How is glaucoma detected?
Regular eye examinations by your ophthalmologist are the
best way to detect glaucoma. A glaucoma screening that checks only 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 exam.
During
your glaucoma evaluation, your ophthalmologist will:
- measure your
intraocular pressure (tonometry);
- inspect the drainage angle of your eye (gonioscopy);
- evaluate whether or
not there is any optic nerve damage (ophthalmolscopy);
- test the peripheral vision of each eye (visual field testing
or perimetry).
Photography of the optic nerve or other computerized imaging may be recommended. Some of
these tests may not be necessary for everyone. These tests may need to be repeated on a regular basis to monitor any
changes in your condition.
How is glaucoma treated?
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.
Medications
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.
Some eye drops may cause:
- a stinging or itching
sensation;
- red eyes or redness of the skin surrounding the eyes;
- changes
in pulse and heartbeat;
- changes in energy level;
- changes in breathing
(especially with asthma or emphysema);
- dry mouth;
- changes in sense of taste;
- headaches;
- blurred
vision;
- changes in eye color.
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 take regularly and share this list with each doctor
you see.
Laser surgery
Laser surgery treatments may be recommended
for different types of glaucoma. In open-angle glaucoma the drain itself is treated. The laser is used to modify
the drain (trabeculoplasty) to help control eye pressure. In closed-angle glaucoma, the laser creates a hole in the
iris (iridotomy) to improve the flow of aqueous fluid to the drain.
Surgery
in the operating room
When surgery is needed to treat glaucoma, your ophthalmologist uses fine microsurgical instruments
to create a new drainage channel for the aqueous fluid to leave the eye. Surgery is recommended if your ophthalmologist
feels it is necessary to prevent further damage to the optic nerve. As with laser surgery, surgery in the operating
room is typically an outpatient procedure.
What is your part in treatment?
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 use 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 six months. This will vary depending on your treatment needs.
Loss of vision can be prevented
Regular medical eye exams can help prevent unnecessary
vision loss. Recommended intervals for eye exams are:
People at any age with symptoms of
or risk factors for glaucoma, such as those with diabetes, a family history of glaucoma, or those of African descent, should
see an ophthalmologist for an exam. Your ophthalmologist will let you know how often to return for follow-up exams.
Adults
20-64 years of age with no signs of or risk factors for glaucoma should get an eye disease screening at age 40 - the time
when early signs of disease and changes in vision may start to happen. Based on the results of the initial screening,
your ophthalmologist will let you know hoe often to return for follow-up exams.
Adults 65 or older
should have an eye exam every one to two years, as recommended by your ophthalmologist.
Reprinted from patient education brochure, Glaucoma, copyright 2008 with permission
of the American Academy of Ophthalmology. All rights reserved.