Glaucoma is a condition that affects a whopping 60 million people across the world and is the second largest cause of blindness globally, as per the World Health Organization.1 Yet, it remains a largely misunderstood disease, and not many people are familiar with what it is. So, here, we’ll take an in-depth look at the causes and symptoms and outline some treatment options.
What Is Glaucoma?
Glaucoma is the name for a group of diseases that damage the optic nerve and can often lead to blindness or partial loss of vision. People develop glaucoma when there is a buildup of fluid in the front part of the eye. The extra fluid increases the pressure inside the eye, which in turn damages the optic nerve.
Types And Causes Of Glaucoma
While there are several types of glaucoma, the two most significant types are open-angle glaucoma and angle-closure glaucoma.
Open-Angle Glaucoma
This is the most common form of glaucoma, which accounts for 90% of all glaucoma cases.2
Open-angle glaucoma is caused by the gradual clogging of the eye’s drainage canals which leads to increased pressure inside the eye. There are virtually no symptoms of open-angle glaucoma. It does not cause any pain or any initial changes in vision.3 This type of glaucoma develops very gradually and is a lifelong condition. It is known as “open-angle” because the drainage angle between the cornea and the iris is as open and wide as it normally should be.4
Angle-Closure Glaucoma
This form of glaucoma is rather rare and develops when the iris is too close to the drainage angle, causing a blockage, which in turn increases eye pressure. When the angle is completely blocked, eye pressure can rise very rapidly. This is known as an acute attack. Unlike open-angle glaucoma, this type of glaucoma is usually accompanied by noticeable symptoms such as severe eye pain, sudden blurry vision, sight loss, headaches, nausea, and vomiting.5
Am I At Risk For Glaucoma?
Yes, everyone is! From toddlers to the elderly, anyone can develop glaucoma. Babies can be born with glaucoma and older adults are particularly at risk for glaucoma. African Americans over the age of 40, Mexican Americans over the age of 60, and people with a family history of glaucoma are considered especially susceptible.6
People of Asian origin are considered particularly at risk for developing angle-closure glaucoma. Other risk factors that can predispose you to glaucoma include eye injuries, myopia (nearsightedness), and hypertension.7
Getting Tested For Glaucoma
Since anyone can develop glaucoma, regular eye exams are crucial to check for damage to the optic nerve and protect your eyes from damage caused by glaucoma. The Glaucoma Research Foundation recommends getting eye exams:
- Every 2–4 years before age 40
- Every 1–3 years between ages 40 and 54
- Every 1–2 years between ages 55 and 64
- Every 6–12 months after age 65
If you belong to one of the high-risk populations specified above, you should get tested every 1–2 years after the age of 35.
A comprehensive glaucoma exam will include an examination of inner eye pressure and field of vision, color and shape of the optic nerve, measuring the angle between the iris and cornea, and the overall thickness of the cornea.8
Symptoms Of Glaucoma
Glaucoma can go undetected for years while gradually compromising your vision without you realizing it. The most common type of glaucoma (open-angle) does not have any noticeable symptoms. There aren’t any early warning signs or associated pain. The first loss of vision is that of peripheral vision, so many people don’t even notice it. Overall sharpness of vision and central (straight) vision does not diminish until much later in the progression of this disease.
So by the time you catch on that something may be wrong with your vision, glaucoma is already in its advanced stages. Glaucoma may develop in just one or both eyes. Without prompt and proper treatment, this can lead to significant loss of vision or total blindness.
Angle-closure glaucoma, however, has noticeable symptoms. Look out for:
- Severe eye pain
- Sudden blurry vision
- Sight loss
- Headaches
- Nausea and vomiting
If you experience any of those symptoms, you should seek emergency care. A rapid hike in eye pressure (acute attack) is considered a genuine eye emergency and, if not treated immediately, can cause blindness.
Glaucoma Treatment Options
Once a diagnosis of glaucoma has been made by your ophthalmologist, it is crucial to treat the condition. Glaucoma cannot be cured and vision loss due to glaucoma is permanent – it cannot be reversed or restored. However, with an early diagnosis (remember to keep up on those regular eye exams), glaucoma can certainly be treated and managed.
