Primary open-angle glaucoma

Glaucoma is the second most common cause of blindness worldwide, behind cataracts. Due to the silent progression of the disease, it is estimated that 50% of people with glaucoma in the country don’t even know it.

By far, the most common type of glaucoma is primary open-angle glaucoma. At first, open-angle glaucoma has no symptoms. But if untreated or undiagnosed, patients will gradually start to lose their peripheral vision (side vision). Eventually, this can lead to “tunnel vision” or even blindness.

Risk factors for glaucoma include elevated pressure in the eye (unrelated to blood pressure), abnormal appearance of the optic nerves, African-American descent, nearsightedness, age 45+, family history of glaucoma, steroid use, and previous eye injuries. “Glaucoma suspect” (or “pre-glaucoma”) describes a person with one or more risk factors that may lead to glaucoma, but this individual does not have proven optic nerve damage or visual field loss. A great overlap can exist between findings in patients who are glaucoma suspects without the disease and those who have moved into early glaucoma.

Treatment for open-angle glaucoma can delay progression of the disease, which makes early diagnosis very important. Treatments include medication drops, selective laser trabeculoplasty (SLT), conventional surgery or a combination of any of these. Selective laser trabeculoplasty uses a laser to lower the pressure in the eye. Surgery is normally only considered after medicines and laser surgeries have failed to control pressure adequately. While these treatments may save remaining vision, there is no way to improve sight already lost from glaucoma.

Angle-closure glaucoma

Unlike the slowly progressing and painless aspects of open-angle glaucoma, angle-closure glaucoma can allow the pressure to elevate quickly in eye causing painful and sudden loss of vision. This occurs when as a result of the angle closing between the iris and the cornea. The definitive treatment consists of a laser procedure, called a peripheral iridotomy, in which a small opening is created in the iris to allow another pathway for fluid to escape the eye. This procedure is very safe and effective.