FAQs about Glaucoma

It’s World Glaucoma Week!  This is established to mainly raise awareness of this disease.

Glaucoma is a disease of the eye that is largely mysterious to the general population, even if it is the second leading cause of blindness in the world.

FAQs about glaucoma:

What is glaucoma?

Quote from http://emedicine.medscape.com/article/1206147-overview:

“The definition of glaucoma has changed drastically since its introduction around the time of Hippocrates (approximately 400 BC). The word glaucoma came from the ancient Greek word glaucosis, meaning clouded or blue-green hue, most likely describing a patient having corneal edema or rapid evolution of a cataract precipitated by chronic elevated pressure. Over the years, extensive refinement of the concept of glaucoma has continued, accelerating, especially in the last 100 years, to the present date.

Glaucoma is currently defined as a disturbance of the structural or functional integrity of the optic nerve that causes characteristic atrophic changes in the optic nerve, which may also lead to specific visual field defects over time. This disturbance usually can be arrested or diminished by adequate lowering of intraocular pressure (IOP).”

Glaucoma is a disease

How do I know if I have glaucoma?  What are the signs and symptoms of glaucoma?

Unfortunately, in most cases of glaucoma, the patient does not feel anything at all!  Visual loss usually starts from the periphery (from the sides) so the person usually does not feel that he is already losing vision until the loss is large enough that he starts bumping into things.

However, some patients may experience sudden, severe eye pain, headache, sudden blurred vision, nausea, vomiting, seeing rainbows around lights (iridiscent vision).  This usually happens if the onset of the glaucoma is sudden (acute).

My doctor says that I am a glaucoma suspect and has requested for some tests.  What does this mean?

This means that your doctor probably thinks your optic nerve’s appearance looks suspicious and/or your intraocular pressure is elevated.  However, you will need to undergo other tests in order to establish if glaucoma is, indeed present.  These tests may include automated perimetry (to check your peripheral vision), optical coherence tomography (to check your retinal nerve fiber layer), gonioscopy (to check your angles — your drainage system), disc photos (photos of your optic nerve), etc.  The doctor will determine which tests you need.

Normal vision.This image is in the public domain because it contains materials that originally came from the National Institutes of Health (http://www.nih.gov/)


A scene as it might be viewed by a person with glaucoma. This image is in the public domain because it contains materials that originally came from the National Institutes of Health (http://www.nih.gov/)

My doctor says that I have glaucoma.  But I feel fine and my vision is great.  Can I just take the medications when I feel something?

Glaucoma is often called “the thief in the night”.  That’s because you begin to lose vision even when you don’t feel it, as the visual loss begins from the periphery going to the center (see photos above).  By the time the visual loss is perceived, the damage has already been made.  Unfortunately, damage to the optic nerve is considered irreversible.  Hence it is important that maintenance eyedrops be put on a regular basis to slow down the progression of the disease.  Check this link out to view how the visual loss progresses.

I believe my doctor!  I am putting drops in my eyes for glaucoma.  He told me to go back for a follow up.  But I am very busy.  Can I just go back when I need to?

Follow-ups are VERY important in glaucoma.  During the follow up, your doctor will determine if the treatment is still working as planned so that any necessary changes may be made if it is not.

I used up the bottle of eyedrop that the doctor prescribed.  I am not yet scheduled to go back for follow up.  Do I stop the meds or do I continue?

Continue your medications.  The eyedrops are considered “lifetime” medications.  Unless your doctor tells you to stop, DON’T.

My doctor says that I need laser for my glaucoma.  What is this?  Will this improve my grade?

Depending on the type of glaucoma, your doctor may be referring to a laser iridectomy, a trabeculoplasty, an iridoplasty or a cycloablative procedure.  None of these are the same as LASIK, which is the most popular laser procedure designed to free you from the use of glasses.

The laser procedures used for glaucoma are designed to help lower the intraocular pressure (or IOP, the pressure inside the eye) because it has been proven that lowering the IOP slows down the progression of visual loss.

My doctor says that I will need surgery for my glaucoma.  Will this surgery improve my vision?

If your surgery is a simple filtering surgery (trabeculectomy), we don’t really expect any visual improvement.  If the surgery is a surgery combined with cataract, your vision will likely improve because your concomitant cataract has been removed.

I saw my doctor because I found that my vision is getting blurred.  I was told that I have glaucoma and was treated for a few months already.  When will my vision get better?  I don’t really see any improvement?

Unfortunately, treatment for glaucoma is designed to preserve the remaining vision.  Any vision that was previously lost due to the glaucoma is considered irreversible.  That is why it is important to catch the disease early, when any visual loss will be mild and not very noticeable to the patient.

I was told that I may have glaucoma.  How it that possible?  I am quite young.  I though only old people get the disease?

While glaucoma is most common for the elderly age group, it does occur to anybody of any age group.  Even babies and children may have glaucoma (congenital or developmental) although this is not very common.

I hope through this article, I have done a small part in educating the public about glaucoma.  Do feel free to ask me about this disease. :)