Understanding glaucoma: What every patient needs to know

Blog08PharmaAdvantage-Eye-Pressure-ExamGlaucoma, which affects more than 2.7 million Americans age 40 and over, is one of those diseases that seems to come on without warning, often stealing parts of a person’s vision seemingly out of the blue. Indeed, half of those suffering don’t even realize they have the disease.1

The team at Pharmacy Advantage RX understands how important it is for individuals not only to be aware of their risk of getting glaucoma, but also to be clued in to the signs and symptoms, as well as available treatments.

Watching for glaucoma
There are actually several different forms of glaucoma to keep on the radar. The most common is open-angle glaucoma, in which the clear fluid in the eye, known as the aqueous humor, builds up as the ocular drainage system becomes less efficient, causing ocular fluid pressure to increase. Over time this damages the optic nerve.2

The first signs for a patient that something is amiss can be noticing blank spots in the vision. A comprehensive exam is the best way to tell if the eye pressure is increasing. But, even this won’t catch all cases, since pressure fluctuates throughout the day. To make a proper diagnosis, the practitioner must also examine your optic nerve.

What’s more, there’s also a form of the disease known as normal-tension glaucoma, where your eye pressure may be in the normal range and yet you can still have optic nerve damage.

Still others have a type of glaucoma known as angle-closure glaucoma in which the iris can block the drainage angle. Most prone to this form of glaucoma are those who are farsighted, as well as those of Asian descent. Signs here include suddenly blurry vision, severe eye pain, headache, nausea and/or vomiting and seeing halos or rainbow-colored rings around lights. Unfortunately, such attacks can be blinding and those experiencing symptoms should immediately contact their ophthalmologist.

Other forms of the disease include congenital glaucoma, affecting babies, and secondary glaucoma, where someone has an injury or is perhaps taking medication that prompts the development of the condition.

Approaches to treatment
The American Academy of Ophthalmology recommends that those age 40 and older receive a baseline comprehensive exam for glaucoma. Those over age 65 should undergo a comprehensive exam every 1 to 2 years. Meanwhile, those at highest risk, such as patients with high intraocular pressure, older age, African or Latino/Hispanic ethnicity, or a family history of glaucoma, as well as those who are nearsighted, or who have Type 2 diabetes or low blood pressure should be examined more frequently.

Use of daily prescription drops that work to either reduce the amount of fluid in the eye or to increase the amount of fluid flowing out of the eye are the most common glaucoma treatment. Some open-angle glaucoma cases may be treated with a laser using either argon laser trabeculoplasty or selective laser trabeculoplasty to increase drainage in the eye.3

In some cases a small plastic tube, known as an aqueous shunt, may be placed in the eye. This allows the fluid to drain through the tube to a plate placed beneath the conjunctiva, where it then collects and is absorbed into the blood vessels.

Another surgical procedure to control pressure known as trabeculectomy may also be needed. With this a small flap is made in the white part of your eye and a tiny reservoir resembling a blister placed in the area to collect fluid, which is then likewise absorbed in the eye.

Those with closed-angle glaucoma may require either a laser iridotomy, in which a pinhead-size hole is created by a laser to improve the flow through the narrow angle, or a peripheral iridectomy in which a small piece of the iris is removed to give the aqueous access to the drainage once again.

Whatever the treatment approach, vigilantly taking your medication and following your doctor’s recommendations can make an important difference in outcomes with glaucoma.