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What is glaucoma?
One part of our eye, the optic nerve, attaches to the back of the eye like a cable to a TV. It transmits signals from our retinal photoreceptors to the visual cortex part of our brain, creating a visual of our world. Additionally, our eyes are filled with clear fluid called the vitreous, which maintains the structure of our eyes similar to the way air does in a tire or water in a balloon. With glaucoma, the vitreous fluid’s pressure is too much for the optic nerve head, and it starts to crush the optic nerve, causing permanent nerve damage.Glaucoma is sometimes called “the thief of sight.” First, the damage to the optic nerve is painless because we do not have any sensation in our optic nerves. Second, the damage starts with our peripheral vision, but our brains have the ability to “fill in” what is “most likely” visually present (such as the edges of a road we are driving on). Therefore, glaucoma may not be detected quickly because we do not perceive these black spots in the missing areas. By the time the damage impacts vision, it is often too late for effective treatment.
Some people confuse glaucoma and cataracts. Cataracts occur when the natural lens in the eye gets damaged and becomes cloudy and opaque. Other people often can see when another person has cataracts (the pupils look whitish or bluish instead of black), but with glaucoma, the disease is not visually apparent. Additionally, while vision loss from cataracts is reversible with surgery to replace the damaged lens, nerve damage from glaucoma is permanent.
What causes glaucoma?
While we don’t know the exact factors that cause glaucoma, the disease has been associated with different gene mutations, suggesting a genetic component. However, this relationship is not clear, and not everyone with one of these mutations gets glaucoma. Nevertheless, a family history of glaucoma is important for your doctor to know. Secondary glaucoma can arise from trauma or inflammation. A history of blunt eye trauma makes regular examinations even more important.The Good News
While this all can sound very alarming, they also alert us to potential danger and to take action. Good news to take to heart:- It is not extremely common; only about 4% of people get glaucoma.
- Glaucoma is very treatable (typically, treatment involves eye drops or laser surgery that can increase fluid drainage), and, in most cases, the damage is slow. This means that for many, regular treatment and adherence to care recommendations may allow functional vision to be maintained for life.
- Eye examinations by your optometrist or ophthalmologist can detect glaucoma long before you notice any changes. While glaucoma is most common in people over 50, it can occur at any age, so beginning and maintaining routine eye exams is essential.
What can you do?
- Get regular eye examinations, which include an eye pressure check and examination of optic nerve health.
- Avoid smoking, as it may accelerate glaucoma damage.
- Regular aerobic exercise may increase blood flow to the optic nerves and lessen damage.
- Vegetables may slow progression, especially green leafy ones, carrots, and other antioxidants.
- Your doctor may recommend changes in your sleeping position, such as elevating the head of your bed, or a consultation for sleep apnea in case a CPAP machine is warranted to maximize blood flow.
- Avoid marijuana. While shown to create a short-term decrease in eye pressure, it is not recommended as it can also result in problems with your vascular system that could ne-gate any positive effects.
- MOST IMPORTANT: if your doctor prescribes eye drops to lower pressure or recommends laser treatments (not LASIK, but a laser procedure to open the eye drainage area), follow the treatment plan thoroughly! While glaucoma can still cause vision loss, regular eye examinations and carefully following medical advice and treatment can help you keep functional vision for the rest of your life!
