Glaucoma: diagnosis and treatment

March 1st, 2010

Glaucoma is a commonly recognized term, but most people really don’t know what it is, other than the fact that if affects the eyes. Actually “glaucoma” is a word that describes an entire group of various conditions. What they all have in common is that they damage the optic nerve and reduce a person’s ability to see. The damage to the optic nerve is typically caused by pressure inside the eye, although that is not the case for all people.

This is a scary condition because it is the second leading cause of blindness. It is not something that will occur suddenly–one day you can see and the next you cannot–but is rather a slow moving condition which causes your vision to deteriorate over time. It is so slow, in fact, that you may not even notice it happen.
Because of the way the disease operates, you need to consult with your eye care professional whenever you have vision loss. Although it may just be that your eyes have naturally worsened with age and you need a stronger eyeglass prescription, you should double-check and make sure it is not more serious. You should be getting a check-up every year anyway.
Your doctor will diagnose glaucoma by first measuring the pressure in your eye. They will also photograph the optic nerve and test it for damage. Your doctor may also perform a pachymetry, which is to figure out the thickness of your corneas. This helps in the diagnosis because a thick cornea may cause an inflated eye pressure test and a thin cornea may result in a low level of eye pressure where glaucoma is still present.

Because loss of peripheral vision is another symptom of glaucoma, your doctor may also test your peripheral vision with something called a visual field test. You may have had something similar done in the past at routine eye screenings.

If you are diagnosed with glaucoma, your doctor will set out a treatment plan for you. The most common first treatment is medicated eye drops. These are not the same as the drops you may put in your eyes for redness or irritation. Rather, these are strong medicines like beta blockers, carbonic anhydrase inhibitors, or epinephrine. Which kind you receive will depend on the severity of your glaucoma, as well as other health factors. Beta blockers, for example, are not recommended for people on insulin treatments.

Other possible treatment options include oral medications when the eye drops don’t work or neuroprotective drugs which may be able to preserve current vision.
If medications do not work,