Glaucoma affects nearly three million Americans and is a major cause of vision loss and blindness around the world.
The disease is most common as we age. Beyond age sixty-five, it develops in 2-3 percent of whites and 4-6 percent of African-Americans. It also occurs in infancy and middle age, but this is less common.
Glaucoma is generally painless and progresses so slowly that patients do not notice vision change until the eye is severely damaged. That makes it very dangerous. For these reasons, it is essential to have a comprehensive eye examination by a medical doctor. Fortunately, when diagnosed, it can usually be controlled with treatment.
Glaucoma Damages Your Optic Nerve
There are dozens of different forms of glaucoma, but they all have one thing in common: they cause damage to the optic nerve, which is the connection between the eye and the brain. Think of the optic nerve as the “power cord” for the eye. As the nerve is damaged, transmission of information between the eye and the brain breaks down, causing vision loss. If the nerve suffers severe damage, the eye can become completely blind.
The Most Common Types of Glaucoma
The most common types are open angle glaucoma and narrow angle glaucoma.
The “angle” is the medical name for the drainage system of the eye. The eye is always producing fluid to keep itself inflated, and this fluid exits through the drain in the angle. In most people, the drain is open, thus the term “open angle glaucoma.” In others, the drainage system is closed, and this is called “narrow angle glaucoma.”
Glaucoma also occurs in dozens of other forms, resulting from injury, infection, degeneration, or congenital malformation.
The Effect of High Eye Pressure
Regardless of the specific type, the disease is often a problem of high eye pressure. The drainage system malfunctions, yielding high eye pressure which seems to damage the delicate fibers of the optic nerve. This usually occurs slowly and painlessly, over many years.
It is important to note that eye pressure is only one component of the disease, and in fact many people with normal eye pressure will also develop it. Eye pressure is just one part of the problem. There are other components of the disease, yet despite decades of research, they remain poorly understood.
How We Treat It
The fundamental treatment is to lower the eye pressure. For most patients, taking eye drops is effective. Others receive laser treatments or undergo surgery in which we implant small drainage devices into the eye.
Fortunately, for the vast majority of people with glaucoma, these treatments succeed in controlling the disease, and the patients continue to see well.
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Learn about Ophthalmology (Eye Care) Services at The University of Vermont Medical Center.
David Diaz, MD, is an ophthalmologist at The University of Vermont Medical Center and assistant professor at the Larner College of Medicine at UVM.