Glaucoma is an eye disease that often strikes without any warning or obvious symptoms. That’s why it is called the “thief of sight”. Glaucoma is the second most common cause of blindness in the United States and the most common among African-Americans. The exact cause of primary Open-angle glaucoma, the most common form, is unknown. However, other forms of glaucoma may occur in conjunction with other abnormalities of the eye. There is no “cure” for glaucoma, but vision loss can usually be prevented or slowed by proper treatment and continual follow up and monitoring of the disease. Glaucoma is one of the most common causes of preventable vision loss. The best way to protect yourself from vision loss caused by glaucoma is to know your risk factors and to have your eyes examined at intervals recommended by one of our specialists.

TYPES OF GLAUCOMA

Open-angle glaucoma the most common form of glaucoma, develops slowly and without symptoms. Damage to the optic nerve often goes unnoticed in early stages. Detection of glaucoma may go unnoticed unless properly diagnosed by a physician. Despite the angle (space between the iris and cornea) being wide open, increased intraocular pressure is caused by the slow clogging of the drainage canals of the trabecular meshwork. This type of glaucoma responds well to medication and surgery – especially if detected early.

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 WHO GETS OPEN ANGLE GLAUCOMA?

Anyone. Glaucoma affects people of all ages, from babies to older adults. Although everyone is at risk for glaucoma, those at higher risk include:

• Increasing age (people over age 60)
• African descent
• Hispanics
• People with other health conditions, such as diabetes or high blood pressure
• Individuals that have experienced a serious eye injury
• People with a family history of glaucoma
• Highly nearsighted individuals (myopic)
• Long-term steroid treatment

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SYMPTOMS OF OPEN ANGLE GLAUCOMA

At first there may be no symptoms, but as the disease progresses a person with glaucoma may notice his or her vision gradually failing with:

1. Usually none
2. Blurred vision
3. Loss of peripheral vision
4. Presence of halos around lights
5. Pain and pressure
6. Nausea and vomiting
7. Loss of central vision

Narrow-angle or Closed-angle glaucoma, a far less common form of glaucoma, can and often does have symptoms. The angle (space between the iris and cornea) is narrow, predisposing the eye to an angle-closure attack (iris plateau). The iris attaches to the ciliary body to close to the trabecular meshwork, where drainage occurs. When the pupil dilates, the peripheral iris tissue bunches up in the drainage angle and can cover up the trabecular meshwork, causing intraocular pressure (IOP) to rise quickly. This type of narrow-angle glaucoma attack can occur in conditions when the pupil dilates in dim lighting or when emotionally excited. Certain prescription medications, even some over the counter medications, can increase risk for an angle-closure attack. An angle-closure is usually painful and vision often becomes very cloudy. Frequently, an individual suffering an attack is also nauseated and vomiting. When these symptoms occur, immediate medical attention is necessary. If not detected and treated early, damage to the optic nerve can result with permanent vision loss. Vision may be preserved or serious damage may be avoided if treated promptly. It is treated with a laser to deepen the angle resulting in normal eye pressure levels, requiring no further treatment or medication. Narrow-angle can be diagnosed before an attack occurs by routine eye examination. Our experts then can prevent an attack from occurring by healing the eye with the laser to keep it from closing.

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WHO GETS NARROW ANGLE GLAUCOMA?

People with a family history of narrow angle glaucoma may be predisposed to an attack and some medications can increase the risk of an attack. It is estimated that 10 percent of those with glaucoma may suffer from an acute attack from narrow angle closure. A group of people who are at high risk include:

• Most prevalent among women in their 60’s
• Highly farsighted individuals (hyperopic)
• Individuals with smaller eyes
  

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SYMPTOMS OF NARROW ANGLE GLAUCOMA

1. Severe pain
2. Redness
3. Blurred vision
4. Nausea
   
5. Vomiting
6. Appearance of colored halos around light

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PREVENTION AND TREATMENT

The only way to tell if you have glaucoma is to have a complete eye exam at least every one to two years. Glaucoma is a lifelong condition. With early detection and treatment, the risk of vision loss can be greatly reduced. Patients and their eye doctor need to work together to agree on a treatment plan that offers the patient the best chance of preserving vision. Common treatments include oral or topical medication, as well as laser and conventional surgery. Talk to your eye doctor about treatment options because some may be better for your condition than others. Do not stop taking medication without talking to your eye doctor first. You and your doctor are a team whose goal is to preserve your vision and help you maintain your quality of life.

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Meet Your Glaucoma Eye Care Specialists

Jeffrey S. Schwartz, M.D. is the first full time fellowship-trained glaucoma specialist in Pinellas County. He has been with The Eye Institute since 1988. His practice is limited to diagnosis, treatment, laser therapy and surgery of patients with glaucoma and other relate diseases. Dr. Schwartz performed his residency at The University of South Florida and completed his glaucoma fellowship at the prestigious Jules Stein Eye Institute at UCLA. He is active in medical research and has made major contributions to the treatment and management of glaucoma. Dr. Schwartz is certified by the American Board of Ophthalmology. He serves as a medical consultant to pharmaceutical companies in the search for more effective glaucoma medications. Dr. Schwartz is on the Board of Directors and is the Medical Consultant for the Lighthouse of Pinellas and has served as the Medical Director for a number of health care plans.

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Kevin C. Greenidge, M.D., M.P.H., F.A.C.S. is a board-certified ophthalmologist fellowship-trained in the diagnosis and treatment of glaucoma. He completed his residency at Emory University in Atlanta and served as a Heed Glaucoma Fellow at the Wills Eye Hospital in Philadelphia. He received a Masters in Public Health from Harvard University. Dr. Greenidge spent 15 years completing his research, training young ophthalmologist, and performing surgery at The New York Eye and Ear Infirmary. His research introduced glaucoma laser surgical techniques currently used worldwide. He has published over seventy-five original research papers, book chapters, editorials and subject monographs. Dr. Greenidge’s distinguished academic career includes his appointment as Professor and Chairman of Ophthalmology at Downstate Medical School in New York, his investment as the first Richard C. Troutman, M.D., Distinguished Chair in Ophthalmic Microsurgery, and his service on the Board of the American Academy of Ophthalmology, receiving their Honor Award as well as their Senior Achievement Award for scientific contributions. He also served on the boards of the Glaucoma Foundation and the New York Eye Bank for Sight Restoration. He is an Associate Examiner for the American Board of Ophthalmology. Dr. Greenidge has lectured on glaucoma throughout the world. He is known for his successful surgery in infants and treatment of complex and difficult glaucoma cases.