Glaucoma Awareness

eye doctor

After Cataracts, Glaucoma is the second leading cause of blindness worldwide! Given its prevalence and asymptomatic nature (in its early stages), assessing for glaucoma is an important part of every routine evaluation. So what is glaucoma and what causes it?

In its most basic form, glaucoma is damage to the nerve fibers that connect the brain to the retina. These nerve fibers conduct signals from the outside world to our brain to produce vision. Peripheral vision is affected first; however, as the peripheral vision continues to constrict, central vision is eventually affected as well.

The cause of this damage is nuanced. We know that high intraocular pressure (IOP) can play a role, but even so, many people have higher IOP with no damage, while others have damage in the presence of “normal” IOP. This makes the evaluation of the retinal nerve fiber and the optic nerve a very important part of every exam, regardless of IOP readings.

Other than high IOP, a few of the most common risk factors for glaucoma include advancing age, racial background (estimated 3-4 times higher risk in Latino or African American patients), thin corneas, and low perfusion pressure (i.e. decreased blood flow to the eye).

Other possible risk factors include diabetes, high blood pressure, and sleep apnea, among others.  Genetics play a role as well, though the mechanism of inheritance is not clear due to the complexity of interactions between multiple genes.  However, there is a 10% prevalence among siblings.

Rest assured, if there is evidence for glaucoma that is discovered at your annual exam, we explain everything and have you back for further evaluation. During this more comprehensive evaluation, we measure how much healthy nerve fiber you have and its response to visual stimuli; this enables us to better assess peripheral vision and overall function. We also use a special instrument (called a gonioscopy lens) to evaluate for any anatomical effects on your intraocular pressure. Oftentimes, a suspicion for glaucoma requires monitoring over time.

The good news is that, if caught early and treated properly, most forms of glaucoma are very manageable! This treatment consists of lowering the intraocular pressure and is usually done through the use of daily eye drops; however, depending on the effectiveness of the drops, surgery may be required as well.

Other than high IOP, a few of the most common risk factors for glaucoma include advancing age, racial background (estimated 3-4 times higher risk in Latino or African American patients), thin corneas, and low perfusion pressure (i.e. decreased blood flow to the eye).

Other possible risk factors include diabetes, high blood pressure, and sleep apnea, among others.  Genetics play a role as well, though the mechanism of inheritance is not clear due to the complexity of interactions between multiple genes.  However, there is a 10% prevalence among siblings.

Rest assured, if there is evidence for glaucoma that is discovered at your annual exam, we explain everything and have you back for further evaluation. During this more comprehensive evaluation, we measure how much healthy nerve fiber you have and its response to visual stimuli; this enables us to better assess peripheral vision and overall function. We also use a special instrument (called a gonioscopy lens) to evaluate for any anatomical effects on your intraocular pressure. Oftentimes, a suspicion for glaucoma requires monitoring over time.

The good news is that, if caught early and treated properly, most forms of glaucoma are very manageable! This treatment consists of lowering the intraocular pressure and is usually done through the use of daily eye drops; however, depending on the effectiveness of the drops, surgery may be required as well.

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