GLAUCOMA, CHRONIC OPEN-ANGLE

General Information

DEFINITION--A condition of the eye in which the fluid that normally drains into and out of the eye is gradually obstructed. This causes loss of vision. Chronic glaucoma--unlike acute glaucoma--usually causes no pain.

BODY PARTS INVOLVED--Eye.

SEX OR AGE MOST AFFECTED--In the general population, adults of both sexes over 60. Among African-Americans, adults of both sexes over 40.

SIGNS & SYMPTOMS

Early stages:

• Loss of peripheral vision in small areas.
• Blurred vision on one side toward the nose.

Later stages:

• Larger areas of vision loss, usually in both eyes.

Late stages:

• Hard eyeball.
• Halos around lights.
• Blind spots.
• Poor night vision.

CAUSES--Symptoms are caused by pressure in the eyeball that damages fibers in the optic nerve. Glaucoma is probably hereditary, but it may be suspected in any person who requires frequent lens changes, has mild headaches or vague visual disturbances, sees halos around electric lights, or whose vision does not adapt well from light to dark.

RISK INCREASES WITH

• Adults over 60.
• Family history of acute or chronic glaucoma.
• Diabetes mellitus.
• African-American race
• Severe nearsightedness

HOW TO PREVENT

• Make sure that tension in the eyeball is measured with every eye examination (at least once a year after age 40).
• Tell your doctor of any changes in your ability to see.
• At least once a year after age 40, make sure to have a comprehensive eye examination or a tonometry test, which measures the pressure in the eye, especially the optic nerve.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies such as tonometry (measurement of pressure within the eyeball).
• Tests such as tonometry (measurement of pressure within the eyeball) and ophthalmoscopy (helps magnify the inside of the eye to look at the optic nerve).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Medication, including eye drops.
• Laser surgery can be performed if eyedrops do not control the disease.
• Traditional eye surgery.

POSSIBLE COMPLICATIONS--Loss of vision before other symptoms begin.

PROBABLE OUTCOME--Symptoms can usually be controlled with treatment. Glaucoma treatment is lifelong. Vision is usually not impaired permanently if glaucoma is is found early and treated.

How To Treat

GENERAL MEASURES--

• Avoid emotional upheavals and fatigue, which increase pressure in the eye.
• Don't smoke. Tobacco constricts blood vessels, restricting the blood supply to the eye.
• See Resources for Additional Information.
• Periodic eye exams are necessary to recheck pressure and change medications if required.

MEDICATION--Your doctor may prescribe:

• Eye medications to lower pressure inside the eye will be prescribed. Follow the instructions and schedule carefully, even if symptoms subside.
• Diuretics to reduce excess fluid.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of chronic glaucoma (although there are usually no early warning symptoms).
• Medicine in the eye becomes intolerable.
• Any sign of eye infection, such as fever, develops.
• Pain begins in the eye.
• Redness occurs in the eye.
• Vision changes suddenly.