Understanding Glaucoma and the Options for Glaucoma Treatment

To get a better understanding of glaucoma treatment, here we also explain what glaucoma is and some of the characteristics.

What is Glaucoma?

Glaucoma is a family of diseases that all damage the optic nerve and produce a characteristic appearance of the optic disc, which is where the optic nerve enters the eye. Though it is often thought of as a "high eye pressure" disease many patients with it have what we consider to be normal eye pressure.

Glaucoma Characteristics

• The disease is a major cause of blindness worldwide, though the types of predominant glaucoma vary in different ethnic groups.
• It causes a characteristic pattern of visual loss measured by a visual field test. The vision loss usually starts in the periphery and slowly works its way into the center.
• Has a hereditary predisposition. It is common for an affected patient to have close relatives that also have the disease.

Glaucoma Symptoms?

Glaucoma has NO symptoms until the disease is advanced. No blurred vision, no pain. In the early disease patients have no way of knowing they are ill other than an eye doctor telling them so.

Many times I find myself wishing that glaucoma was painful so that patients would come in for examinations more often and remember to take their medication more faithfully.

Consequently glaucoma is referred to as "The Thief of Sight".

Detection

Glaucoma is best detected by a dilated eye examination with detailed analysis of the optic nerve. Routine eye pressure checks (IOP) will miss a large percentage of cases.

Note: The disease has nothing to do with wearing glasses. I put this in because at least once a week I have a patient tell me he/she doesn't need glasses so he/she must not have glaucoma.

Glaucoma usually occurs in patients over 50 years of age, though we occasionally diagnose children and young adults with it.

Click here for information about the Types of Glaucoma listed below:

• Primary Open Angle Glaucoma (POAG)
• Normal Tension Glaucoma (NTG)
• Narrow Angle Glaucoma (NAG)
• Pigmentary Glaucoma (PG)
• Pseudo-Exfoliative Glaucoma (PXG)
• Neovascular Glaucoma

Normal Versus Glaucomatous Optic Nerve

Normal Optic Nerve	Optic Nerve in Glaucoma. Enlarged central cupping is evidence of loss of retinal nerve tissue.

Glaucoma Treatment Methods

• Glaucoma is usually treated initially with prescription eye drops that lower the eye pressure. Even in patients with "Low-Pressure" Glaucoma we still lower the pressure to treat the disease.



• Sometimes a laser treatment called argon laser trabeculoplasty (ALT) or selective laser trabeculoplasty (SLT) is used to additionally lower the pressure. These glaucoma treatment procedures do not always work and when they are effective they last only three to five years.
• In cases when the pressure cannot be controlled or when vision loss occurs despite medical and laser treatments, a major surgery called trabeculectomy or tube shunt may be done. These surgeries are effective but carry significant risks, and are used when other methods fail.

Glaucoma Treatment Through Nutrition?

Ironically, glaucoma is my primary responsibility and it is the least responsive eye disease to nutritional treatment. We just don't have any large studies showing significant benefit from nutrition, and probably never will, due to the enormous expense of such trials.

However, there are some small studies that have indicated some natural remedies might help.

• Two new retrospective studies published in peer-reviewed ophthalmology journals showed that patients with diets high in fruits and vegetables were about 65% less likely to develop glaucoma. Retrospective studies don’t prove the association is causal, but in these cases do show a strong relationship.
• Small studies show that omega-3 fatty acids (fish oil) lower intraocular pressure (IOP) somewhat.
• Ginkgo biloba, commonly used to increase blood flow to tissue and improve memory, has shown interesting abilities to protect the nerves in some studies.
• Curcumin (Curry) has been shown in small studies to be helpful.

Possible Causes of Increased Eye Pressure

In addition to the helpful nutrition, there are a few things that may increase your eye pressure, which is not a good thing...

• Coffee has been shown to increase eye pressure a small amount.
• Wearing a necktie with the top button buttoned will raise your eye pressure a couple of points.

Remember the importance of epigenetics, since this is to varying degrees a genetic disease.

Related Information

For more information about glaucoma also check the following pages:

• Types of Glaucoma
• Treating Glaucoma and Glaucoma Surgery