Glaucoma Symptoms, Risk Factors and Treatment at OU Health Dean McGee Eye Institute

Glaucoma is the second leading cause of blindness in America behind diabetic retinopathy. Only about half of the estimated three million Americans who have glaucoma are even aware that they have the condition. The hallmark of glaucoma is a malfunction in the drainage of fluid drainage from the eye that can cause serious damage to the optic nerve.

“That is the danger with glaucoma. If undetected and untreated, it can cause blindness. Glaucoma can strike silently with minimal symptoms in the early stages, allowing the damage to the eye to progress so slowly that most patients don’t notice the damage until it is too late,” said Andrew K. Bailey, MD, OU Health Dean McGee Eye Institute glaucoma specialist and Clinical Assistant Professor in the University of Oklahoma College of Medicine’s Department of Ophthalmology. “It is important to know your risk factors for developing the disease such as diabetes, a family history of glaucoma or being of African descent. Even if you have no risk factors for glaucoma, regular eye exams with an ophthalmologist should begin for everyone over the age of 40. Increase those exams to at least every two years if you are 65 or older.”

To maintain a constant healthy eye pressure, your eye continually produces a small amount of clear fluid called aqueous humor, while an equal amount of this fluid flows out of your eye. If you have glaucoma, the aqueous humor does not flow out of the eye properly. Fluid pressure in the eye builds up and, over time, causes damage to the optic nerve fibers.

Testing your eye pressure is an important part of a glaucoma evaluation. The ophthalmologist measures the intraocular pressure using an instrument called a tonometer. A high-pressure reading is often, but not always, the first step in diagnosing glaucoma. During this test, the eye is numbed with eye drops. The ophthalmologist also evaluates the appearance of the optic nerve. If findings are suspicious for glaucoma, other testing such as measurement of the peripheral vision may be performed.

Types of glaucoma:

• Open-angle glaucoma
• Normal-tension glaucoma
• Closed-angle glaucoma (also known as narrow-angle glaucoma or angle-closure glaucoma)
• Congenital glaucoma
• Secondary glaucoma

Risk factors for glaucoma include:

• Age – over 60 years old
• Family history of glaucoma
• Diabetes
• African or Hispanic ancestry
• Nearsightedness
• Elevated eye pressure
• Past eye injury
• Having a thinner central cornea (the clear, front part of the eye covering the pupil and colored iris)
• Not having eye examinations when they are recommended
• Conditions that affect blood flow, such as migraines and low blood pressure

Symptoms of Glaucoma

In its early stages, open-angle glaucoma has no obvious signs. As the disease progresses and more damage occurs, blind spots develop in your peripheral (side) vision. These spots may not be noticeable until the optic nerve has become severely damaged — or until detected by an ophthalmologist during a complete exam.

People at risk for closed-angle glaucoma (also called narrow-angle or angle-closure glaucoma), where the eye’s drainage angle becomes blocked, usually have no symptoms before the attack. However, some early symptoms can include blurred vision, halos, headache or mild eye pain or redness.

Glaucoma Medication

Medicated eye drops are the most common way to treat glaucoma. These medications lower your eye pressure in one of two ways — either by slowing the production of aqueous humor or by improving the flow through the drainage angle.

Glaucoma Surgery

In some patients with glaucoma, laser surgery or incisional surgery is recommended. Glaucoma surgery improves the flow of fluids out of the eye, resulting in lower eye pressure.

If you have any questions or concerns about your eye health, call 405-271-7873. Established patients can request an appointment by visiting the DMEI MyChart page.