What is glaucoma?
a group of diseases that can damage the eye's optic nerve and result in vision
loss and blindness. However, with early treatment, you can often protect your
eyes against serious vision loss.
What is the optic nerve?
nerve is a bundle of more than 1 million nerve fibers. It connects the retina to
the brain. The retina is the light-sensitive tissue at the back of the eye. A
healthy optic nerve is necessary for good vision.
How does open-angle glaucoma damage the optic nerve?
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. When the
fluid reaches the angle, it flows through a spongy meshwork, like a drain, and
leaves the eye.
when the fluid reaches the angle, it passes too slowly through the meshwork
drain. As 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--and vision loss--may result. That's why
controlling pressure inside the eye is important.
Does increased eye pressure mean that I have glaucoma?
necessarily. Increased eye pressure means you are at risk for glaucoma, but does
not mean you have the disease. A person has glaucoma only if the optic nerve is
damaged. If you have increased eye pressure but no damage to the optic nerve,
you do not have glaucoma. However, you are at risk. Follow the advice of your
eye care professional.
Can I develop glaucoma if I have increased eye pressure?
necessarily. Not every person with increased eye pressure will develop glaucoma.
Some people can tolerate higher eye pressure better than others. Also, a certain
level of eye pressure may be high for one person but normal for another.
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?
Glaucoma can develop without increased eye pressure.
This form of glaucoma is called low-tension or normal-tension
glaucoma. It is not as common as open-angle glaucoma.
Who is at risk for open-angle glaucoma?
develop glaucoma. Some people are at higher risk than others. They include:
African Americans over age 40.
Everyone over age 60, especially Mexican Americans.
People with a family history of glaucoma.
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 half.
What are the symptoms of glaucoma?
open-angle glaucoma has no symptoms. It causes no pain. Vision stays normal.
remains untreated, people may miss objects to the side and out of the corner of
their eye. Without treatment, people with glaucoma will slowly lose their
peripheral (side) vision. They seem to be looking through a tunnel. Over time,
straight-ahead vision may decrease until no vision remains.
develop in one or both eyes.
How is glaucoma detected?
detected through a comprehensive eye exam that includes:
This eye chart test measures how well you see at various distances.
This test measures your side (peripheral) vision. It helps your eye care
professional tell if you have lost side vision, a sign of glaucoma.
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.
An instrument (right) measures the pressure inside the eye. Numbing drops may be
applied to your eye for this test.
A numbing drop is applied to your eye. Your eye care professional 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.
Can glaucoma be treated?
Immediate treatment for early stage, open-angle glaucoma can delay progression
of the disease. That's why early diagnosis is very important.
treatments include medicines, laser trabeculoplasty, conventional surgery, or a
combination of any of these. While these treatments may save remaining vision,
they do not improve sight already lost from glaucoma.
Medicines, in the form of eyedrops or pills, are the most common early treatment
for glaucoma. Some medicines cause the eye to make less fluid. Others lower
pressure by helping fluid drain from the eye.
begin glaucoma treatment, tell your eye care professional about other medicines
you may be taking. Sometimes the drops can interfere with the way other
medicines may be taken several times a day. 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.
are available to treat glaucoma. If you have problems with one medicine, tell
your eye care professional. Treatment with a different dose or a new drug may be
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.
your eye care professional shows you how to put the drops into your eye.
Laser trabeculoplasty helps fluid drain out of the eye. Your doctor may suggest
this step at any time. In many cases, you need to keep taking glaucoma drugs
after this procedure.
trabeculoplasty is performed in your doctor's office or eye clinic. Before the
surgery, numbing drops will be applied to your eye. As you sit facing the laser
machine, your doctor will hold a special lens to your eye. A high-intensity beam
of light is aimed at the lens and reflected onto the meshwork inside your eye.
You may see flashes of bright green or red light. The laser makes several evenly
spaced burns that stretch the drainage holes in the meshwork. This allows the
fluid to drain better.
surgery, laser surgery can cause side effects, such as inflammation. Your doctor
may give you some drops to take home for any soreness or inflammation inside the
eye. You need to make several follow-up visits to have your eye pressure
If you have
glaucoma in both eyes, only one eye will be treated at a time. Laser treatments
for each eye will be scheduled several days to several weeks apart.
that laser surgery is very good at reducing the pressure in some patients.
However, its effects can wear off over time. Your doctor may suggest further
Conventional surgery makes a new opening for the fluid to leave the eye.
Your doctor may suggest this treatment at any time. Conventional surgery often
is done after medicines and laser surgery have failed to control pressure.
surgery is performed in an eye clinic or hospital. Before the surgery, you will
be given medicine to help you relax. Your doctor will make small injections
around the eye to numb it. A small piece of tissue is removed to create a new
channel for the fluid to drain from the eye.
weeks after the surgery, you must put drops in the eye to fight infection and
inflammation. These drops will be different from those you may have been using
laser surgery, conventional surgery is performed on one eye at a time. Usually
the operations are four to six weeks apart.
surgery is about 60 to 80 percent effective at lowering eye pressure. If the new
drainage opening narrows, a second operation may be needed. Conventional surgery
works best if you have not had previous eye surgery, such as a cataract
instances, your vision may not be as good as it was before conventional surgery.
Conventional surgery can cause side effects, including cataract, problems with
the cornea, and inflammation or infection inside the eye. The buildup of fluid
in the back of the eye may cause some patients to see shadows in their vision.
If you have any of these problems, tell your doctor so a treatment plan can be
What are some other forms of glaucoma?
glaucoma is the most common form. Some people have other types of the disease.
low-tension or normal-tension glaucoma, optic nerve damage and
narrowed side vision occur in people with normal eye pressure. Lowering eye
pressure at least 30 percent through medicines slows the disease in some people.
