Glaucoma can be broadly described as an optic neuropathy or pathology of the optic nerve. Glaucoma is just one type of optic neuropathy, but one of the more common eye disorders that can lead to blindness.
Glaucoma is through of as a problem where the eye pressure is elevated to such a level that damage occurs in the optic nerve. This damage manifests itself as a loss of peripheral vision. The optic nerve has over one million nerve fibers. The optic nerve has a good deal of redundancy, meaning that it can withstand severe damage before a person becomes aware of any sudden problem, or in fact, before a clinician can detect a problem in the peripheral vision. Current thinking suggests that a person needs to lose somewhere between 30 to 50% of their nerve fiber before the peripheral vision is affected. Such difficulties with early diagnosis have led to the development of nerve fiber analysis.
While glaucoma can occur at any age, it appears more frequently after the 6th decade. In fact, age is probably the greatest risk for developing glaucoma. Other significant risk factors are increased eye pressure, family history (primary relative), diabetes, race and some medications such as steroids.
Normal eye pressures are 8 to 21mm Hg. However in glaucoma, eye pressures before treatment can vary a great deal. Eye pressures also vary with the time of day. Some patients develop glaucoma even when eye pressures are in the normal range, making the diagnosis of glaucoma difficult. Thus to properly diagnosis glaucoma, the clinician must take into account many factors. It may require several visits and tests before your eye doctor can determine whether or not you have glaucoma. Despite several examinations and tests, it may still be impossible to definitively say if you have glaucoma; in that ase you are a glaucoma suspect and must be closely followed.
Treatment is usually accomplished with eye drops. Around 90% of glaucoma patients can be controlled with one eye drop. The remaining 10% of patients need more that one eye drop or sometimes surgery. The selection of eye drops for treating glaucoma needs to take into account the patient’s age, health problems, severity of the glaucoma, eye structure, and life style.
