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Medical Author:

Andrew A. Dahl, MD, FACS

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.

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Medical Editor:

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.

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Medical Editor:

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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In this Article

• What is glaucoma?
• How common is glaucoma?
• What causes glaucoma?
• What are glaucoma risk factors?
• What are the different types of glaucoma?
• What are glaucoma symptoms and signs?
• How is glaucoma diagnosed?
• How often should someone be checked (screened) for glaucoma?
• What is the treatment for glaucoma?
• Glaucoma medications (eyedrops)
• Glaucoma surgery or laser
• Can glaucoma be prevented?
• What is in the future for glaucoma?
• Glaucoma At Glance
• Patient Comments: Glaucoma - Surgery Experience
• Patient Comments: Glaucoma - Effective Treatments
• Find a local Eye Doctor in your town
• Glaucoma Index

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.

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.

Many 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.

• Glaucoma is a disease that is often associated with elevated intraocular pressure, in which damage to the eye (optic) nerve can lead to loss of vision and even blindness.
• Glaucoma is the leading cause of irreversible blindness in the world.
• Glaucoma usually causes no symptoms early in its course, at which time it can only be diagnosed by regular eye examinations (screenings with the frequency of examination based on age and the presence of other risk factors).
• Intraocular pressure increases when either too much fluid is produced in the eye or the drainage or outflow channels (trabecular meshwork) of the eye become blocked.
• While anyone can get glaucoma, some people are at greater risk.
• The two main types of glaucoma are open-angle glaucoma, which has several variants and is a long duration (chronic) condition, and angle-closure glaucoma, which may be a sudden (acute) condition or a chronic disease.
• Damage to the optic nerve and impairment of vision from glaucoma are irreversible.
• Several painless tests that determine the intraocular pressure, the status of the optic nerve and drainage angle, and visual fields are used to diagnose glaucoma.
• Glaucoma is usually treated with eyedrops, although lasers and surgery can also be used. Most cases can be controlled well with these treatments, thereby preventing further loss of vision.
• Much research into the causes and treatment of glaucoma is being carried out throughout the world.
• Early diagnosis and treatment is the key to preserving sight in people with glaucoma.

Previous contributing authors and editor:

Medical Authors: Lawrence J. Schwartz, MD, and Camille Hylton, MD
Medical Editor: Leslie J. Schoenfield, MD, PhD

REFERENCES:

American Academy of Ophthalmology. "Primary Angle Closure, Preferred Practice Pattern." Oct. 2010.

American Academy of Ophthalmology. "Primary Open-Angle Glaucoma, Preferred Practice Pattern." Oct. 2010.

American Academy of Ophthalmology. "Primary Open-Angle Glaucoma Suspect, Preferred Practice Pattern." 2005.