Glaucoma

There are two main types of glaucoma: open-angle glaucoma and narrow-angle glaucoma. Although open-angle glaucoma is the most common type, narrow-angle glaucoma is considered more severe because it may occur suddenly and pose a greater threat to your vision.

This type of glaucoma usually occurs gradually and happens when the eye does not drain fluid properly. As a result, eye pressure will accumulate and take a toll on the optic nerve. Initially, this will not cause any pain or vision problems. However, over time it may lead to irreversible vision loss. Some people have optic nerves that are sensitive to normal eye pressure, making them more susceptible to developing the condition. This is known as normal-tension glaucoma.

Also called angle-closure or closed-angle glaucoma, this type of glaucoma happens when the iris is too close to the drainage channel in the eye. This may cause the drainage channel to become blocked, leading to an increase in eye pressure. In some cases, the drainage channel may become completely blocked. This is known as an acute attack. If you are experiencing an acute attack, it is essential to see a doctor immediately, as this may cause serious vision problems and even blindness in a short amount of time due to the rapid build-up of pressure.

Anyone can get glaucoma, but certain groups and risk factors make some people more susceptible to the disease. Glaucoma is commonly seen in those over 40, and you are more likely to develop the condition if you have family members who have been diagnosed with glaucoma. Other risk factors for the disease include:


• Being of African, Hispanic, or Asian heritage
• Having corneas that are thin in the center
• The thinning of the optic nerve
• Having diabetes or high blood pressure
• Previous eye injuries or surgery
• Long-term use of steroid medications
• Being nearsighted

Those with more than one of the above risk factors are at an even higher risk for developing the condition. If you are concerned about your risk for glaucoma, talk to an ophthalmologist. They will be able to perform a comprehensive eye exam, determine if you are at risk for the disease, and assist you in taking steps to prevent vision loss.

Glaucoma leads to optic nerve damage, which may result in vision loss. Your optic nerve consists of over a million tiny nerve fibers that send visual information from your eye to your brain. Glaucoma causes these nerve fibers to deteriorate gradually, resulting in peripheral vision loss. If the disease progresses, it may eventually lead to complete blindness once all of the optic nerve fibers have deteriorated.

In open-angle glaucoma, there are usually no symptoms until the disease has progressed and vision is already being lost. This is why open-angle glaucoma is often called the “silent thief of sight.” The best way to protect your vision is to get regular comprehensive eye exams so that the disease can be detected early and treated before it causes significant damage.

Those susceptible to narrow-angle glaucoma typically show no symptoms before an acute attack. If you are experiencing an acute attack, you may have the following symptoms:


• Severe eye pain
• Eye redness
• Blurred or decreased vision
• Headaches
• Nausea or vomiting
• Seeing halos or rainbows

As mentioned, narrow-angle glaucoma is a medical emergency and may cause serious vision problems or even vision loss in a short amount of time if left untreated. Therefore, if you notice any of the above symptoms, see an ophthalmologist immediately.

Diagnosing glaucoma early is essential in preventing permanent damage to the eye. Because there are no symptoms in the early stages of glaucoma, patients with risk factors for glaucoma should have their eyes examined regularly. If you are at high risk, your doctor may perform a ‘pressure test,’ or tonometry, in which he or she will apply a numbing eye drop before measuring the pressure inside your eyes with a special tonometer. Your doctor or ophthalmologist may also conduct other tests depending on what signs and symptoms they observe.

If diagnosed with glaucoma, patients are typically prescribed eye drops to decrease intraocular pressure (glaucoma medications), which is the only way the disease can be managed. Surgery is also available for some patients to prevent further loss of vision.

Patients of Cascade Eye & Skin Centers and referral patients from all over Washington state receive evaluations and treatment from our skilled ophthalmologists. These physicians have had advanced training in the treatment of glaucoma and have been managing challenging cases for many years.

While most cases of glaucoma can be managed with SLT, eye drops, and timely follow-up appointments to monitor for changes, some patients require incisional surgery at Cascade’s Ambulatory Surgery Center on the Puyallup campus.

At our ambulatory surgery center, our highly competent staff is involved with ensuring that each patient receives compassionate care. Glaucoma surgeries, such as a trabeculectomy or a glaucoma tube-shunt implant, are performed by board-certified ophthalmologists who concentrate on treating glaucoma through medical and surgical interventions.