If you’ve been diagnosed with glaucoma, you might be feeling daunted and a little bit scared. It’s not an easy diagnosis to come to terms with – after all, if not treated it is possible to lose your vision entirely. However, with the proper treatment and preparation, you can live a perfectly normal life even after diagnosis – and preserve your vision.

 

Believe it or not, an early glaucoma diagnosis actually puts you at an advantage compared to those experiencing glaucoma without a diagnosis. A diagnosis means that a treatment plan can begin right away – and while there is not yet a cure for the disease, treatment can keep you from becoming blind.

 

If glaucoma is something you’re coming to terms with, it’s important to remember you’re not alone. According to glaucoma.com, over 3 million Americans are estimated to have the disease, and, because early symptoms are often non-existent, only about half of those know it. It is estimated that there are about 60 million people living with glaucoma worldwide.

 

Glaucoma is the second leading cause of the blindness in the world – and while anyone of any age can get glaucoma, it is most common in people over the age of 60. More than 120,000 US citizens are blind from glaucoma – usually because they did not receive a diagnosis until much of their vision was already lost.

 

While anyone can get glaucoma, African Americans are especially susceptible, from a younger age. African Americans are 6-8 times more likely to go fully blind, and 15 times more likely to become visually impaired. To put this into perspective, open-angle glaucoma accounts for 19% of blindness among African Americans, whereas it only accounts for 6% of blindness among Caucasians. Asian and Hispanic people are also at a higher risk of glaucoma than Caucasians.

 

Other people at high risk are those who have a relative with glaucoma, those who are extremely near or far sighted, people who have high eye pressure, an eye injury, or use steroids. 

 

Clearly, Glaucoma affects a significant number of people every year – so whether or not you’ve been diagnosed, it’s important to understand what the disease and how to detect it – even without symptoms.

 

On today’s episode of All Home Care Matters, we’ll go into exactly what glaucoma is and how it affects vision. We’ll talk about the different types of glaucoma and how they are diagnosed. Then, we’ll go over symptoms, treatment, and what life might look like after diagnosis. By the end of this episode, listeners should have a good understanding of the disease – including what to expect and what treatment plans to follow.

 

So, what is glaucoma? It’s an eye disease that can lead to blindness without treatment, or if diagnosed too late. To understand exactly how glaucoma works, let’s talk about the eye itself.

 

Millions of nerve fibers exist in each of our eyes that run from the retina to the optic disc and onward through the optic nerve. The retina is in the back of our eyes, and its job is to take light and turn it into electrical signals. The signals then travel through the optic nerve into the brain – where the brain processes visual information. This is how we see.

 

When a person has glaucoma, the fibers do not travel up the optic nerve, but become clogged at the optic disc. Without traveling up the optic nerve, the signals become blogged and do not reach the brain. At the same time, the eye’s drainage system cannot function due to the clog – so the fluids in our eyes that are normally drained out through our pupil build up and do not drain. The build-up of fluid leads to pressure inside the eye, which can damage the nerve fibers, leading to loss of vision.

 

Glaucoma occurs in both eyes for most people, but it tends to begin in one eye before gradually affecting the other. Usually, people experience blindness of their peripheral, or side vision, first – and it can be so slight that some might not even notice. Many patients will subconsciously turn their head to see to the side, and not even realize that their peripheral vision is not functioning properly. Without treatment, central vision will eventually be lost, too. Early detection, though, can mean preventing total or even partial loss.

 

While a build-up of pressure is certainly a leading cause of glaucoma, it is not the only cause. We know this because some people with glaucoma have perfectly normal pressure ranges within their eyes. Researchers are still working to find out the other causes of the disease.

 

There are about ten different types of glaucoma, but the two most common are open-angle glaucoma and angle-closure glaucoma. Primary open-angle glaucoma is by far the most common, as it accounts for about 90% of all cases – that’s about 2.7 million Americans, usually over the age of 40.

 

Open-angle glaucoma occurs when the angle where your iris, or the colored part of your eye, meets the cornea, or the clear part of your eye, opens how it should, but a clog of fluids prevents drainage from occurring properly.

