Glaucoma is a disease of the optic nerve of the eye. Most often, it is associated with elevated eye pressure which slowly and irreversibly damages nerve fibers over time. Even today, glaucoma is one of the leading causes of preventable blindness in our country and world wide!
The eye contains a drain called the trabecular meshwork which is responsible for allowing fluid to exit from inside the eye. In glaucoma, this drain becomes diseased causing fluid to build up and the pressure inside the eye to rise. Over time, the chronically elevated pressure causes the optic nerve fibers to slowly die leading to irreversible vision loss.
Unfortunately, the vast majority of patients cannot tell if they have glaucoma. This is because, glaucoma robs the eye of its extreme peripheral vision first, and we are not as sensitive to this type of vision loss. Also, elevated pressure normally does not cause pain. This is why glaucoma testing on routine examination is so important.
- Increased age
- Ethnicity including African American and Latin American patients
- Family history
- Steroid use
Everyone should be screened for glaucoma with vision testing, eye pressure checks, and optic nerve examination during a routine visit. However, a complete glaucoma evaluation is necessary for any patient who is a suspect as follows:
- Gonioscopy: direct exam of the drainage system using a lens
- Tonometry: using a device which touched the cornea to establish eye pressure
- Pachymetry: measurement of the corneal thickness to establish how accurate the pressure readings are
- Optic nerve exam: direct exam of the optic nerve in the back of the eye with a lens
- Optic nerve analysis with a machine such as HRT, GDX, OCT
- Visual field testing