What is it?
Glaucoma (glaw-KO-muh) is an eye disease that can damage your optic nerve and cause loss of vision (sight). Although it can happen quickly, glaucoma more commonly steals a person's vision slowly over time. Some people do not know they have glaucoma until they begin to lose their side vision. Many people do not even know they have glaucoma until they have their eyes checked by an eye doctor. Glaucoma is a disease you will have for the rest of your life. You can have it in one or both of your eyes. There is no cure for glaucoma, but it can be controlled with medicine or surgery. Without treatment, you can lose some or all of your vision.
How does glaucoma damage the eyes? A clear fluid flows through the eye all the time to keep it moist (wet) and healthy. As new fluid is made, old fluid flows out of the eye through the trabecular (truh-BEK-u-ler) meshwork. The trabecular meshwork is a tiny drain system located where the iris and the cornea join together. With glaucoma, the drain system becomes blocked or clogged. Like a sink drain, clogging causes the old eye fluid to drain too slowly or not drain at all. Fluid builds up and increases pressure in the back of the eye. When the fluid pushes too hard against the optic nerve, the nerve becomes damaged. The optic nerve is the nerve of sight, which sends messages to your brain. When the messages reach the brain, you are able to understand what you are seeing. When the optic nerve is damaged, you may lose parts of your vision or you may become blind.
Is glaucoma always caused by high eye pressure?
- No. People with normal eye pressure can have glaucoma, too. Doctors have found that some people have damage because even a normal eye pressure is too high for their eyes. When a person with normal eye pressure has glaucoma, it is called "normal-tension" or "low-tension" glaucoma. If you have this glaucoma, your doctor will give you medicine to keep your eye pressure lower than it normally is. This will help to stop or slow down damage caused by normal eye pressure.
- Doctors have also found that some people with high eye pressure do not have glaucoma. High eye pressure without glaucoma is called "ocular hypertension." If you have ocular hypertension, it is important to see your eye doctor regularly. The doctor will check the health of your optic nerve and make sure you are not developing glaucoma.
Who is at high risk for having glaucoma?
- Anyone over 60 years old.
- African-Americans over 40 years old.
- People who have a family member with glaucoma.
- People who have diabetes (di-uh-BE-tees) or high blood pressure.
- People who have had a severe (very bad) eye injury. Glaucoma can occur immediately after the injury or may happen any time in the future.
What is primary open-angle glaucoma?
- Most people have this type of glaucoma. Open-angle glaucoma is a slow forming type of glaucoma that is common in people as they get older. With open-angle glaucoma, your eye drain system may become clogged and drains fluid much too slowly. Fluid build-up causes your eye pressure to become too high and optic nerve damage to happen. There are usually no clear signs or symptoms until damage to the eye has already been done.
- If glaucoma goes untreated, you can lose your side vision first. You may have blurred vision on one side toward your nose. You may have problems focusing on work that is close to your eyes. You may need to change your glass prescriptions often. Poor night vision or blind spots in your vision are other late signs. At night, you may see rainbows or halos (circles) around lights as your glaucoma gets worse.
What are other less common types of glaucoma?
- Angle-closure glaucoma: This is a quick forming type of glaucoma that may also be called "acute glaucoma." There is a sudden total blockage of fluid behind the iris (colored part of the eye). Pressure inside the eye increases quickly because of the fluid backup. You may have blurred vision and a bad headache. You may have red eyes, severe throbbing eye pain, or see colored rings around lights. You may feel sick to your stomach or may vomit (throw up). Acute angle-closure glaucoma is a medical emergency. It must be quickly treated to prevent blindness.
- Secondary glaucoma: This may be caused by an injury, infection, or certain medicines, such as eye drops containing steroids. It may be caused by a tumor, bleeding or blood clots inside the eye, or diabetes. These problems can cause pressure inside the eye to increase.
- Congenital (kun-JEN-ih-tull) glaucoma: Congenital glaucoma happens to a baby while he is growing inside his mother's uterus (womb). With this type of glaucoma, the passages inside the eye are not normal. A baby with this kind of glaucoma may have eyes that water a lot. Bright lights may bother the baby's eyes. This is not a common type of glaucoma.
To prevent glaucoma, diabetes and high blood pressure should be treated with medicine and diet.
Eye tests will be done to learn about your glaucoma. To treat glaucoma, you may need medicines or surgery. Any vision that you have lost because of glaucoma may not return. You will need to have your eyes checked often to control glaucoma.
Herbs and Supplements:
Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition.
- Coleus (Coleus forskolii) may be helpful for glaucoma and has been studied in people.
- Lipoic acid has been used, but has not been studied in people who have glaucoma.
- Magnesium has been used, but has not been studied in people who have glaucoma.
Recommended Screening Tests/Exams:
There is no cure for glaucoma but it can be treated and controlled if found early. A complete eye exam, to include checking the pressure, should be done every year starting at 40 years.
Other ways of treating your symptoms:
Other ways to treat your symptoms are available to you.
Talk to your caregiver if:
- You would like medicine to treat glaucoma.
- Your symptoms have not gone away or improved by these self-help measures.
- You have questions about what you have read in this document.
SEEK CARE IMMEDIATELY IF:
- You have sudden, severe eye pain.
- You have a sudden change in your vision.
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
1. Meyer BH, Stulting AA, Muller FO et al: The effects of forskolin eye drops on intraocular pressure. S Afr Med J 1987; 71:570-571.
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