Glaucoma
What is glaucoma?
Glaucoma is a disease
of the optic nerve, the part of the eye that
carries the images we see to the brain. The
optic nerve is made up of many nerve fibers,
like an electric cable containing numerous
wires. When damage to the optic nerve
fibers occurs, blind spots develop. These
blind spots usually go undetected until the
optic nerve is significantly damaged. If the
entire nerve is destroyed, blindness results.
Glaucoma is the leading cause of blindness
in the United States, especially for older
people. But loss of sight from glaucoma can
often be prevented with early treatment.
What causes glaucoma?
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Clear liquid called
aqueous humor circulates inside the front
portion of the eye. To maintain a healthy
level of pressure within the eye, a small
amount of this fluid is produced constantly
while an equal amount flows out of the eye
through a microscopic drainage system.
Because the eye is a closed structure, if the
drainage area for the aqueous humor (called
the drainage angle) is blocked, the excess
fluid cannot flow out of the eye. Fluid pressure
within the eye increases, pushing against the
optic nerve and causing damage.
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What are the different types of glaucoma?
The most common form is chronic openangle
glaucoma and the risk of developing
this form increases with age. The drainage
angle of the eye becomes less efficient over
time, and pressure within gradually increases,
which can damage the optic nerve. Typically
open-angle glaucoma has no symptoms in its
early stages. As the optic nerve becomes more
damaged, blank spots appear in the field of
vision. You typically won’t notice these blank
spots until the optic nerve is significantly
damaged and these spots become large. If all
the optic nerve fibers die, blindness results.
Closed-angle glaucoma occurs in people
whose eyes are formed with the iris (the colored
part of the eye) too close to the
drainage angle. In these eyes, the iris can be
sucked into the drainage angle and block it
completely. Since the fluid cannot exit the
eye, pressure inside builds rapidly and causes
acute closed-angle attack. This is a true eye
emergency and unless this type of glaucoma
is treated quickly, blindness can result.
Detecting and treating glaucoma
Regular eye exams are the best way to detect
glaucoma. A glaucoma screening that checks
only the pressure of the eye is not sufficient.
The only sure way to detect glaucoma is to
have a complete eye examination to inspect
the drainge angle, test your peripheral vision
of each eye and evaluate whether or not
there is any optic nerve damage. As a rule,
damage caused by glaucoma cannot be
reversed. Eyedrops, laser surgery, and surgery
in the operating room are used to help prevent
further damage. In some cases, oral
medications may also be prescribed.
Dr. Elmquist will recommend the treatment
appropriate for you.
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