 

The lack of drainage and increase of fluids raises the pressure in the eye until it damages the optic nerve, keeping light signals from reaching the brain and causing vision loss. Think of it as a clogged pipe in a sink, that keeps the liquid from draining.

 

Open-angle glaucoma is a slowly developing disease that has no early warning signs. That’s why so many people do not realize they have the disease until they are already going blind. However, if open-angle glaucoma is detected early enough, it can be treated. This type of glaucoma can be detected in eye exams even before loss of vision occurs – so make sure to get your eyes checked at least every two years as a precaution.

 

Angle-closure glaucoma, sometimes called narrow-angle glaucoma, is the second leading type of the disease. About 16 million people worldwide suffer from angle-closure glaucoma, according to Glaucoma Today.

 

In angle-closure glaucoma, the angle where the iris meets the cornea fails to open. This closed angle causes the drainage of fluids to become blocked and eye pressure is increased, leading to optic nerve damage and, eventually, vision loss. Like open-angle glaucoma, this is a slow moving disease without early symptoms.

 

In the early stages of angle-closure glaucoma, the angle might not be fully closed, and the optic nerve can still function properly. That’s why, if found early, treatment can be affective.

 

There is a form of this type of glaucoma that is especially dangerous and requires immediate medical attention. That’s acute angle-closure glaucoma, in which the pressure in the eye rises quickly, causing pain in the eye, blurry vision, redness, colorful halos, and nausea or vomiting. This can cause severe vision damage. If you or a loved one is experiencing these symptoms, get to a doctor right away.

 

There are eight other, rarer, types of glaucoma that are mostly variations of open-angle or angle-closure glaucoma. These include normal-tension glaucoma, secondary glaucoma, pigmentary glaucoma, congenital glaucoma, exfoliative glaucoma, neovascular glaucoma, uveitic glaucoma, and traumatic glaucoma.

 

Normal-tension glaucoma occurs when the optic nerve is damaged even though there is not a pressure build-up in the eye. It affects Japanese people at a higher rate than any other groups, as well as people with migraines, irregular heart rhythm, and low blood pressure. Researchers are still attempting to find out why glaucoma happens without increased pressure.

 

Secondary glaucoma happens when a person has a concrete cause of their glaucoma – this could mean eye injury, inflammation, or a negative response to medication. Treatment for secondary glaucoma will vary depending on whether the angle where the iris meets the cornea is open or closed.

 

Pigmentary glaucoma occurs when pigment granules in the iris become trapped in the drainage system. This is considered a type of open-angle glaucoma. The trapped pigments can lead to a clog in the system, preventing fibers from traveling up the optic nerve and sending signals to the brain. Pigmentary glaucoma mostly effects Caucasian males who are significantly near-sighted.

 

Congenital glaucoma happens to babies at birth. It affects about 1 in 10,000 babies each year. It happens when the eye’s drainage system does not fully develop or develops incorrectly before birth. Babies with congenital glaucoma might have large eyes, cloudy corneas, and suffer from light sensitivity. This is often an inherited form of the disease.

 

Exfoliative glaucoma happens when flaky pieces of the outer layer of the eye peel off and gather in the angle where the cornea and iris meet. This will clog the drainage system and raise eye pressure. People with exfoliative glaucoma will experience higher pressures than people with other types of the disease. It is most common in people from Russia, India, and the Mediterranean.

 

Neovascular glaucoma happens when new blood vessels form abnormally over the eye’s drainage cells. The blood vessels block the fluid from draining and eye pressure increases, causing the optic nerve to become damaged. People with diabetes are more likely to have this type of glaucoma.

 

Uveitic glaucoma is a result of uveitis, which happens when the iris is inflamed. The inflammation blocks drainage and damages the optic nerve. Sometimes, people with uveitis respond poorly to the steroids used to calm the inflammation, and the optic nerve is damaged.

 

Traumatic glaucoma occurs when a person suffers an eye injury – usually blunt injuries that bruise the eye or injuries that penetrate the eye. This type of glaucoma might happen immediately after injury – but it can develop years later.

