Author: Dr. Jorge Rafael Hernández
To understand these facts we need to know how the eye works. In a general manner, the eye works very similar to a digital camera; it captures an image that is sent via a cable to the computer that analyzes it. If the cable from the digital camera to the computer is damaged, the latter cannot analyze the images the camera takes. The eye captures the image on the retina and it is then sent to the brain via the nerve fibers (which together form the optic nerve); if these fibers are damaged, the images perceived by the eye do not reach the brain, a process which can lead to blindness.
1. Glaucoma is the slow death of the nerve fibers of the optic nerve
The bundle of nerve fibers that carry the image to the brain can be damaged and if so, they will stop sending information to the brain. When this happens, the image does note reach the brain and vision is lost.
2. In glaucoma, the death of the nerve fibers is related to inadequate eye pressure.
The vast majority of people with glaucoma have an inadequate (higher) intraocular pressure, causing eye compression and therefore, death of the optic nerve fibers. The only globally accepted treatment for glaucoma is to lower the intraocular pressure levels with medication, laser or surgery.
3. During early stages of glaucoma there are no symptoms.
Glaucoma is also called the "silent thief of sight" because it progresses slowly causing vision loss and the patient does not perceive it until it is too late. That's why an early and periodic evaluation of the optic nerve can detect glaucoma at its initial stages, before there is any damage to the eye structures.
4. With glaucoma, side vision is affected.
In the vast majority of people suffering from glaucoma the first place where vision is lost is in the area around the nose. This is a point where the visual fields of both eyes overlap and that makes it difficult to perceive any changes. In advanced stages of glaucoma, central vision is preserved and vision on both sides of the eye is lost.
5. In general, you did nothing wrong to cause glaucoma. There are risk factors that can cause someone to develop glaucoma more than others. Family history and age (over 40 years) are the risk factors associated with glaucoma.
6. Direct causes of glaucoma may exist
There are several types of glaucoma: Primarily closed-angle and open-angle glaucoma. Among open-angle glaucoma, one of the most devastating types is presented in young people as a secondary effect from the use of topical steroids. Steroids are anti-inflammatory eye drops and make people feel fresh eyes but the intraocular pressure may rise causing damage to the optic nerve. If these drugs are used for a long time they can lead to blindness.
7. Overall exposure to world does not cause glaucoma
Personal habits, diet, and activity generally do not cause glaucoma, but there are some risk factors that may. The risk factors are different for open-angle and closed angle glaucoma. Some risk factors for closed-angle glaucoma are: age after 40, hyperopia (small eyes), the behavior of the internal structures of the eye (iris, lens, choroid, etc.) and pseudo-exfoliation.
8. The odds of going blind from glaucoma are low.
It is true that once the damage occurs it cannot be repaired, but if detected early, and given treatment to lower and stabilize intraocular pressure there might be no progression of glaucoma. Compliance and strict monitoring of the treatment program further reduces the chances of reaching blindness from glaucoma.
9. You do not have to change your life if you have glaucoma.
If you have glaucoma is ideal to keep a healthy diet full of vegetables and fruits and to exercise. It is best to avoid smoking and avoid positions where your head is below the waist for a long time (for example some yoga positions). Reading and drinking a glass of wine do not hurt anyone!
10. Follow-up appointments with the glaucoma specialist are very important to control glaucoma.
Glaucoma is a progressive disease and specialists should periodically follow up the optic nerve damage. To detect any change in glaucoma specialist should:
• Measure intraocular eye pressure (tonometry)
• Assess whether the angle is open or closed (gonioscopy)
• Examine the optic nerve (ophthalmoscopy, photographs, CT scans, etc.),
• Evaluate periferal vision (perimetry or visual field test)
In conclusion, glaucoma is damage to the optic nerve caused by raised intraocular eye pressure. Initially glaucoma has no symptoms but it can progress reducing the visual field all the way up to blindness. People who are at higher risk for glaucoma are those who have relatives with glaucoma and who are over 40 years old.
It is very important to get a complete evaluation (including intraocular pressure measurement and pupillary dilation) by an ophthalmologist, performed regularly to detect risk factors and avoid possible damage from glaucoma.