Glaucoma is one of the leading causes of blindness in the United States. Glaucoma is a disease of the eye in which the eye pressure is too high. When the pressure is too high, damage is inflicted on the optic nerve. The optic nerve connects the eye to the brain and is responsible for carrying the images we see to the brain. Glaucoma usually affects your peripheral vision initially and then your central vision. You may have glaucoma for years and not even know it, because the damage can occur slowly and insidiously. Fortunately, glaucoma is treatable. This is especially true if detected early.

What are the Different Types of Glaucoma?
There are many types of glaucoma, but these are the two general categories of glaucoma:

• Open - Angle Glaucoma:
  This is the most common type of glaucoma. The drainage system in the eye is open and functioning. In this type there is an imbalance of the production of fluid and the rate at which it drains, thereby, producing higher pressure than the eye can tolerate. Patients usually do not have any symptoms such as blurred vision, red eye, or pain. This type of glaucoma is diagnosed usually by routine eye exams.
• Closed - Angle Glaucoma:
  Unlike open - angle glaucoma, this type of glaucoma can cause rapid onset of symptoms such as pain, blurred vision, halos around lights, headache, nausea, and a red eye. The drainage system closes off, thereby producing a rapid increase in eye pressure. This is an emergent eye condition and must be treated or permanent vision loss can result within hours.

Who is at Risk for Glaucoma?

For open - angle glaucoma:

• African - Americans
• Patients with diabetes or high blood pressure
• Patients with a family history of glaucoma
• Advanced age
• Past eye injuries

For closed - angle glaucoma:

• Asians
• Far - sighted (hyperopic) patients
• Patients with developing cataracts and hyperopia
• Women more common than men

How is Glaucoma Detected?
Regular eye exams by Dr Anderson are the best way to detect glaucoma. During an eye exam we will:

• Measure your eye pressure
• Inspect the drainage system of your eye
• Look at the optic nerve for any damage (sometimes photographs are taken for future comparison)
• Test the peripheral vision of each eye using computerized instruments

How is Glaucoma Diagnosed?
Dr Anderson will consider all of the information including your risk factors, eye pressure, optic nerve appearance, and peripheral vision tests. High eye pressure alone does not mean that you have glaucoma. Some patients have high eye pressure, but never develop glaucoma. This is called Ocular Hypertension. Conversely, patients can have low or normal eye pressures and go blind from glaucoma. This is called Normal Pressure Glaucoma. This is why just measuring your eye pressure is not enough to diagnose glaucoma. If you have some, but not all, of the signs of glaucoma, Dr Anderson may label you as a Glaucoma Suspect and watch you closely for the development of glaucoma.

How is Glaucoma Treated?
Damage already caused by glaucoma cannot be reversed - it is permanent. The goal of glaucoma treatment is to lower the eye pressure to a level in which no more damage takes place. There are 3 general ways to do so:

• Medicines:
  This is the first line of therapy. Eye drops are used to either slow down the production of fluid or improve the drainage of fluid within the eye. Patients are usually started on one drop and then additional drops may be added if the pressure is not adequately controlled. It is not uncommon for a patient to be using 3 different eye drop medicines during the day. These are prescription medicines and have side effects just like a pill may have. Dr. Anderson will choose the best medicine to lower the eye pressure while trying to avoid possible side effects.
• Laser surgery:
  The laser is used in two ways depending on the type of glaucoma a patient has. For open - angle glaucoma the laser treats the drainage system to make it more efficient in draining fluid from within the eye. In closed - angle glaucoma the laser creates a hole in the iris (colored part of eye) in order to improve flow of fluid to the drainage system.
• Operative surgery:
  This is the usually the last resort when medicines and laser surgery have incompletely controlled the eye pressure. Dr Anderson will refer the patient to a glaucoma specialist that uses surgical instruments to create a new drainage channel for the fluid to drain from the eye. Surgery has more risks than medicines or laser surgery, but Dr Anderson and the glaucoma specialist feel that it is safer to operate than to allow the optic nerve damage to continue.

When Should You be Examined for Glaucoma?

• Age 20-39:
  If you have a family history of glaucoma or you are of African - American descent you should be examined by Dr Anderson every 3 to 5 years. Others can be examined at least once during these years.
• Age 40-64:
  Every 2 years.
• Age 65 or older:
  Every year.