Glaucoma in Adults: A Patient's Guide

The National Eye Institute [Website] This information can help you decide what to do if you are diagnosed with glaucoma. Talk to your eye care professional so you can make the choice that is right for you.

What Is Glaucoma?

Glaucoma is an eye disease in which the normal fluid pressure inside the eyes slowly rises, leading to vision loss or even blindness.

What Causes Glaucoma?

At the front of the eye, there is a small space called the anterior chamber. Clear fluid flows in and out of the chamber to bathe and nourish nearby tissues. In glaucoma, for still unknown reasons, the fluid drains too slowly out of the eye. As the fluid builds up, the pressure inside the eye rises. Unless this pressure is controlled, it may cause damage to the optic nerve and other parts of the eye, and loss of vision.

Who is Most Likely to Get It?

Nearly 3 million people have glaucoma, a leading cause of blindness in the United States. Although anyone can get glaucoma, some people are at higher risk. They include:

• Blacks over age 40
• Everyone over age 60
• People with a family history of glaucoma.

Symptoms of Glaucoma

At first, there are no symptoms. Vision stays normal, and there is no pain. However, as the disease progresses, a person with glaucoma may notice his or her side vision gradually failing. Objects in front may still be seen clearly, but objects to the side may be missed. As the disease worsens, the field of vision narrows and blindness results.

How is Glaucoma Detected?

Many people may know of the "air puff" test or other tests used to measure eye pressure in an eye examination. But, this test alone cannot detect glaucoma. Glaucoma is found most often during an eye examination through dilated pupils. This means drops are put into the eyes during the exam to enlarge the pupils. This allows the eye care professional to see more of the inside of the eye to check for signs of glaucoma.

Glaucoma Treatments

While glaucoma cannot be cured, it can usually be controlled. The most common treatments are:

• Medications: Eye drops or pills are designed to reduce pressure by slowing the flow of fluid into the eye, or may improve fluid drainage. For most people with glaucoma, regular use of medications will control the increased fluid pressure. But these drugs may stop working over time, or they may cause side effects. If a problem occurs, the eye care professional may select other drugs, change the dose, or suggest other ways to deal with the problem.
• Laser Surgery: During laser surgery, a strong beam of light is focused on the part of the anterior chamber where the fluid leaves the eye. This results in a series of small changes, which makes it easier for fluid to exit the eye. Over time, the effect of laser surgery may wear off. Patients who have this form of surgery may need to keep taking glaucoma drugs.
• Surgery: Surgery can also help fluid escape from the eye and thereby reduce the pressure. However, surgery is usually reserved for patients whose pressure cannot be controlled with eye drops, pills or laser surgery.

Vision Protection

Studies have shown that the early detection and treatment of glaucoma, before it causes major vision loss, is the best way to control the disease. If you fall into one of the high-risk groups for the disease, make sure to have your eyes examined through dilated pupils every two years by an eye care professional.

Controlling Glaucoma

Visit with your doctor and decide on a treatment that is best for you. You and your doctor will work in partnership to achieve your best possible level of health. An important part of this relationship is good communication. Here are some questions you can ask your doctor to get your discussion started:

About My Disease or Disorder

• What is my diagnosis?
• What caused my condition?
• Can my condition be treated?
• How will this condition affect my vision now and in the future?
• Should I watch for any particular symptoms and notify you if they occur?
• Should I make any lifestyle changes?

About My Treatment

• What is the treatment for my condition?
• When will the treatment start, and how long will it last?
• What are the benefits of this treatment, and how successful is it?
• What are the risks and side effects associated with this treatment?
• Are there foods, drugs, or activities I should avoid while I'm on this treatment?
• If my treatment includes taking a medication, what should I do if I miss a dose?
• Are other treatments available?

About My Tests

• What kinds of tests will I have?
• What do you expect to find out from these tests?
• When will I know the results?
• Do I have to do anything special to prepare for any of the tests?
• Do these tests have any side effects or risks?
• Will I need more tests later?

Understanding your doctor's responses is essential to good communication.

Here are a few more tips:

• If you don't understand your doctor's responses, ask questions until you do understand.
• Take notes, or get a friend or family member to take notes for you. Or, bring a tape-recorder to assist in your recollection of the discussion.
• Ask your doctor to write down his or her instructions to you.
• Ask your doctor for printed material about your condition.

If you still have trouble understanding your doctor's answers, ask where you can go for more information. Other members of your health care team, such as nurses and pharmacists, can be good sources of information. Talk to them, too.

This information was gathered on Omni, a high-quality Internet resource for health and medicine. For more information, visit the website. To learn more about glaucoma write: National Eye Health Education Program, 2020 Vision Place, Bethesda, MD 20892-3655.