Keeping with the theme of glaucoma awareness, this week’s Eye-Q blog is part two of our informative glaucoma run-down where we will be covering the symptoms of glaucoma, as well as information on how it is diagnosed and some of the common treatment options. If you haven’t yet checked out part one make sure to give it a look to find out what exactly glaucoma is (including the different types of glaucoma) and what your risk factors are for developing the sight stealing disease.
Ok, let’s get started.
Primary Open Angle Glaucoma (POAG) - No symptoms typically present.
Low Tension Glaucoma - No symptoms typically present.
Angle Closure Glaucoma - Angle closure glaucoma is one of the only types of glaucoma that will exhibit symptoms. These can include sudden onset eye pain, hazy or blurred vision, rainbow colored circles around bright lights, nausea or vomiting, and sight loss. It is important to seek immediate medical care if these symptoms are suddenly experienced.
Childhood Glaucoma - Much like adult glaucoma, juvenile glaucoma will usually develop without any obvious symptoms. However, a few things you can look for are a cloudy appearance to the eye (s), an abnormal enlargement of the eye(s), and some systemic symptoms such as loss of appetite, vomiting, and irritability. For more information on childhood glaucoma visit the American Association for Pediatric Ophthalmology here .
By now you might be wondering how in the world glaucoma is diagnosed if there aren’t even any symptoms. Again, the key is early detection through yearly eye health exams. Your eye doctor can detect glaucoma or even an increased risk for glaucoma long before any damage is done to your sight. The importance of this truly can’t be stressed enough because once your vision is gone, it can’t be restored. Here are a few of the common tests performed together with a comprehensive eye examination to help your optometrist determine if you have glaucoma or are at an increased risk for developing the disease.
Imaging Technology - There are now a number of advanced imaging systems available to assist your optometrist in evaluating the optic nerve and retinal nerve fiber layer (these are the areas commonly damaged by glaucoma). These devices include laser polarimetry, scanning laser tomography, and ocular coherence tomography (OCT). Photographs of the optic nerve are also extremely useful in documenting changes over time that could signal damage or the onset of glaucoma as well as other systemic or eye health conditions.
Visual Field Testing - As the name would suggest, this offers your doctor a detailed view of your field of vision - focusing primarily on your peripheral vision (aka side vision). This is important in glaucoma because your peripheral vision is most commonly affected first. However, this loss is typically so faint initially that most people do not even notice the visual decrease until it moves farther in centrally.
Tonometry - So far we have mentioned the eye’s intraocular pressure (IOP) a few times as an important factor in diagnosing and managing glaucoma. A tonometer is the device used to measure and calculate this value. There are several different kinds of tonometers including the infamous NCT (non-contact tonometry) machine better known to most as the “puff-of-air” test.
Pachymetry - This is a quick and painless measurement of how thick or thin the cornea (front surface of the eye) is. This is helpful because if a person has particularly thick corneas, their IOP will appear to be higher than it actually is. Having the most accurate IOP measurement possible is important in obtaining a diagnosis of glaucoma as well as in managing and treating the disease.
Gonioscopy - Gonioscopy allows your optometrist to view the angle between the iris and cornea where fluid drains from the eye with the use of a handheld mirrored lens. This lens shows the doctor if the angle is wide open or narrow. Narrow angles increase an individual's risk for a sudden acute glaucoma attack. Furthermore, gonioscopy can also determine if there are any blockages in the drainage canal such as abnormal vessel growth or excessive pigment.
While glaucoma can be an aggressive and potentially devastating eye disease, the good news is - it doesn’t have to be. If detected early and properly managed, most people will not have to go through losing their sight. Luckily there are several different options for treatment depending on the type of glaucoma you have and how advanced it is.
Eye Drops - Eye drops are primarily used to help lower the eye’s IOP by decreasing the amount of fluid made by the eye and/ or helping the eye’s fluid to drain more effectively. There are a number of drops available to treat glaucoma and each is classified by their active ingredient. There are also combination drops available for those who need more than one type of medication.
