Eye Diseases

Glaucoma (Information furnished by the Glaucoma Research Foundation)

Primary Open Angle Glaucoma

This is the most common form of glaucoma, affecting about three million Americans. It happens when the eye¹s drainage canals become clogged over time. The inner eye pressure (also called intraocular pressure or IOP) rises because the correct amount of fluid can't drain out of the eye. With open angle glaucoma, the entrances to the drainage canals are clear and should be working correctly. The clogging problem occurs inside the drainage canals, like the clogging that can occur inside the pipe below the drain in a sink.

Most people have no symptoms and no early warning signs. If open angle glaucoma is not diagnosed and treated, it can cause a gradual loss of vision. This type of glaucoma develops slowly and sometimes without noticeable sight loss for many years. It usually responds well to medication, especially if caught early and treated.

Angle Closure Glaucoma

This type of glaucoma is also known as acute glaucoma or narrow angle glaucoma. It is much more rare and is very different from open angle glaucoma in that the eye pressure usually goes up very fast. This happens when the drainage canals get blocked or covered over, like the clog in a sink when something is covering the drain. With angle closure glaucoma, the angle between the iris and cornea is not as wide and open as it should be. The outer edge of the iris bunches up over the drainage canals, when the pupil enlarges too much or too quickly. This can happen when entering a dark room.

A simple test can be used to see if your angle is normal and wide or abnormal and narrow. Treatment of angle closure glaucoma usually involves surgery to remove a small portion of the outer edge of the iris. This helps unblock the drainage canals so that the extra fluid can drain. Usually surgery is successful and long lasting. However, you should still receive regular check-ups. Symptoms of angle closure glaucoma may include headaches, eye pain, nausea, rainbows around lights at night, and very blurred vision.

Secondary Glaucoma

Glaucoma can occur as the result of an eye injury, inflammation, tumor or in advanced cases of cataract or diabetes. It can also be caused by certain drugs such as steroids. This form of glaucoma may be mild or severe. The type of treatment will depend on whether it is open angle or angle closure glaucoma.

Normal Tension Glaucoma (NTG)

Normal tension glaucoma is also known as low tension glaucoma or normal pressure glaucoma. In this type of glaucoma, the optic nerve is damaged even though intraocular pressure (IOP) is not very high.

Doctors do not know why some people¹s optic nerves are damaged even though they have what is considered to be "normal" (between 12-22 mm Hg) pressure levels.

Those at higher risk for this form of glaucoma are people with a family history of normal tension glaucoma, people of Japanese ancestry, and people with a history of heart disease, such as irregular heart rhythm. Normal tension glaucoma is usually detected after an examination of the optic nerve.

The Glaucoma Research Foundation sponsored an international study to help determine the best treatment for this type of glaucoma (Collaborative NTG Study). The study concluded eye drops that lower IOP were effective even in cases of normal tension glaucoma. Currently, most doctors treat normal tension glaucoma by keeping normal eye pressures as low as possible with medicines, laser surgery, or filtering surgery.

Pigmentary Glaucoma

This is a form of secondary open angle glaucoma. It occurs when the pigment granules in the back of the iris (the colored part of the eye) break into the clear fluid produced inside the eye. These tiny pigment granules flow toward the drainage canals in the eye and slowly clog them, causing eye pressure to rise. Treatment usually includes medications or surgery.

Cataracts and Glaucoma

Both cataracts and glaucoma can be a natural part of the aging process. Many people over 60 may have both. Otherwise, the two are not associated. With the exception of glaucoma due to secondary causes such as trauma or steroids, glaucoma does not cause cataracts and cataracts do not cause glaucoma. While glaucoma is most often a problem with drainage, a cataract is a clouding of the eye¹s lens allowing less light to pass through.

Both cataracts and glaucoma are serious conditions that can cause you to lose vision. However, loss of vision due to cataracts can be reversed with surgery. Loss of vision from glaucoma is, as yet, irreversible.