Glaucoma may worsen in others despite low pressures.
comprehensive medical history is important in identifying other potential risk
factors, such as low blood pressure, that contribute to low-tension glaucoma. If
no risk factors are identified, the treatment options for low-tension glaucoma
are the same as for open-angle glaucoma.
angle-closure glaucoma, the fluid at the front of the eye cannot reach the
angle and leave the eye. The angle gets blocked by part of the iris. People with
this type of glaucoma have a sudden increase in eye pressure. Symptoms include
severe pain and nausea, as well as redness of the eye and blurred vision. If you
have these symptoms, you need to seek treatment immediately. This is a
medical emergency. If your doctor is unavailable, go to the nearest hospital
or clinic. Without treatment to improve the flow of fluid, the eye can become
blind in as few as one or two days. Usually, prompt laser surgery and medicines
can clear the blockage and protect sight.
congenital glaucoma, children are born with a defect in the angle of the eye
that slows the normal drainage of fluid. These children usually have obvious
symptoms, such as cloudy eyes, sensitivity to light, and excessive tearing.
Conventional surgery typically is the suggested treatment, because medicines may
have unknown effects in infants and be difficult to administer. Surgery is safe
and effective. If surgery is done promptly, these children usually have an
excellent chance of having good vision.
can develop as complications of other medical conditions. These types of
glaucomas are sometimes associated with eye surgery or advanced cataracts, eye
injuries, certain eye tumors, or uveitis (eye inflammation). Pigmentary
glaucoma occurs when pigment from the iris flakes off and blocks the
meshwork, slowing fluid drainage. A severe form, called neovascular glaucoma,
is linked to diabetes. Corticosteroid drugs used to treat eye inflammations and
other diseases can trigger glaucoma in some people. Treatment includes
medicines, laser surgery, or conventional surgery.
What can I do if I already have lost some vision from glaucoma?
If you have
lost some sight from glaucoma, ask your eye care professional about low vision
services and devices that may help you make the most of your remaining vision.
Ask for a referral to a specialist in low vision. Many community organizations
and agencies offer information about low vision counseling, training, and other
special services for people with visual impairments. A nearby school of medicine
or optometry may provide low vision services.
What can I do to protect my vision?
If you are
being treated for glaucoma, be sure to take your glaucoma medicine every day.
See your eye care professional regularly.
You also can
help protect the vision of family members and friends who may be at high risk
for glaucoma--African Americans over age 40; everyone over age 60, especially
Mexican Americans; and people with a family history of the disease. Encourage
them to have a comprehensive dilated eye exam at least once every two years.
Remember: Lowering eye pressure in glaucoma's early stages slows progression of
the disease and helps save vision.
covers an annual comprehensive dilated eye exam for some people at high risk for
glaucoma. These people include those with diabetes, those with a family history
of glaucoma, and African Americans age 50 and older.
What should I ask my eye care professional?
protect yourself against vision loss by working in partnership with your eye
care professional. Ask questions and get the information you need to take care
of yourself and your family.
some questions to ask?
eye disease or disorder
What is my diagnosis?
What caused my condition?
Can my condition be treated?
How will this condition affect my vision now and in the future?
Should I watch for any particular symptoms and notify you if they occur?
Should I make any lifestyle changes?
What is the treatment for my condition?
When will the treatment start and how long will it last?
What are the benefits of this treatment and how successful is it?
What are the risks and side effects associated with this treatment?
Are there foods, drugs, or activities I should avoid while I'm on this
If my treatment includes taking medicine, what should I do if I miss a dose?
Are other treatments available?
What kinds of tests will I have?
What can I expect to find out from these tests?
When will I know the results?
Do I have to do anything special to prepare for any of the tests?
Do these tests have any side effects or risks?
Will I need more tests later?
If you don't understand your eye care professional's responses, ask questions
until you do understand.
Take notes or get a friend or family member to take notes for you. Or, bring a
tape recorder to help you remember the discussion.
Ask your eye care professional to write down his or her instructions to you.
Ask your eye care professional for printed material about your condition.
If you still have trouble understanding your eye care professional's answers,
ask where you can go for more information.
Other members of your health care team, such as nurses and pharmacists, can be
good sources of information. Talk to them, too.
patients take an active role in their health care. Be an active patient about
your eye care.
National Institutes of Health (NIH)
Nutritional and Herbal Therapy for Glaucoma
- Eat foods rich in carotenes and bioflavonoids, such as
dark leafy greens, yellow and orange vegetables and dark berries.
- Avoid stimulating foods (ex. sugar and refined foods),
alcohol, drugs, smoking, coffee, salt and drinking too much water
- Vitamin C (500 to 1,000 mg three times a day)
- Vitamin E (400 to 800 IU a day), vitamin A
(10,000 IU a day) or beta carotene (25,000 IU a day), and thiamine
(10 mg a day)
- Selenium (200 mcg a day) and zinc (30
mg a day)
- Omega-3 fatty acids (300 to 500 mg daily)
- Melatonin (2 to 5 mg before bed)
- Ginkgo (120 mg two times a day) to improve blood
- The Chinese herbal formula,
Qi Ju Di Huang
can help relieve symptoms. Another effective formula is
Shi Hu Ye Guang Wan.
- According to the
Tao of Nutrition, drink a natural tea made of mulberries, oyster
shell and black sesame three times a day to help relieve symptoms. Another
helpful tea can be made of chrysanthemum and mint, twice a day
- Bilberry (100 to 200 mg twice a day)
Tao of Nutrition, by Maoshing Ni, Ph.D., C.A., and Cathy McNease,