Eye Specialists of Westchester

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Glaucoma is a disease of the optic nerve. The optic nerve is the part of the eye that carries the images we see to the brain. It is made up of many nerve fibers (like an electric cable containing numerous wires.) Glaucoma damages the nerve fibers, which can cause vision loss to develop.
Glaucoma is often related to the pressure inside of the eye. This is referred to as the intraocular pressure (IOP). When the clear liquid that fills the front portion of the eye has difficulty draining out of the eye, pressure builds up in the eye. The resulting increase in the IOP can damage the optic nerve. When damage to the optic nerve fibers occurs, blind spots develop. These blind spots usually go undetected until the optic nerve is significantly damaged. If the entire nerve is destroyed, blindness results.
Early detection and treatment are the keys to preventing optic nerve damage and blindness from glaucoma. Glaucoma is a leading cause of blindness in the United States, especially in older people. But loss of sight from glaucoma can often be prevented with early treatment.

Causes of Glaucoma

Aqueous humor, a clear liquid, circulates inside the front portion of the eye. To maintain a healthy level of pressure within the eye, a small amount of this fluid is produced constantly, while an equal amount flows out of the eye through a microscopic drainage system. This liquid is not part of the tears on the outer surface of the eye. Because the eye is a closed structure, if the drainage area for the aqueous humor is blocked, the excess fluid cannot flow out of the eye. Fluid pressure within the eye increases, pushing against the optic nerve and causing damage.

Types of Glaucoma

Primary Open-Angle Glaucoma The most common form of glaucoma in the United States is primary open-angle glaucoma. Primary open-angle glaucoma is where the aqueous fluid that normally circulates in the front portion of the eye is blocked from flowing out of the eye through a tiny drainage system.This causes the pressure inside of the eye to increase, which can damage the optic nerve and lead to vision loss. As the optic nerve becomes more damaged, blank spots begin to appear in your field of vision. Most people who develop primary open-angle glaucoma have no symptoms until vision is impaired. The risk of developing primary open-angle glaucoma increases with age.

Angle Closure Glaucoma In angle-closure glaucoma, the iris (the colored part of the eye) may drop over and completely close off the drainage angle, abruptly blocking the flow of the aqueous fluid and leading to increased IOP or optic nerve damage. In acute angle-closure glaucoma, there is a sudden increase in IOP due to the buildup of aqueous fluid. This condition is considered an emergency because optic nerve damage and vision loss can occur within hours of the problem. Symptoms can include nausea, vomiting, seeing halos around light, and eye pain. If you have these symptoms, call the office immediately.

Normal Tension Glaucoma Even people with “normal” IOP can experience vision loss from glaucoma. This condition is called normal tension glaucoma. In this type of glaucoma, the optic nerve is damaged even though the IOP is considered normal. Normal tension glaucoma is not well understood, but we do know that lowering IOP has been shown to slow progression of this form of glaucoma.

Childhood Glaucoma Childhood glaucoma is rare and may start in infancy, childhood or adolescence. Like primary open-angle glaucoma, there are few, if any, symptoms in the early stages. Blindness can result if it is left untreated. Like most types of glaucoma, this type of glaucoma may run in families.

Risk Factors

Dr. Scharf or Dr. Donev may tell you that you are at risk for glaucoma if you have one or more risk factors, including:

  • age;
  • elevated eye pressure;
  • family history of glaucoma;
  • African or Hispanic ancestry;
  • farsightedness or nearsightedness;
  • past eye injuries;
  • thinner central cornea thickness;
  • systemic health problems including diabetes, migraine headaches, and poor circulation;

The best way to detect glaucoma is by regular eye examinations with your ophthalmologist. A glaucoma screening that checks only the pressure of the eye is not sufficient to determine if you have glaucoma. The only way to detect glaucoma is to have a complete eye examination.