Pills - When eye drops alone are not able to efficiently control IOP, oral medications might be added to your regimen. Oral glaucoma medications have the same purpose as eye drops - to lessen the production of fluid within the eye.
Laser Surgery - There are actually several different kinds of laser surgeries used to treat glaucoma depending on the type of glaucoma you have as well as the severity. The most commonly performed treatment is called a trabeculoplasty. This is a quick and painless procedure in which a high energy light beam is focused on the eye’s drainage system and makes subtle changes that allow the aqueous fluid to drain more efficiently.
Traditional Surgery - In more advanced glaucoma when medications and/or laser treatments are not able to lower eye pressure adequately, conventional surgery might be recommended. The most commonly performed procedure is called trabeculectomy. During this surgery, a passage is created in the sclera (the white of the eye) that allows excess fluid to drain freely.
Regardless of the method - the goal of any treatment is to prevent the loss of vision. It is extremely important to stay on top of taking medications as prescribed and keeping your follow up appointments to see your doctor.
More than likely if you are reading this, you’ve experienced the strange sensation of an eyelid twitch. It can happen anywhere, at any time, and almost always stops the moment you try to point it out to someone else (and of course resumes the second they turn away just to make you look extra crazy). Well you aren’t crazy - at least in this case - eyelid twitches are a real thing!
Better known in professional lingo as “myokymia”, this twitching sensation is the result of involuntary, spontaneous, rippling muscle contractions. These spasms can actually occur in almost any of the muscles in your body. When relating to the eyelids, myokymia is most common in your lower lids but can happen in your top lids as well.
Eyelid myokymia is typically very temporary. The twitching will usually only last for a few minutes, but in some rare cases can last for a few days or even weeks.Your doctor will likely advise you that there is no cause for concern as common Myokymia resolves on its own without the need for treatment. Other than causing mild annoyance, the eyelid twitching shouldn’t cause any long term complications or interference with your vision.
Do your eyes ever feel dry and itchy? Do you ever experience eye fatigue, redness, blurred vision, or excessive watering? You could be suffering from dry eyes - especially if you live in Oklahoma City which ranks as the 17th driest city in the U.S. And despite the name, dry eye isn’t just an annoying feeling - it’s a legitimate chronic eye disease that affects an estimated 4.88 million Americans over the age of 50 alone. And since another estimated 89% of the population have never even heard of Dry Eye Syndrome, it’s easy to see why some would just write off those annoying symptoms as a normal part of their lives.
In honor of Mother’s Day kicking off Women’s Week, the Eye- Q blog has decided to dedicate a post solely to women’s eye health related issues. So what makes women’s eye health so special? Women are actually more commonly affected than men by a number of ocular health issues including dryness, cataracts, age related macular degeneration, and complications from autoimmune disorders such as Sjogren's or lupus. Furthermore, according to Prevent Blindness America, 66% of people who are blind or visually impaired are women.Let’s start with that statistic - why are women more at risk for eye complications than men?
No, it’s not a typo. Sjogren’s - pronounced show-grins - is a type of autoimmune disorder that causes inflammation and damage to various parts of the body; most commonly the tear and saliva glands. This damage results in symptoms ranging from dryness and discomfort to difficulty swallowing and can even affect the lungs and kidneys.So why exactly does this happen? Let’s start with a quick health lesson. The immune system is responsible for fighting disease and killing harmful viruses and bacteria. However, with autoimmune diseases, your immune system has a hard time knowing when to stop fighting and mistakenly attacks your own body. With Sjogren’s, your exocrine glands - the glands that secrete moisture such as saliva, sweat, tears, breast-milk, gastric mucous, etc - become the main targets.
So it’s the weekend and the mild discomfort you were experiencing midweek has now escalated into full blown intense pain. Or maybe you were working on the yard and something flew into your eye? Or perhaps you were wearing your contact lenses for too long and your eye is now extremely red and unhappy. Who do you call? (I’ll give you a hint, it’s not Ghostbusters.) But seriously, should you go to the ER if you injure your eye in some way? The answer might surprise you.