Glaucoma and Management

Our optometrists have extensive experience with this condition.   If you live in or near Cape Girardeau, Perryville or Fredericktown Missouri and suspect your eyesight is affected, make an appoint now to have your eyes examined.   Early detection and management are essential to preserve your eyesight.   Our office numbers are located on the "Make an Appointment" page along with map directions.

What is glaucoma?

Glaucoma is a group of diseases that damage the eye’s optic nerve and can result in vision loss and blindness.   However, with early detection and management, you can often protect your eyes against serious vision loss.

Frequently Asked Questions

Press or click each question to open the explanation

What is the Optic Nerve

The optic nerve is a bundle of more than 1 million nerve fibers.   It connects the retina to the brain.   (See diagram)   The retina is the light-sensitive tissue at the back of the eye.   A healthy optic nerve is necessary for good vision.

How does the optic nerve get damaged by open-angle glaucoma?

Several large studies have shown that eye pressure is a major risk factor for optic nerve damage.   In the front of the eye is a space called the anterior chamber.   A clear fluid flows continuously in and out of the chamber and nourishes nearby tissues.   The fluid leaves the chamber at the open angle where the cornea and iris meet.   (See diagram below.)   When the fluid reaches the angle, it flows through a spongy meshwork, like a drain, and leaves the eye.

In open-angle glaucoma, even though the drainage angle is "open", the fluid passes too slowly through the meshwork drain.   Since the fluid builds up, the pressure inside the eye rises to a level that may damage the optic nerve.   When the optic nerve is damaged from increased pressure, open-angle glaucoma — with vision loss — may result.   That’s why controlling pressure inside the eye is important.

Another risk factor for optic nerve damage relates to blood pressure.   Thus, it is important to also make sure that your blood pressure is at a proper level for your body by working with your medical doctor.

Fluid pathway is shown in teal.

Can I develop glaucoma if I have increased eye pressure?

Not necessarily.   Not every person with increased eye pressure will develop glaucoma.   Some people can tolerate higher levels of eye pressure better than others.   Also, a certain level of eye pressure may be high for one person but normal for another.

Whether you develop glaucoma depends on the level of pressure your optic nerve can tolerate without being damaged.   This level is different for each person.   That’s why a comprehensive dilated eye exam is very important.   It can help your eye care professional determine what level of eye pressure is normal for you.

Can I develop glaucoma without an increase in my eye pressure?

Yes.   Glaucoma can develop without increased eye pressure.   This form of glaucoma is called low-tension or normal-tension glaucoma.   It is a type of open-angle glaucoma.

Who is at risk for open-angle glaucoma?

Anyone can develop glaucoma.   Some people, listed below, are at higher risk than others:

  • African Americans over age 40
  • Everyone over age 60, especially Mexican Americans
  • People with a family history of glaucoma

A comprehensive dilated eye exam can reveal more risk factors, such as high eye pressure, thinness of the cornea, and abnormal optic nerve anatomy.   In some people with certain combinations of these high-risk factors, medicines in the form of eyedrops reduce the risk of developing glaucoma by about 50%.

Glaucoma Symptoms

At first, open-angle glaucoma has no symptoms.   It causes no pain.   Vision stays normal.   Glaucoma can develop in one or both eyes.

Without management, people with glaucoma will slowly lose their peripheral (side) vision.   As glaucoma remains untreated, people may miss objects to the side and out of the corner of their eye.   They seem to be looking through a tunnel.   Over time, straight-ahead (central) vision may decrease until no vision remains.

Normal vision.

The same scene as viewed by a person with glaucoma.

How is glaucoma detected?

Glaucoma is detected through a comprehensive dilated eye exam that includes the following:

Visual acuity test.   This eye chart test measures how well you see at various distances.

Visual field test.   This test measures your peripheral (side vision).   It helps your eye care professional tell if you have lost peripheral vision, a sign of glaucoma.

Dilated eye exam. In this exam, drops are placed in your eyes to widen, or dilate, the pupils.   Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems.   After the exam, your close-up vision may remain blurred for several hours.

Tonometry is the measurement of pressure inside the eye by using an instrument called a tonometer.   Numbing drops may be applied to your eye for this test.   A tonometer measures pressure inside the eye to detect glaucoma.

Pachymetry is the measurement of the thickness of your cornea.   Your eye care professional applies a numbing drop to your eye and uses an ultrasonic wave instrument to measure the thickness of your cornea.

Can glaucoma be cured?

No.   There is no cure for glaucoma.   Vision lost from the disease cannot be restored.   This is why early detection and management are so important.   This helps retain the vision still present.

Glaucoma Management

Immediate assessment and active management for early-stage, open-angle glaucoma can delay progression of the disease.   That’s why early diagnosis and detection is very important.

Glaucoma management include medicines, laser trabeculoplasty, conventional surgery, or a combination of any of these.   While these methods may save remaining vision, they do not improve sight already lost from glaucoma.

Medicines.   Medicines, in the form of eyedrops or pills, are the most common early management for glaucoma.   Taken regularly, these eyedrops lower eye pressure.  Some medicines cause the eye to make less fluid.   Others lower pressure by helping fluid drain from the eye.

Before you begin glaucoma management, tell your eye care professional about other medicines and supplements that you are taking.   Sometimes the drops can interfere with the way other medicines work.

Glaucoma medicines need to be taken regularly as directed by your eye care professional.   Most people have no problems.   However, some medicines can cause headaches or other side effects.   For example, drops may cause stinging, burning, and redness in the eyes.

Many medicines are available to manage glaucoma.   If you have problems with one medicine, tell your eye care professional.   Management with a different dose or a new medicine may be possible.

Because glaucoma often has no symptoms, people may be tempted to stop taking, or may forget to take, their medicine.   You need to use the drops or pills as long as they help control your eye pressure.   Regular use is very important.

Be sure to follow the directions given by your eye care professional on how to put the drops into your eye.

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