Glaucoma Screening

Glaucoma is an eye condition that causes vision loss and optic nerve damage over time.  Glaucoma is associated with high eye pressures that contribute to optic nerve damage and ultimately vision loss.

There are 2 large categories of glaucoma:

1. Open-angle glaucoma

2. Closed-angle glaucoma

OPEN-ANGLE GLAUCOMA:

Open angle glaucoma occurs when the drainage system remains open, but the fluid inside the eye starts to drain more slowly.  Over time, the eye pressure can increase causing optic nerve damage.  In the beginning, there are no symptoms, much like high blood pressure has no symptoms when it is mild.  As the disease progresses, peripheral vision loss occurs first and then central vision loss happens last.  There is no way to reverse this vision loss.

CLOSED-ANGLE GLAUCOMA:

Closed angle glaucoma occurs in people who are more likely to be hyperopic (far-sighted).  The fluid in the eye is made behind the lens and needs to travel through the pupil to reach the angle (drain inside the eye).  If the lens becomes too large, the iris pushes forward and blocks the drain. The fluid inside the eye cannot access the drain and the eye pressure builds up very quickly inside the eye. This typically occurs in the evening or dim light.  If this occurs, this is an eye emergency.

The eye will become very red, and painful.  Often the pain is so severe, that the person will have significant nausea and vomiting.  The vision will become very blurred, sometimes be unable to see from the eye, except light.  This condition can cause blindness if not treated urgently.

Please see the American Academy of Ophthalmology website for further details and information.

HOW DO YOU TREAT GLAUCOMA?

If glaucoma is suspected, but not diagnosed, sometimes your ophthalmologist will have you perform visual field testing (peripheral vision tests) in the office with eye examinations to determine if you have glaucoma. If changes are seen over time, then glaucoma will be diagnosed and treated.

In mild open angle glaucoma, your ophthalmologist will likely start you on eyedrops to lower your eye pressure.  She will discuss side effects of the medications with you.  She will then monitor your eye pressure and visual field tests over time.

In more severe glaucoma, you may be one more than 1 eye drop or require surgery.  If surgery is required, your ophthalmologist may refer you to an ophthalmologist who is specialized in glaucoma.

In closed angle glaucoma, your ophthalmologist will treat you with many eye drops and oral medications to lower your eye pressure quickly. She will then recommend a laser procedure (laser peripheral iridotomy) in order to create a small hole in the iris (coloured part of the eye) so the fluid has a secondary path to travel through in order to access the drain of the eye.

If the eye pressure remains high, you may require a referral to an ophthalmologist who specializes in glaucoma for glaucoma surgery.

Please see the American Academy of Ophthalmology website or https://www.seethepossibilities.ca/eye-health/glaucoma/ for further details and information.