced constantly while an equal amount flows out of the eye through a microscopic drainage system. (This liquid is not part of the tears on the outer surface of the eye.) Because the eye is a closed structure, if the drainage area for the aqueous humor – called the drainage angle – is blocked, the excess fluid cannot flow out of the eye. Fluid pressure within the eye increases, pushing against the optic nerve and causing damage.
Typically, open-angle glaucoma has no symptoms in its early stages and vision remains normal. As the optic nerve becomes more damaged, dark spots (Scotoma) begin to appear in the field of vision. You typically won't notice these blank spots in your day-to-day activities until the optic nerve is significantly damaged and these spots become large. If all the optic nerve fibers die without glaucoma treatment, blindness results.
Symptoms may include:
This is a true eye emergency. If you have any of these symptoms, call your ophthalmologist immediately. Unless this type of glaucoma is treated quickly, blindness can result.
Unfortunately, two-thirds of those with closed-angle glaucoma develop it slowly without any symptoms prior to an attack.
Your ophthalmologist considers many kinds of information to determine your risk for developing the disease. The most important risk factors include:
Dr. Breaux will weigh all of these factors before deciding whether you need treatment for glaucoma, or whether you should be monitored closely as a glaucoma suspect. This means your risk of developing glaucoma is higher than normal, and you need to have regular examinations to detect the early signs of damage to the optic nerve.
Regular eye examinations by your ophthalmologist are the best way to detect glaucoma. A glaucoma screening that only checks the pressure of the eye is not sufficient to determine if you have glaucoma. The only sure way to detect glaucoma is to have a complete eye examination.
During your glaucoma evaluation, Dr Breaux will:
Photography of the optic nerve or other computerized imaging may be recommended and performed in the office.
As a rule, damage caused by glaucoma cannot be reversed. Eye drops, laser surgery and surgery in the operating room are used to help prevent further damage. In some cases, oral medications may also be prescribed. With any type of glaucoma, periodic examinations are very important to prevent vision loss. Because glaucoma can progress without your knowledge, adjustments to your treatment may be necessary from time to time.
Glaucoma is usually controlled with eye drops taken daily. These medications lower eye pressure, either by decreasing the amount of aqueous fluid produced within the eye or by improving the flow through the drainage angle.
Never change or stop taking your medications without consulting your ophthalmologist. If you are about to run out of your medication, ask your ophthalmologist if you should have your prescription refilled. Glaucoma medications can preserve your vision, but they may also produce side effects. You should notify your ophthalmologist if you think you may be experiencing side effects.
All medications can have side effects or can interact with other medications. Therefore, it is important that you make a list of the medications you regularly take and give this list to all of your doctors, including Dr. Breaux.
Laser surgery may be recommended for different types of glaucoma.
In open-angle glaucoma, the laser is used to increase the drainage of fluid (trabeculoplasty) from the eye and reduce the pressure. The Lumenis SLT laser is our laser of choice and is the latest and best technology for performing SLT to treat glaucoma.
Treatment for glaucoma requires teamwork between you and your doctor. Your ophthalmologist can prescribe treatment for glaucoma, but only you can make sure that you follow your doctor's instructions and take your eye drops. Once you are taking medications for glaucoma, your ophthalmologist will want to see you more frequently. Typically, you can expect to visit your ophthalmologist every three to four months. This will vary depending on your treatment needs.
Regular medical eye exams may help prevent unnecessary vision loss. Recommended intervals for eye exams are:
If you would like to schedule an eye exam for early detection or treatment of glaucoma, contact Dr. Breaux today. He is very experienced at diagnosing and treating all forms of glaucoma, including performing advanced laser procedures. In Pinole, call (510) 724-8100 and in Oakland or Berkeley call (510) 655-6626 to schedule an eye examination.
Credit: American Academy of Ophthalmology
