Glaucoma

  • Medical Author:
    Andrew A. Dahl, MD, FACS

    Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Quick GuideCommon Eye Problems and Infections

Common Eye Problems and Infections

Can glaucoma be prevented?

Primary open-angle glaucoma cannot be prevented, given our current state of knowledge. However the optic-nerve damage and visual loss resulting from glaucoma can be prevented by earlier diagnosis, effective treatment, and compliance with treatment.

Secondary types of glaucoma can often be prevented by avoidance of trauma to the eye and prompt treatment of eye inflammation and other diseases of the eye or body that may cause secondary forms of glaucoma.

Most cases of visual loss from angle-closure glaucomas can be prevented by the appropriate use of laser iridotomy in eyes at risk for the development of acute or chronic angle-closure glaucoma.

What is in the future for glaucoma?

New eyedrops will continue to become available for the treatment of glaucoma. Some drops will be new classes of agents. Other drops will combine some already existing agents into one bottle to achieve an additive effect and to make it easier and more economical for patients to take their medication.

Although lowering intraocular pressure is still the primary method of treating glaucoma, experts see the disease as more a neurological condition than an eye disorder. Researchers are investigating the therapeutic role of neuroprotection of the optic nerve, especially in patients who seem to be having progressive nerve damage and visual field loss despite relatively normal intraocular pressures. Animal models have shown that certain chemical mediators can reduce injury or death of nerve cells. Proving such a benefit for the human optic nerve, however, is more difficult because, for one thing, biopsy or tissue specimens are not readily available. Nevertheless, if any of these mediators in eyedrops can be shown to protect the human optic nerve from glaucomatous damage, this would be a wonderful advance in preventing blindness.

In other studies, new surgical methods are being evaluated to lower the intraocular pressure more safely without significant risk of damage to the eye or loss of vision.

Finally, increased efforts to enhance public awareness of glaucoma, national free screenings for those individuals at risk, earlier diagnosis and treatment and better compliance with treatment are our best hopes to reduce vision loss from glaucoma.

REFERENCES:

The AGIS Investigators. “The Advanced Glaucoma Intervention Study (AGIS): Comparison of treatment outcomes within race: 10-year results.” Ophthalmology. 111.4 (2004): 651-664.

Epstein, D. L., et al. “A long-term clinical trial of timolol therapy versus no treatment in the management of glaucoma suspects.” Ophthalmology. 96.10 (1989): 1460-1467.

Gedde, S. J., et al. “Treatment outcomes in the Tube Versus Trabeculectomy (TVT) Study after five years of follow-up.” American Journal Ophthalmology. 153.5 (2012): 789-803.e2. Gordon, M. O., et al. “The Ocular Hypertension Treatment Study: Baseline factors that predict the onset of primary open-angle glaucoma.” u>Archives of Ophthalmology. 120.6 (2002): 714-720.

Heijl A, et al. “Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial.” Archives of Ophthalmology. 120.10 (2002): 1268-1279.

Kass, M. A., et al. “The Ocular Hypertension Treatment Study: A randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma.” Archives of Ophthalmology. 120.6 (2002): 701-713.

Katz, L. J., et al. “Selective laser trabeculoplasty versus medical therapy as initial treatment of glaucoma: a prospective, randomized trial.” Journal of Glaucoma. 21.7 (2012):460-468.

Krupin, T., et al. “Low-Pressure Glaucoma Study Group. A randomized trial of brimonidine versus timolol in preserving visual function: results from the Low-Pressure Glaucoma Treatment Study.” American Journal of Ophthalmology. 151.4 (2011) 671-681.

Lichter, P.R., et al. “CIGTS Study Group. Interim clinical outcomes in the Collaborative Initial Glaucoma Treatment Study comparing initial treatment randomized to medications or surgery.” Ophthalmology. 108.11 (2001): 1943-1953.

Musch, D. C., et al. “CIGTS Study Group. Intraocular pressure control and long-term visual field loss in the Collaborative Initial Glaucoma Treatment Study.” Ophthalmology. 118.9 (2011): 1766-1773.

Wishart, P. K. “Interpretation of the glaucoma ‘landmark studies.’” British Journal of Ophthalmology.” Br J Ophthalmol. 293.5 (2009): 561-562.

Medically Reviewed by a Doctor on 9/23/2015

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