Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 30, 2016

Glaucoma is a disease that damages the optic nerves, which are the direct paths from the eyes to the brain. It is one of the leading causes of vision loss and blindness.


Definition & Facts

A slow and degenerative disease, glaucoma can be found in any age group, but it is more common in the elderly. While this condition does have various treatment options available, it is presently incurable.

Treatment for glaucoma focuses on slowing or preventing glaucoma from advancing any further, but this disease is often left unnoticed until moderate to significant damage has been done to the eye. This is in part due to how glaucoma gradually decreases vision, and therefore takes a longer amount of time to detect.

Symptoms & Complaints

Vision loss is the primary symptom of glaucoma. The exact characteristics of how loss of vision is experienced depends on the type of glaucoma. Acute angle-closure glaucoma often has the following symptoms: blurred vision or foggy vision, general eye pain, redness of the eyes, nausea, and/or severe headaches. By contrast, open-angle glaucoma patients experience a loss in peripheral vision, which can lead to tunnel vision in the advanced stages.

Both forms of glaucoma will eventually lead to a significant loss in vision and, most likely, blindness if left untreated. Approximately 15% of people that receive treatment for their glaucoma will still lose vision entirely in at least one eye.


Glaucoma is caused by high levels of pressure in the eye. The eyes normally function with the fluid draining through the front of the eye, which is why the eyes are usually moist. However, people with glaucoma have a blockage that prevents the fluid from draining properly.

Acute-closure is caused by a bulge in the eye that blocks off the draining paths between the iris and the cornea, and the open-closure form of the disease involves increased pressure due to the trabecular meshwork in the eye being partially blocked. This increased pressure is known as intraocular pressure, and it is the cause of the damaged optic nerves.

These optic nerves are the pathways between the eye and the brain, and when they are damaged the visual cortex in the brain (the brain's control center for vision that takes in information from the eyes and translates it into 'sight') is not able to function properly. With this faulty connection between the eyes and the brain, the person with this disease will begin to notice losses in vision range and depth.

The acute form of glaucoma will be much more severe and noticeable since it is an abrupt rise in eye pressure, and it is considered a medical emergency; the open-closure, on the other hand, is a gradual increase in pressure and often goes unnoticed before it cause irreparable damage.

A family history of high blood pressure, diabetes, heart disease and high intraocular pressure in the family means that the patient is more likely to have glaucoma due to genetic factors.

Other factors that can lead to this disease are eye injuries, being over the age of 60, having other eye defects that cause vision loss, and taking certain medications for an extended period of time.

Diagnosis & Tests

The first step of diagnosing glaucoma is taking family history into account to determine the risk factors a patient may have. Most doctors will then run a few simple tests to check for eye pressure, and the doctor will take a look at the optic nerve and possible blockage points in the eye to see if further testing needs to be done.

They should also check the areas of vision to see if glaucoma has reduced peripheral vision; should any of these indicate the possibility of glaucoma the doctor can utilize an X-ray device to get a perfect image of the eye to check the areas in question

Treatment & Therapy

Treatment for glaucoma attempts to stop or slow its progression. Any damage caused to the optic nerve by this disease cannot currently be reversed. The main goal of treatments is to reduce the pressure that has built up in the eye because of the blockage. The treatments will usually consist of prescription eye drops with the possibility of surgery or laser therapy. These treatments will reduce the pressure in the eye by either increasing the amount of fluid that is draining or by reducing how much fluid the eye produces.

Alternative treatments may include having the patient sleep with their head inclined to assist the fluid in draining, eating healthy to bring in the nutrient and minerals necessary for eye health, exercising to maintain good health and possibly reduce eye pressure for patients that have open-angle glaucoma, and limiting caffeine intake since it increases eye pressure.

Prevention & Prophylaxis

Any person that has a family history of glaucoma should regularly see an eye doctor for a thorough examination, and other people without the family history need to get the same examinations when they reach the age of 40 and beyond. While these examinations will not prevent glaucoma, they will enable to patient to be in control of the disease before it causes too much damage.

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