Glaucoma is a disease of the eyes marked by increased pressure within the eyeball that can ultimately damage the optic nerve. It affects about two million Americans. Glaucoma cannot be prevented, but it can be treated and sometimes cured by surgery or laser techniques. If it is caught early, glaucoma need not result in blindness.
Open-angle glaucoma, the most common type (accounting for 90 percent of all cases), produces almost no symptoms in its early stages; its earliest sign is a painless increase in eyeball pressure, which can only be measured by an eye-care specialist. Side or peripheral vision may be affected, but only gradually.
A rarer typeclosed-angle glaucomatypically manifests itself as a sudden attack. This form of glaucoma is sometimes mistaken for an upset stomach, since in addition to severe eye pain and reduced vision there may be nausea and vomiting. But in fact, closed-angle glaucoma is a medical emergency that should be treated immediately.
Symptoms of Glaucoma
- Symptomless in early stages
- In open-angle glaucoma, loss of peripheral vision, marked by blind spots; usually affects both eyes
- In closed-angle glaucoma, sudden attacks that involve pain in one eye; blurring of vision; a halo effect around objects; inability to adjust in darker conditions; a cloudy cornea; redness of the eye; and possibly nausea and vomiting. Anyone with symptoms of closed-angle glaucoma should immediately seek medical help, since glaucoma of this type can quickly damage the optic nerve.
What Causes Glaucoma?
The cause of open-angle glaucoma appears to be an increase in intraocular pressure (IOP)that is, pressure within the eyeball. This rise in pressure may be due to a blockage of a spongelike network of connective tissue surrounding the lens. If the network becomes clogged, there is an excessive buildup of the aqueous humorthe clear fluid inside the eye that supplies nutrients and carries waste products away from the lens and cornea (which have no blood supply).
But researchers now know that there is more to glaucoma than IOP. Some people have IOP within the normal range and yet have glaucoma; others have high IOP and don’t have the disease and won’t go on to develop it. It’s true, though, that high IOP is an important risk factor for developing glaucoma; if your pressure is above normal, you need to be checked often.
Several suspected (but still theoretical) causes of glaucoma are insufficient blood supply to the optic nerve, low blood pressure, and sleep apnea.
Some people are at higher risk than others for developing glaucoma,
- anyone with a family history of the disease,
- the severely nearsighted,
- anyone with diabetes,
- anyone over age 65 (up to 3 percent of whom may have the disease),
- anyone taking certain blood pressure medications or cortisone.
Closed-angle glaucoma is caused by a sudden blockage near the iris that prevents aqueous humor from reaching the connective tissue, resulting in a rapid, extremely sharp rise in intraocular pressure that can cause permanent vision loss within a day or two.
Who Should Be Tested?
There are no hard-and-fast recommendations about who should be tested for glaucoma and how often. When you see an optometrist or ophthalmologist, you’ll usually get an eye-pressure test, as well as the test for peripheral vision and an exam of the optic nerve. Both the American Academy of Ophthalmology and the American Optometric Association recommend eye exams, including glaucoma tests, for all adults every three to five years, beginning at age 39.
You may need screening more frequently if you are 65 or older, an African-American over 40, severely nearsighted, have diabetes, or are taking certain blood pressure medications or cortisone. Follow the advice of your eye-care professional about frequency of screenings.
A family history of glaucoma is also a risk factor. And if you have been diagnosed with sleep apnea, you should also be tested for glaucoma.
What If You Do Nothing?
Glaucoma will worsen if not treated, and may lead to blindness through damage to the optic nerve. Early detection and treatment can help prevent or limit vision loss.
Home Remedies for Glaucoma
Glaucoma requires diagnosis and treatment by a vision specialist.
There is no way known to prevent glaucoma. But you can prevent or reduce the vision damage caused by glaucoma by getting tested and obtaining appropriate treatment if you have glaucoma.
Beyond Home Remedies: When To Call Your Doctor
Studies have shown that a combination of screening procedures is more likely to uncover early glaucoma than the simple hand-held tonometer used by many primary-care physicians. Accurate screening for glaucoma is best done by an ophthalmologist or optometrist, and all adults should see one of these eye-care professionals for an exam, which should include testing for glaucoma.
What Your Doctor Will Do
An ophthalmologist can use a diagnostic procedure called tonometry to measure pressure within the eye. Other tests for glaucoma include dilating the pupil for a complete look inside the eye and carrying out measurements to detect subtle losses of peripheral vision.
Medications to reduce glaucoma come in pill or eyedrop form. These drugs are effective in preserving vision and must be taken for life. In some cases laser and surgical techniques may be helpful.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media