What is glaucoma?

Glaucoma is a term that refers to a group of similar eye diseases, and what they all have in common is that they're diseases of the optic nerve. That's the important nerve that carries vision from the eyes to the brain. Glaucoma damages the optic nerve and the damage leads to vision loss, especially peripheral vision loss. In many cases, glaucoma is associated with high pressure in the eye, but there doesn't have to be high pressure for vision loss and glaucoma to occur.

Who is most likely to develop glaucoma?

Glaucoma's a really common eye disease. In fact, two to three million Americans are affected with glaucoma. There are several risk factors that make it more likely for some to get glaucoma:

• One of the most important risk factors is increased age. Glaucoma becomes much more common as we grow older, and those over the age of 80 are up to 10 times more likely to develop glaucoma than those that are under the age of 40.
• Family history is another important risk factor for glaucoma. Close relatives of people with glaucoma have up to eight times higher risk for getting glaucoma than someone with no family history.
• Race is an important risk factor for glaucoma. Some racial groups or ethnic groups have higher risk for getting glaucoma. And the one you mentioned that is probably the most important is that African-Americans are at much higher risk for getting glaucoma than Caucasians.
• High pressure in the eye is one of the most important risk factors for glaucoma. The higher the pressure in the eye, the higher the risk for developing glaucoma, and when someone has many of the risk factors I mentioned, those people would be at the highest risk for getting glaucoma.

What are the symptoms of glaucoma?

Early in the disease, there really aren't any symptoms that a patient might recognize. Most cases of glaucoma are painless and vision loss that occurs is usually so gradual, that a patient would be unaware of it. In fact, as many as half of the patients with glaucoma don't know they have it. But if it's left untreated or undetected, eventually vision loss will be recognized—usually as blind spots in the periphery. But with time, vision loss can progress and affect center vision as well.

How is glaucoma diagnosed?

Glaucoma can only be diagnosed with an eye exam by an eye doctor. An eye doctor has special equipment that lets them look into the eye and they can check for damage to the optic nerve. An eye doctor can also check for problems with peripheral vision. During a glaucoma check, an eye doctor measures pressure in the eye.

This is probably the most important message I could give today—these examinations are quick and painless and, in fact, most of the elements of a glaucoma exam are done as part of a routine visit to any eye doctor. These regular exams are the best way to detect glaucoma in its early stages. The recommendation is that people over the age of 40 should have an eye exam at least every two to four years; and with age, there should be more frequent exams, such an exam every one to two years when you're over the age of 65.

How is it treated?

All of the currently available treatments are aimed at preventing nerve damage and loss of vision by lowering pressure in the eye. The first line of treatment is to use medicated eye drops. In most cases, medicated eye drops do a good job of controlling pressure on their own, but in some cases more intensive therapies, such as laser treatments or surgeries, are important for lowering pressure and preventing glaucoma from progressing.

Once vision is lost to glaucoma, can it be restored with treatment?

Unfortunately, once vision is lost to glaucoma, it can't be recovered. That's why the message of early detection and early treatment is so important for glaucoma.

Is The University of Iowa involved in any research with regard to glaucoma?

Yes, there is a lot of research going on around the world as well as here at Iowa. At Iowa, we're particularly interested in studying inherited forms of glaucoma. A lot of our studies are aimed at searching for genes that cause the glaucoma that runs in families. We're also conducting studies that look at the basis of nerve damage that occurs in glaucoma.

If someone has glaucoma and is interested in participating in research, whom should they contact?

People interested in the glaucoma research we're doing here at Iowa can visit our lab Web site www.carverlab.org. Some of my colleagues and I have created an online glaucoma guide, Patient's Guide to Glaucoma.  If someone is interested in more information, they can call 866-495-2873. 

KXIC broadcasts are presented in mp3 format. The latest version of Windows Media Player, QuickTime Player, or Real Player is required to play them.

Listen to the radio broadcast

John Fingert, MD, PhD

Patient's Guide to Glaucoma