Glaucoma is a disease of the major nerve of vision, called the optic nerve. Glaucoma is caused mostly by elevated pressure in the eye. The disease generates progressive damage to the optic nerve that generally begins with a subtle loss of side vision, or peripheral vision.
Overview and Symptoms
There are many different types of glaucoma and are classified as either open-angle glaucomas, which are usually conditions of long duration (chronic), or angle-closure (closed angle) glaucomas, which include conditions occurring both suddenly (acute) and over a long period of time (chronic). The glaucomas usually affect both eyes, but the disease can progress more rapidly in one eye than in the other.
An ophthalmologist can detect if you are at risk for glaucoma before nerve damage occurs. The doctor also can identify if you already have glaucoma by observing nerve damage or visual field loss. The following painless tests may be part of this evaluation:
- Tonometry determines the pressure in the eye by measuring the tone or firmness of its surface.
- Pachymetry measures the thickness of the cornea. After the eye has been numbed with anesthetic eyedrops, the pachymeter tip is touched lightly to the front surface of the cornea.
- Gonioscopy is done by numbing the eye with anesthetic drops and placing a special type of contact lens with mirrors onto the surface of the eye to determine whether the eye is subject to chronic angle closure, whether blood vessels are abnormal, or whether hidden tumors might be blocking the drainage of the aqueous fluid out of the eye.
- Ophthalmoscopy is when the doctor uses a handheld device, a head-mounted device or a special lens, and the slit lamp to look directly through the pupil to examine the optic nerve.
- Visual field testing maps the visual fields to detect any early or late signs of damage to the optic nerve.
- Confocal laser scanning systems and optical coherence tomography are noninvasive imaging systems that create a three-dimensional image of the optic nerve and retina to evaluate the degree of cupping and the thicknesses of the retinal nerve fiber layer
Unfortunately, glaucoma cannot usually be reversed. It is, however, a disease that can generally be controlled. Treatment can make the intraocular pressure normal and prevent or slow further nerve damage and visual loss. Treatment may involve the use of eyedrop medications, pills, laser or microsurgery.
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