Medication
Your ophthalmologist may prescribe pills or eye drops to help balance your eye pressure by lowering the amount of fluid inside your eyes or facilitating better fluid drainage. It is crucial to not discontinue glaucoma medication without discussing it with your ophthalmologist first. Once you’ve begun medication, it is important to visit your ophthalmologist as often as instructed (usually every 6–12 months).
Laser Trabeculoplasty
A laser trabeculoplasty is meant to facilitate better fluid drainage from the eye. The procedure can be performed at an eye clinic and involves using a laser machine projecting a high-intensity beam of light on the mesh-like structure inside your eye. The high-intensity laser beam will make evenly spaced burns inside your eye which will stretch the drainage channels, allowing fluids to drain effectively. While laser trabeculoplasty can be effective, its impact may lessen over time.
Conventional Surgery
Traditional glaucoma surgery entails making a new opening in your eye for the fluids to drain effectively. This procedure is known as a trabeculectomy, is performed in an OR, and can be recommended by your ophthalmologist if medication and laser procedures have been ineffective in lowering eye pressure.
If you have glaucoma in both eyes, surgery will be done one eye at a time, usually about 6 weeks apart.9 10
Nutritional Supplements
Talk to your doctor about possible nutritional supplements that can help with overall eye health. Minerals that promote good eye health include copper and zinc. Vitamins A, C, and E also ensure good visual acuity. Foods rich in antioxidants are considered to help manage glaucoma although these claims have not been proven in clinical studies. To get more antioxidants into your body, incorporate more berries, broccoli, cabbage, cauliflower, tomatoes, and citrus fruits into your diet. Physicians particularly recommend leafy greens like spinach and kale as superfoods that can help protect vision. Spinach contains two crucial antioxidants, zeaxanthin and lutein, that naturally occur in the eye, making it fantastic for overall eye health.11
Exercise
Research shows that regular exercise three times a week can reduce eye pressure organically, besides also helping with glaucoma-related conditions such as hypertension and diabetes. Whats’s more, the exercise doesn’t have to be rigorous. Just a brisk 20-minute walk around the block, four times a week, can lower intraocular pressure.12
Before you start exercising regularly though, make sure your eye doctor has assessed the impact of exercise on your specific glaucoma diagnosis. Why? Because some forms of glaucoma don’t really respond to exercise and, sometimes eye pressure can even increase after vigorous exercise.13
Acupuncture And Meditation
Both acupuncture and meditation are often suggested for the management of glaucoma, but there isn’t any empirical evidence yet to suggest that they actually help.
Medical Marijuana
Some studies in the 70s and 80S demonstrated that smoking medical marijuana can lower eye pressure. Further investigations by the National Institutes of Health have found that while smoking medical marijuana does lower eye pressure, the effect lasts only about 3-4 hours. Since glaucoma must be treated round the clock, one would have to smoke medical marijuana eight times a day to maintain lower eye pressure. Smoking that much medical marijuana is not recommended due to its effect on your mood, judgment, and mental capabilities.14
Ayurvedic Medicine
The ancient Indian medicinal system of Ayurveda considers glaucoma to be a manifestation of an imbalance in the body’s doshas. Ayurvedic supplements such as punarnava, amalaki, haritaki, vibhitaki, and curcumin are promoted in the treatment of glaucoma due to their ability to reduce excess body fluids, regulate fluid retention, and for overall benefits to the eye.15 Consuming herbal extracts of these plants under supervision may help in the management of glaucoma, but clinical studies have not proven these claims yet.
Glaucoma Don’ts
If you have been diagnosed with glaucoma, keep an eye on the following:
Coffee Intake
Some studies have shown that consuming too much coffee in a short amount of time can increase eye pressure but others counter this claim and have found no significant relationship between caffeine intake and eye pressure. Caffeine and its relationship with glaucoma is still an active area of research and there’s still no conclusive evidence to suggest a direct relationship (or lack thereof) between the two.That said, if you suffer from glaucoma, experts recommend that you err on the side of caution and limit your coffee consumption to moderate levels.16 17
Water Intake
People with glaucoma are also encouraged to drink water in small amounts throughout the day because drinking too much water too quickly is known to elevate eye pressure.18
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