Primary Care in Rochester and Kasson

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Test your glaucoma IQ

1/23/2020 by Bernard Aoun, MD

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Musician Bono. Actresses Roseanne Barr and Whoopi Goldberg. Baseball Hall of Famer Kirby Puckett. All have been affected by glaucoma. But you don't have to be famous — anyone can contract this "silent" eye disease, which typically has no symptoms until damage has been done. So take a moment to test your glaucoma IQ. 

Q: What is glaucoma?

A: Glaucoma is a disease that is caused by increased pressure in the eye, leading to nerve damage and blindness. 

Q: Why is it important to recognize glaucoma early?

A: The effects of glaucoma can be so gradual that you may not notice a change in your vision until the condition is at an advanced, irreversible stage. If glaucoma is recognized early, vision loss can be slowed or prevented. 

Q: What are the types of glaucoma?

A: There are two main types: 

  • Angle-closure glaucoma. This can come on suddenly and is caused by a rapid rise in eye pressure due to poor drainage. 
  • Open-angle glaucoma. This is the most common type of the disease. Pressure build up is gradual and so is loss of vision.

Q: Who is at risk for glaucoma?

A: Glaucoma occurs mostly in people age 60 or older. African-Americans are at higher risk, while angle-closure glaucoma is more common in Asians. A family history of glaucoma also is a risk. In addition, certain medical conditions, including hypertension, sleep apnea and long-term corticosteroid use can put you at risk. 

Q: What are the symptoms of glaucoma? 

A: The most common symptoms are vision loss, needing more light for reading or tasks, eye pain, seeing haloes or rainbows around lights or redness in your eye. You also may experience narrowing of vision or tunnel vision, difficulty distinguishing boundaries and colors, headaches, nausea and vomiting. 

Q: When should I see a doctor?

A: If you experience sudden or rapidly changing vision, in addition to severe headache, severe eye pain, nausea or vomiting, you should seek care immediately. 

Q: Is there a test for glaucoma?

A: If you are having any symptoms of glaucoma, ask your primary care provider to do an eye (funduscopic) exam and test your field of vision. If needed, you may be referred to an ophthalmologist for more detailed testing. This includes a tonometry test that measures the pressure in the eyes. If you think you are at risk, you should address your concerns with your primary care provider. Glaucoma screening frequently is done when getting your vision checked. 

Q: How is glaucoma treated?

A: Several treatments are available, depending on the type of glaucoma: 

  • Closed-angle glaucoma. Urgent treatment is required, which can include IV medications and/or laser surgery. This treatment often is done also in the unaffected eye as a preventive measure. 
  • Open-angle glaucoma. The most-common treatment is eye drops. Sometimes pills are prescribed to lower the pressure inside the eye. 

If these more conservative treatments aren't effective or the glaucoma is more severe, there are surgical options. These include laser therapy to open blocked channels and fluid drainage through minimally invasive surgeries. 

Q: Is there anything new in glaucoma treatment?

A: There's been improvement in laser and minimally invasive surgery techniques. In addition, new topical medications have been approved. 

Q: Can glaucoma be cured?

A: Open-angle glaucoma cannot be cured and damage caused by the disease cannot be reversed. It's a chronic disease best managed by early detection and regular assessment, in addition to the treatments described above. Treatment for glaucoma is generally lifelong. 

Angle-closure glaucoma is an opthalmologic emergency. Treatment depends on the cause, such as pupillary block, blockage by a tumor and hyperopia. Getting immediate care to relieve the high pressure can lead to better results. 

Dr. Bernard Aoun practices in Primary Care in Rochester's Department of Community Internal Medicine (CIM) at Mayo Family Clinic Northwest and Senior Services. He specializes in internal medicine and geriatric medicine.