What is Glaucoma?8:49 PM
A lot of my patients know that I check for glaucoma during their eye exam, but there aren't too many that really know what it is. If you find yourself wondering what the heck glaucoma is, you are not alone! In reality, scientists and the top medical researchers don't really know everything about glaucoma. Here's some information about what we do know:
Glaucoma is a spectrum of ocular diseases that cause optic nerve destruction
There are so many different types of glaucoma, and all of them work in different ways. One thing unites them all: the optic nerve that delivers the message from the eye to the brain is destroyed. The destruction is most commonly slow and painless, but in some types of glaucoma can be very quick with acute headaches and halos around lights. Damage to the optic nerve causes PERMANENT vision loss, and that is why glaucoma is such a devastating ocular disease.
To simplify this discussion, let's talk about the most common form of glaucoma: primary open angle glaucoma.
Glaucoma typically is caused by high pressure building up inside the eye. There is a fluid called the aqueous humor that is made to deliver nutrients to the internal components of the eye. If too much fluid gets made, or if too much is retained inside the eye instead of draining out into surrounding tissue, then the fluid builds up in the eye. This creates increasing pressure pushing against the back of the eye and the delicate optic nerve.
Eye Pressure or Intraocular Pressure
|Goldmann Tonometry, the "gold|
standard" pressure reading
Photo via http://www.sco.edu/
What Glaucoma Looks Like
Most offices use retinal photographs to show patients what an eye disease looks like, but glaucoma is a disease that is not easy to "see." What your doctor looks for to detect glaucoma is atypical appearance of the optic nerve.
|Photo via http://www.glaucoma-eye-info.com/|
THE PROGRESSION OF GLAUCOMA. All of the photos below are of the same eye of the same patient, over a course of 9 years of retinal photography. Please ignore that the magnification gets bigger in every photo. Just compare the size of the entire optic nerve to the size of the cup (or lighter colored hole) in the center of the nerve. If you are an optometry student and look at this and get concerned, yes this person is being treated for glaucoma and is under the care of an ophthalmologist.
|2011: Note hole or cup is getting BIGGER near the bottom edge. If you look close, you can see a hemorrhage near the area of inferior damage (a tell-tale Drance heme)|
|2012: Even thinner at the inferior edge of the nerve!!|