January is Glaucoma Awareness Month, and now is a good time to schedule a comprehensive eye exam with your optometrist or ophthalmologist.

Glaucoma is the leading cause of vision loss and blindness in the United States for people over 60 years old. Glaucoma has no early warning signs or symptoms and more than half of people with this disease don’t know they have it. The only way to find out if you have glaucoma is to get a dilated eye exam. There’s no cure, but early treatment can often slow the damage and protect your vision.

What is glaucoma?

Glaucoma is a group of eye diseases that can cause vision loss by damaging a nerve in the back of your eye called the optic nerve. It usually happens when fluid builds up in the front part of your eye. That extra fluid increases the pressure in your eye, damaging the optic nerve. There are different forms of glaucoma, but open-angle glaucoma is the most common. This type of glaucoma is painless and causes no vision changes at first. As the disease progresses, blind spots develop in your peripheral (side) vision. Sometimes, blind spots can develop in the center of your vision as well. Glaucoma can affect one or both of your eyes. It's important to note that not all types of glaucoma involve elevated eye pressure. Up to 40% of people with glaucoma have normal eye pressure.

Am I at risk for glaucoma?

Some people have a higher-than-normal risk of getting glaucoma. This includes people who:

• Are over age 60
• Have family members with glaucoma
• Are of African, Hispanic or Asian heritage
• Are farsighted or nearsighted
• Have had an eye injury
• Use long-term steroid medications
• Have corneas that are thin in the center
• Have thinning of the optic nerve
• Have diabetes, migraines, high blood pressure, poor blood circulation or other health problems affecting the whole body

What’s the treatment for glaucoma?

Doctors use different types of treatment for glaucoma, including medication, laser treatment and surgery. If you are diagnosed with glaucoma, it’s important to start treatment right away. Treatment won’t undo damage to your vision, but it can slow down the process and sometimes stop it from getting worse. 

Prescription eye drops are the most common treatment. The drops are used everyday and lower the pressure in your eye which can prevent further damage to your optic nerve. Depending on the type of drops, you may need to use them once, twice or multiple times a day. It’s important to talk to your doctor about any potential side effects you may encounter with prescription eye drops.

Laser treatment is another option. To lower your eye pressure, doctors can use lasers to help the fluid drain out of your eye. In many cases, it’s a simple procedure that your doctor can do in the office. During the procedure, your doctor will use eye drops to numb your eye(s) and aim a small beam of light into your eye using a special lens. You may see small flashes of red light during the treatment. Most people feel little or no pain during the procedure. 

If medication and laser treatment don’t work, your doctor might suggest surgery. There are different types of surgery that can help the fluid drain out of your eye.

Glaucoma drainage devices: Your ophthalmologist may implant a tiny drainage tube in your eye. The glaucoma drainage implant sends fluid to a collection area (called a reservoir). Your eye surgeon creates this reservoir, and the fluid is then absorbed into nearby blood vessels.

Trabeculectomy: This type of surgery is usually used to treat open-angle glaucoma. The surgeon will create a tiny opening in the top of your eye, under your eyelid where no one will see it. This opening allows extra fluid in your eye to drain away, lowering pressure in your eye. Usually, you’ll be awake during this surgery, but you will receive numbing medicine to prevent any discomfort. Patients typically go home the same day after trabeculectomy surgery, but will need someone to drive home.

Minimally invasive glaucoma surgery: If you have mild glaucoma, your doctor may recommend a new approach called minimally invasive glaucoma surgery (MIGS). This procedure also lowers eye pressure, but it’s safer and helps you recover faster. There are different types of MIGS, so ask your eye doctor about whether MIGS may be an option for you.

Treating glaucoma is a team effort between you and your doctor. Once you begin taking medications for glaucoma, your ophthalmologist will likely want to see you regularly. You can expect to visit your ophthalmologist every few months. However, this can vary depending on your treatment needs.