Glaucoma is a disease which may cause significant visual loss if not diagnosed and treated early.  The most common form of this disease is open-angle glaucoma.  The eye receives its nourishment form a clear fluid that circulates within, called aqueous humor.  It returns to the blood stream through a drainage canal called the trabecular meshwork.  When the aqueous fluid cannot adequately leave through the mesh, increased pressure within the eye results. The elevated pressure causes damage to the blood vessel system which provides nourishment to the optic nerve.  The peripheral, or side vision slowly fades and central (straight-ahead) vision is affected late in the course of glaucoma.  With advanced glaucomatous nerve damage, a "gun barrel" type of vision results.  The lack of pain or awareness of visual change leads us to call glaucoma the "silent thief of vision" and makes regular eye exams mandatory for all adults. 

Glaucoma of this type can occur at any age, although it is most commonly diagnosed in people over age 40.  Patients of African-American descent, diabetics, and those with a family history of glaucoma are at greater risk for this condition. 

Routine eye testing utilizes a number of simple tests which aid in the detection of glaucoma.  Tonometry measures eye pressure.  Ophthalmoscopy, looking into the interior of the eye through the pupil, permits study of the shape and color of the optic nerve.  Nerve fiber analysis testing can also be beneficial.  Perimetry, or visual field testing, maps of the field of vision.

The goal of treatment is the lowering or control of eye pressure.  In most patients this can be achieved by the use of daily drops.  If eye drops do not successfully control the pressure, laser or filtration surgery may be required.

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