 

Even though glaucoma does not have many symptoms, doctors can diagnose the disease by measuring the pressure in the eye, examining the shape and color of the optic nerve, testing a person’s field of vision, examining the angle where the iris meets the cornea, and measuring the thickness of the cornea. These tests can discover glaucoma long before a person experiences symptom – so it’s essential to get your eyes checked at least twice a year, so you can get a diagnosis in time to start treatment.

 

Vision changes happen for most people around the age of 40, so at this age it’s especially important to book regular appointments with your eye doctor. There, your doctor will let you know how often you should come back. If you have diabetes, blood pressure issues, or glaucoma in your family, they will likely recommend you come in more often.

 

Now, in some of the rarer types of glaucoma a person might experience actual symptoms. These might include eye pain, headaches, nausea or vomiting, sudden sight loss, hazy vision, or seeing rainbow-colored circles – particularly around bright lights. If you are experiencing any of these symptoms, make sure to book an appointment with an eye doctor as soon as possible.

 

If you’ve been diagnosed with glaucoma, there are treatments that can keep you living a normal life and prevent you from suffering extreme vision loss. This is especially true if your glaucoma is diagnosed early enough, before vision loss begins to occur.

 

Doctors treat glaucoma by lowering the pressure in the eye through a variety of methods. These might include medications, incisional surgery, laser surgery, or all three. Treatment will vary depending on the individual case.

 

While there is no cure for glaucoma, treatment is usually successful for most patients when implemented early enough. Incisional surgery, for instance, has a success rate of 70-90%, according to glaucoma.com. While the treatments might sound a bit frightening (no one likes getting surgery) they are often the only way to prevent vision loss.

 

Now, that said, a glaucoma diagnosis does not necessarily guarantee that you will go blind. Total blindness only occurs in about 5% of patients, but some populations, like African Americans, are more likely to suffer from total blindness than others. Significant vision loss, while not total blindness, occurs in about 10% of patients, especially if they do not receive treatment.

 

Speak to your doctor about the best treatment plan for you, so you can combat glaucoma before you suffer any vision impairment. Your doctor will have a plan for you to follow so you can manage the disease in the best way for you.

 

People with glaucoma can continue to live a high quality of life, as long as they are getting treatment. Patients will meet with doctors periodically and take eye medications daily. If vision impairment has occurred, driving might be affected – along with some activities like playing sports. You also might feel especially sensitive to light. Still, you should be able to live life pretty much as usual. If you are feeling sensitive to light, you can get tinted glasses to help.

 

Most glaucoma patients will visit with their doctors about once a week or a month at the beginning of treatment, but over time your visits will shift to a few times a year. Your doctor will be able to help you find the plan that works best for you.

 

Glaucoma can feel like a daunting diagnosis – but with early detection, regular doctor appointments, and proper treatment, it can be a manageable disease that does not result in significant loss of vision.

 

If you or your loved one has been diagnosed with the disease, make sure treatment begins right away – so you can keep doing what you love, for as long as you want to.

 

We want to thank you for joining us here at All Home Care Matters, All Home Care Matters is here for you and to help families as they navigate long-term care issues. Please visit us at allhomecarematters.com there is a private secure fillable form there where you can give us feedback, show ideas, or if you have questions. Every form is read and responded to. If you know someone is who could benefit from this episode, please share it with them.

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Sources:

https://www.glaucoma.org/GRF_Understanding_Glaucoma_EN.pdf

 

https://www.webmd.com/eye-health/understanding-glaucoma-symptoms

 

https://www.brightfocus.org/glaucoma/news/understanding-glaucoma

 

https://www.webmd.com/eye-health/glaucoma-eyes

 

https://www.healthcentral.com/slideshow/glaucoma-symptoms-types-treatment

 

https://www.mayoclinic.org/diseases-conditions/glaucoma/diagnosis-treatment/drc-20372846#:~:text=Glaucoma%20is%20treated%20by%20lowering,combination%20of%20any%20of%20these.

 

https://www.aao.org/eye-health/diseases/glaucoma-treatment

 

https://www.glaucoma.org/news/blog/new-treatment-options-for-managing-glaucoma.php

 

https://glaucomatoday.com/articles/2009-july-aug/GT0709_08-php

 

https://www.glaucoma.org/treatment/conventional-surgery.php