By: Jonathan Myers, MD

Glaucoma is the leading cause of irreversible blindness worldwide. In America, more than 150,000 people are blind from glaucoma, and half of those who have glaucoma are unaware that they have this disease and are at risk to become blind. With treatment, the vast majority of patients will have useful vision their entire life.

What is glaucoma? Glaucoma is a process in which the optic nerve, which transmits the information from the eye to the brain, becomes progressively damaged, usually from high pressure within the eye. As the optic nerve becomes damaged, areas of vision are irreversibly lost. This slow, painless process is often not noticed until the damage is severe.

The pressure in the eye is a balance between the fluid production and drainage. In narrow angle glaucoma, the iris covers the drainage channel, leading to fluid build-up and higher pressure. This is one of the few types of glaucoma that can lead to a sudden attack of high pressure, which can be painful and blind an eye within hours. In open angle glaucoma, the drainage channel is not blocked, but does not function properly leading to higher pressure.

In most cases, glaucoma involves elevated pressure, but in some cases the optic nerve may be sensitive to even normal levels of pressure. For every type of glaucoma, lowering the eye pressure will slow or stop the progressive damage in most patients. Eye pressure can be lowered with eye drops, laser treatments, or surgeries to create new drainage pathways for the eye.

Who is at risk? All adults (it is rare in children). The risk increases with age, and so screening every few years with a complete ophthalmologic examination makes sense after the age of 40. People with a family history of glaucoma or anyone of African descent are at significantly greater risk and should be checked every 2 years. Anyone who regularly takes steroid medications in any form (these are often used to treat allergies, asthma and other respiratory diseases, as well as arthritis and some skin problems) must also be monitored as these can increase the eye pressure.

Dr. Myers is part of a thirteen-physician team at Delaware Ophthalmology Consultants. For more information about this article or to schedule an appointment, call 302-479-EYES (3937) or visit www.delawareeyes.com. Delaware Ophthalmology Consultants has two convenient offices in Wilmington and a third in Middletown. Each location offers full-service optical centers featuring affordable, fashionable frame designs and the latest in lens technology.

Figure 1:
A healthy optic nerve has a pinkish- orange color. It is shaped like a donut: there is a small “dimple” in the center that is called the cup.

Figure 2:
An optic nerve damaged by glaucoma. The nerve is pale and the “cup” has enlarged as almost all the nerve tissue has been destroyed by glaucoma (all hole, no donut left). This eye has little remaining vision.