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Glaucoma
What is Glaucoma?
Glaucoma is defined as "an increase in pressure in the eye with a loss of vision." The disease is quite painful in most cases, especially when the eye pressure is very elevated. The signs of glaucoma include: redness, cloudy eye, tearing, loss of vision, an enlarged eyeball, unusual aggressiveness, lethargy, and loss of appetite. The normal physiology of the fluid in the eye calls for the fluid to be made in one structure behind the pupil (ciliary body), travel through the pupil, and exit out the space between the cornea and the iris. When the fluid cannot properly drain from the eye, the pressure in the eye is increased. An analogy would be a kitchen sink – if the drain is open and the water is running, there is no problem. However, if a plug is placed in the drain and the water keeps coming, then the sink fills up with water and overflows! Some patients have primary glaucoma where there is no concurrent disease but some secondary causes of glaucoma include: inflammation, trauma, and tumors. All of these factors can obstruct the drainage of fluid from the eye.
Is it a serious condition?
Glaucoma is an ophthalmic emergency and must be treated immediately. If the pressure remains elevated for even a few hours, permanent vision loss occurs. The disease is difficult to treat but several options are available depending on whether the patient still has vision, the specifics of the patient, financial considerations, etc. Some of the options include: medical management with pills and eye drops, laser treatment to reduce the fluid production, cryosurgery to freeze the structure producing fluid, injection of medication into the vitreous, surgically placed drainage tubes, and removal of the blind and painful eye with a cosmetic prosthesis or complete removal of the eye. There are pros and cons to each of these treatments, and these variables are discussed during the ophthalmic examination.
How is Glaucoma treated?
Glaucoma treatment is complex and at times frustrating. Due to the complexity of the problem and the severity of the damage occurring within the eye, the success of treatment is highly variable. Vision loss is unfortunately very common. Medical treatment usually requires the use of several drugs (eye drops and tablets). The cost can be several dollars per day. Surgical treatment can either help reduce the need for medical treatment or in the case of some procedures eliminate the need for medical treatment completely.
If there is a chance of vision then the following is often recommended: medical treatment and consider laser surgery. If vision has been lost, then the recommendations may be to: remove the eye and place a silicone implant in the socket, place a silicone implant within the eyeball itself, or perform a chemical ablation. If in the problem is chronic, the eye pressure may spontaneously reduce and minimal treatment could be called for.
Glaucoma cases usually need much follow-up. If only one eye is involved, the other eye may need preventative treatment to delay or avoid glaucoma and subsequent vision loss.
Please feel free to ask further questions about cataracts to our outstanding support staff.
Steven M. Roberts, DVM, MS, DACVO
Holly L. Hamilton, DVM, MS, DACVO
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