Glaucoma Center

Glaucoma is the second leading cause of blindness. Sometimes called the silent thief of sight, glaucoma can damage your vision so gradually you don't notice any loss of vision until the disease is at an advanced stage.  Glaucoma is an eye condition that develops when too much fluid pressure builds up inside of the eye.  This increase in pressure, called intraocular pressure, can damage the optic nerve, which transmits images to the brain. If damage to the optic nerve from high eye pressure continues, glaucoma will cause loss of vision. Without treatment, glaucoma can cause total permanent blindness within a few years. Because most people with glaucoma have no early symptoms or pain from this increased pressure, it is important to have regular routine eye exams so that glaucoma can be diagnosed and treated before long-term visual loss occurs.

Is Glaucoma Hereditary?

A family history of glaucoma does increase the incidence of glaucoma in family members and a routine ophthalmologic examination should be scheduled.

What is the difference between ocular hypertension and glaucoma?

Ocular hypertension describes the condition where the intraocular pressure is above normal. Glaucoma describes the condition where there is damage to the eye associated with elevated intraocular pressure.

What is narrow angle glaucoma? Is it more, or less, serious than other types of the disease? What is the prognosis for the average patient? What are the symptoms?

Narrow angle glaucoma is a type of glaucoma where the aqueous (the fluid produced normally in the eye) cannot reach the trabecular meshwork, which is the site where most of this fluid normally exits the eye. The prognosis is good for patients in whom a timely diagnosis is made and appropriate laser treatment performed. With narrow angle glaucoma, an acute glaucoma attack can occur which is often associated with pain, blurred vision, and a red eye. However, some patients have a chronic form of this disease and have no symptoms.

Is it possible to have glaucoma and cataracts at the same time?

Glaucoma and cataracts often appear together, as they are commonly present in older patients. There are many new surgical techniques which can help patients with both of these conditions.

Is there any bleeding associated with glaucoma?

Glaucoma is a disease not typically associated with bleeding. However, there are cases where bleeding can be a cause of elevated intraocular pressure although these are infrequent.

May I have some information on possible preventive steps for glaucoma?

The best measure for protecting your vision is to have a complete eye examination performed by an ophthalmologist annually.

Could you explain the range of numbers for glaucoma?

Statistically, most patients will have intraocular pressure less than 22 mm Hg. However, glaucoma can occur with pressures lower than this and also some patients’ eyes can tolerate pressures considerably higher than this. The only way we can determine an exact target pressure by monitoring and after a complete ocular examination along with some diagnostic tests such as a visual field test, photos of your optic nerves and an Optical Coherence Tomography (OCT).

Can you discuss the risks and benefits of glaucoma surgery vs. eye drops alone?

This is a complicated question and is affected by the specifics of a given patient and their tolerance of medication. I would urge you to discuss this with our doctors who can review it with particular regard to your specific eye condition.

I’ve heard that marijuana, which is currently an illegal substance, is helpful in treatment of glaucoma. Is this true? If so, why can’t it be prescribed?

The only marijuana currently approved by the FDA for medical use is Marinol.  It was developed as an agent that reduces nausea in chemotherapy patients and is taken orally in capsule form.  The effects of Marinol on glaucoma are not impressive and therefore are not prescribed.

Where is some of the most advanced work being done on glaucoma? Who might be a good source of information about support groups?

There are many centers where active research is being performed in the glaucoma field. The Glaucoma Research Foundation in San Francisco may be able to give you the names of the research centers in your area. They may also have additional information on support groups. You can contact them at (415) 986-3162. You may also visit their website at: www.glaucoma.org.

How often should a person suffering from glaucoma have their intraocular pressure (IOP) measured and their visual field tested to prevent risk of further damage?

The required frequency of visual field testing and IOP testing varies from patient to patient; this is something you should discuss specifically with your ophthalmologist.

When a person suffering from glaucoma is having blurred vision, is it a sign of further damage? What can one do to avoid risk of further damage?

Unfortunately, with glaucoma, typically there are no symptoms until extensive damage has occurred. For this reason, it is important to have routine eye examinations by an ophthalmologist.

Does reading, computer use and other such hobbies increase damage to the eyesight of persons with glaucoma?

No. Using your eyes does not damage them, even if you have glaucoma.

Can the two types of topical medication — the type increasing outflow of aqueous and the type reducing amount of aqueous produced — be used simultaneously?

Yes, both types of topical medication can be used simultaneously.

Besides medication, what precautions should a person suffering from glaucoma take to prevent risks of vision damage? For example, is reading in bright/dim light harmful?

Most routine activities will not negatively influence your glaucoma.

Is a glaucoma patient with shortness of breath affect the type of glaucoma medication that is prescribed?

There are many types of medications available to treat glaucoma. You need to speak with your ophthalmologist who can then review the other alternatives available to you. Patients with breathing abnormalities should not use drops  that are beta-blockers. Beyond medications, laser and additional surgeries are usually an option.

My doctor says that I have pigmentary dispersion. Does that mean I will get glaucoma?

Not all people who have pigmentary dispersion develop glaucoma. Pigmentary dispersion is a disorder in which some pigment granules leak out of the iris. The granules may clog the trabecular meshwork, preventing the normal aqueous outflow. This in turn causes an increase in intraocular pressure, which may lead to glaucoma.

It is impossible to know for sure which individuals with pigmentary dispersion will develop glaucoma, so it is particularly important for you to have regular medical eye exams.

Why are there so many prescriptions that warn against their use if you have glaucoma? Should I be concerned?

Certain medications are not to be used in a particular type of glaucoma called “narrow angle” glaucoma. This type of glaucoma is relatively rare. Individuals with the much more common “open-angle” glaucoma do not have to be as concerned about taking such medications. We suggest all patients with glaucoma consult with their pharmacist before taking any type of new medication.