Glaucoma is a disease that is a challenge for most of us to understand. The word itself is unique and not used outside the world of eye care.

There are different causes and forms of glaucoma. The most common form is called primary open-angle glaucoma. It is a condition that slowly damages the eyes at a rate that causes no symptoms at all.

Unlike cataracts and eye infections, patients do not typically have pain or perceive loss of vision quality. The lack of symptoms is why some doctors will call glaucoma a “silent thief” of vision.

So what is glaucoma?

Glaucoma is a term that we use to explain a disease process where nerve fibers that connect our eyes to our brain die. The optic nerve in our eye is the structure that consists of the collection of these vision-sensing nerve fibers.

The optic nerve acts like a wire or cord to send the signals of light into the brain, where vision is processed and experienced. So if damage occurs to these “wires,” the signal of vision will be lost.

Unfortunately, we do not have any good therapy to repair these nerve fibers once they die. Thus it becomes critical to prevent and protect nerve fibers from further damage if the disease is detected or suspected in patients.

How do we know if we have glaucoma?

As a patient it is nearly impossible to self-diagnose glaucoma. With modern technologies and routine eye care, we are able to identify patients with increased risk factors or early disease better than ever before.

Patients must have routine care to detect the disease before significant damage happens. Risk factors include patients with high eye pressure patterns, over age 60, family history, high glasses prescriptions, and many others.

Eye doctors measure the eye pressure at almost every visit. Many people are familiar with the “puff of air test” or something done where there is a force placed directly to the eye (almost everyone dislikes this one). To test the pressure of the eye we push against the eyeball to see the return force, kind of like squishing a ball to see if it is inflated or going flat.

Many other tests are critical to having a full glaucoma assessment. Eye pressure is not the only factor. We also perform optic nerve scans, visual field tests, corneal thickness testing, dilated exams and other structural assessments using a microscope.

How is glaucoma treated?

As mentioned above there is no way to regenerate optic nerve fibers once they die. However, maintaining the living fibers can be managed in most scenarios successfully.

Reducing eye pressure has been well established as the strategy to slow down disease progression and in some people even stop the disease. Treatments are typically started with medication eye drops to lower eye pressure. They are frequently once-a-day dosed and very effective.

If medication alone is not sufficient we have many different surgical treatments that can be performed with high success.

Can I prevent the disease?In some cases the answer may be yes. You would not be able to do this alone, though. That is why I recommend everyone over the age of 60 should have annual dilated eye exams.

Early detection and assessment of risk factors is key to close management or early treatment. Patients who elect to only see a doctor when they feel a symptom run increased risk for blindness causing eye diseases.

Remember to have routine care and make sure you understand that health insurance companies cover eye disease management. You do not have to have eyeglasses or vision plan coverage to receive eye care.