Is it an emergency?
Recently, you’ve noticed that there seems to be certain places in your field of vision that you can’t see something if it’s in a particular spot. Other than that, your vision seems to be fine. So, what is going on? Why can’t you see in these areas? Should you go to a doctor?
Glaucoma is what happens when there is damage to the optic nerve typically from elevated eye pressure due to the buildup of the aqueous humor (the fluid that flows inside your eye). The aqueous humor drains into the anterior chamber (front part of the eye) through the trabecular meshwork (specialized tissue) at the angle where the iris and cornea meet. There are two types of glaucoma: open-angle and angle-closure. Open-angle is the most common and is the leading cause of blindness in the United States. This occurs when pressure within the eye gradually increases over time due to blockages in the trabecular network that cause the natural flow of aqueous humor drainage to be decreased. Since this happens slowly, many people aren’t aware they have a problem until their vision is gone. In angle-closure, the iris bulges forward, which narrows or blocks the drainage angle from the cornea and iris. Since the aqueous humor can’t circulate through the eye like it normally doesn’t, the pressure inside the eye increases. This closure can happen slowly or rapidly, therefore, is referred to as chronic or acute. Certain things can increase your risk of developing glaucoma, such as being over 60, having a family history of glaucoma, being African American or Hispanic, having high internal eye pressures, having certain medical conditions (diabetes, high blood pressure), having other eye conditions/injuries, early estrogen deficiencies and taking corticosteroids for extended periods of time.
Symptoms of open-angle glaucoma are sporadic blind spots that can occur in your field of vision. These blind spots can be on the side (peripheral) or central areas of your vision and often occur in both eyes. As the condition advances, many people experience tunnel vision. Acute angle-closure glaucoma symptoms include eye pain, severe headache, blurred vision, halos around lights, eye redness and nausea/vomiting. If you have any of these symptoms, it is considered a medical emergency and you should be evaluated by a doctor immediately.
For acute angle-closure glaucoma, the treatment goal is to reduce the pressure within your eye as quickly as possible. Often this involves a procedure known as a laser peripheral iridotomy, which involves taking a small laser to create a tiny hole in your iris that allows the aqueous humor to flow through it, thus relieving the pressure. Unfortunately, the damaged that is caused by any type of glaucoma cannot be reversed. Treatment for glaucoma types, other than acute angle-closure, is aimed at slowing or preventing vision loss, which is done by decreasing the pressure within your eye. Most often the first step in doing this involves prescription eyedrops. The eyedrops either improve how the aqueous humor drains from your eye or decreases the amount of it that is produced. If these alone aren’t working, your doctor may prescribe oral medications to help reduce the pressure in your eye. If you still aren’t having improvement in your eye pressures, your doctor may recommend surgery to correct whatever is the underlying cause of your glaucoma.
Preventing glaucoma might not be possible depending on your risk factors, but there are several things that you can do to help decrease the impact it has on your life. One of the key ways to do this is to catch it early. The best way to do this is getting eye exams every four years starting at the age of 40 and every two years staring at the age of 65. If you are at increased risk for developing glaucoma, your doctor may recommend other screening time frames. This is why it is essential to know what risk factors you having, including family history of glaucoma since it is often hereditary. Always wear eye protection when doing anything that could result in something striking your eye, such as using power tools or playing sports. Exercising regularly helps to manage your blood pressure and other conditions, so in turn, it helps to reduce your eye pressure. Eating a healthy diet and limiting caffeine can also be helpful in reducing eye pressure. If your doctor prescribes eye drops, be sure to take them as prescribed, even if you aren’t experiencing any symptoms.
Glaucoma is definitely a life-changing experience. It is essential to do what you can to decrease your eye pressure and seek prompt treatment for any vision changes that you notice. If you have any questions or concerns, please speak with your doctor. If you would like more information, please visit the American Academy of Ophthalmology’s Glaucoma page at https://www.aao.org/eye-health/diseases/what-is-glaucoma