When the pressure inside the eye is too high, the nerve tissue inside the eye is damaged. This disease condition, called GLAUCOMA, can lead to blindness if it is not treated properly.

The eye can be thought of as a ball. The tissue inside the eye where fluid (aqueous humor) is produced is called the ciliary body. There is another area where this fluid is drained from the eye, called the anterior chamber angle. The amount of pressure inside the eye is the balance between fluid production and fluid drainage. Increased pressure causes permanent nerve damage that causes a loss of vision.

There are many different types of glaucoma. Glaucoma is mostly a disease of older adults. Sometimes, children can have the disease, and rarely, babies are born with glaucoma. As we age, the risk of glaucoma increases. Other factors can increase the risk of having glaucoma. Glaucoma tends to run in families. If someone in the family has glaucoma, it means that the rest of the family has a greater chance of developing the disease. Certain medical conditions, like diabetes, increase the chances of getting glaucoma.

For people in their 40s, one person out of 1000 has glaucoma. By the time people reach their 80s, 14 people out of 100 have the disease. Most types of glaucoma have no symptoms until the disease is far advanced. The nerve damage happens so slowly that people don't know they have the disease unless their eye doctor checks for it. It is estimated that one million people in the United States have glaucoma, but don't know it, because they have not been tested for it. Testing includes measuring the pressure in the eye, testing side (peripheral) vision, and examining the appearance of the optic nerve.

There are less common types of glaucoma that come on suddenly with pain and blurred vision. These "acute" types of glaucoma must be treated immediately. Permanent vision loss can occur within hours in these situations.

Fortunately, we have a wide variety of treatments for this disease. Medicines are prescribed that lower the pressure to safe levels. When medicine, alone, is not enough, surgery can be performed to lower the pressure. LASER SURGERY is frequently successful in controlling glaucoma and postponing the need for conventional surgery.

Copyright, 1997. Richard E. Gans, M. D.

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