Glaucoma is often described as the "sneak thief of sight" because it strikes without any obvious symptoms until it is too late and vision has been lost. Unfortunately there is no cure for glaucoma; once your vision has been lost it cannot be restored. Glaucoma is fairly common over the age of 40, affecting two people in every 100, with African-Americans six to eight times more likely to be affected. It is one of the most common causes of preventable blindness: more than three million Americans have the disease, and approximately 120,000 people are living with blindness caused by glaucoma.

Thankfully, with regular eye exams, glaucoma can be detected early -- before vision loss occurs. Treatments can delay or even prevent vision loss.

Glaucoma runs in families, and people of African, Scandinavian, Celtic and Russian ancestry are especially at risk. If someone in your family has glaucoma, it should be a warning to you, as you may also develop it.

What Causes Glaucoma?

Glaucoma affects the eye by increasing pressure. The increased pressure causes damage to the optic nerve. The optic nerve sends visual signals to the brain. When the optic nerve is damaged, the signals transmitted from the eye to the brain are also damaged.

In addition, the front of the eye is filled with a liquid called the aqueous humor. The aqueous humor bathes and nourishes the eye. Fluid flows into the eye and then drains from the eye. If the outlet where the liquid drains is clogged or overwhelmed by too much liquid production, the fluid builds up and creates pressure inside the eye. This also causes pressure on the optic nerve.

A blockage in the drainage system of the eye can also be caused by an injury, tumor, hemorrhage, infection, or simply the aging process. This can affect the aqueous humor drainage as well.

Secondary glaucoma is due to other health problems of the body or the eye. This type also reduces drainage of the eye.

Could You Have Glaucoma?

Only your eye doctor can help you answer that question, but studies have shown that anyone who meets one or more of the following criteria is at increased risk:

• Over the age of 40
• Family history of glaucoma
• Abnormally high intraocular pressure
• African, Scandinavian, Celtic or Russian ancestry
• Diabetic
• Nearsighted
• Regular long-term use of steroids/cortisone
• Previous eye injury

If you have one or more of these risk factors, it is important that you get regular eye exams. Early detection and treatment of glaucoma can slow the disease's progress and help to prevent blindness.

Types of Glaucoma

Chronic open-angle glaucoma is also known as chronic simple glaucoma or primary open-angle glaucoma and is the most common type. It primarily occurs in people over the age of 40 and is symptom-less. When the drainage capacity of the eye is reduced, pressure within the eye slowly mounts, harming the optic nerve.

Congenital glaucoma is present at birth or shortly after birth and is usually caused by a defect in the drainage system of the eye. Symptoms include increased sensitivity to light or eyes that quickly fill with tears.

Acute angle-closure glaucoma, also known as primary narrow-angle glaucoma or acute glaucoma, results from an immediate, complete blockage of the drainage area. The iris may press against the drain area, causing a sudden obstruction and consequently rapidly increasing pressure. Symptoms include rainbow-like halos or circles around lights, severe pain in the eyes or forehead, nausea and blurred vision. This type of glaucoma can occur at any age and requires immediate professional treatment to prevent blindness, which can occur within a day or two without treatment.

Secondary glaucoma is due to some other health problem of the eye or the entire body that reduces drainage of the eye and can occur rapidly or more slowly. If it is rapid, immediate attention is required.

How Is Glaucoma Diagnosed?

A comprehensive eye examination is required to check the level of pressure in the eye. An instrument called a tonometer is used; it is a simple, painless test that takes a fraction of a second to perform.

Your eye care professional here at Mielcarek Eye Associates will also determine the health of the optic nerve. Visual field tests are performed to determine the presence of blind spots or shrinkage in the peripheral field of vision.

How Is Glaucoma Treated?

Damage to the optic nerve fibers cannot be reversed. The goal of glaucoma treatment is to prevent further damage and to preserve the highest possible level of vision.

Glaucoma is treated by reducing the pressure within the eye. Oral medication or eye drops are used to enhance drainage of the aqueous humor to lower the pressure in the eye or reduce the quantity of liquid produced. Medication usually continues for life and must be taken regularly.

More recently, FDA (Food and Drug Administration) has approved the Aqua Flow Collagen Glaucoma Drainage Device, a tiny piece of collagen that is implanted under the white of the eye. Our surgeons create a space maintained by the device to increase fluid outflow and reduce pressure inside the eye. Within six to nine months the implant slowly dissolves; however, the space it occupied remains, allowing fluid to drain from the eye and thus lowering the pressure.

Dr. Mielcarek and Dr. Roat perform this procedure and have been experiencing excellent results.

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