Understanding the Different Types of Glaucoma

Glaucoma is a collection of eye conditions that damage the optic nerve, which sends electrical signals to your brain about what you see. If the nerve is damaged in any way, you can lose your vision. 

At Omphroy Eye Care, ophthalmologist and cataract surgeon Dr. Luis C. Omphroy diagnoses and treats glaucoma at our Aiea, Hawaii, office. In fact, he tests for glaucoma every time you come in for a comprehensive eye exam. 

Early detection can prevent the disease from progressing and help save your sight.

Types of glaucoma

Glaucoma develops when the pressure from the fluid (aqueous humor) inside your eye builds up. The resulting pressure on the optic nerve damages or destroys it. It’s a major cause of vision loss in people over 60. 

Normally, the humor drains from the eye through a structure of ducts called the trabecular meshwork. But if something blocks the ducts or if the eye produces too much fluid to drain properly, the pressure inside the eye rises.

Doctors can’t always pinpoint what causes the duct blockage or the production of excess fluid, but they do know some part is hereditary. That means you’re more likely to develop the disease if a close family member has it.

Glaucoma can also occur due to blunt-force trauma to the eye, a chemical injury, diabetes, a severe eye infection, high blood pressure, and some inflammatory conditions. Still, the largest percentage of cases can be pinned down to age or genetics.

Glaucoma comes in two forms:

Open-angle (wide-angle) glaucoma

Open-angle glaucoma is by far the more common form. In this case, the trabecular meshwork appears normal, but the fluid still doesn’t drain properly. 

Glaucoma is often called the "sneak thief of vision," because it rarely produces symptoms until late in the disease, after you’ve lost most of your peripheral vision. 

Since you can’t recover any vision you lose, it’s extremely important that you make yearly eye exams, which include a test for intraocular pressure (IOP). That way, we can catch any problem early, when it’s more easily treatable.

Angle-closure (narrow-angle) glaucoma

Angle-closure glaucoma is more common in Asia, though the reasons for it remain unclear. The drainage space between the iris and cornea narrows until the fluid can’t drain properly, causing a sudden buildup of IOP.

In this form of glaucoma, symptoms appear rapidly and damage occurs equally as rapidly, so if you experience any of the following symptoms, contact us at Omphroy Eye Care ASAP or go to the nearest emergency room:

• Halos around lights
• Severe eye pain
• Vision loss
• Eye redness
• Eyes that appears hazy (especially in infants)
• Nausea or vomiting

Treatment involves draining the fluid causing the pressure buildup, and doing so is essential to preventing further vision loss.

Treatments for glaucoma

The treatment goal for both types of glaucoma is to lower your IOP without further damaging the optic nerve. Treatments include:

• Medications like beta-blockers (reduce fluid entering eye), prostaglandins (foster fluid outflow), and alpha-adrenergic agonists (decrease humor production)
• Laser trabeculoplasty, which unblocks clogged drainage tubes and restores normal fluid flow
• Surgery, which includes filtering (like trabeculoplasty), inner eye drainage tubes, and other minimally invasive procedures

Once he’s made his diagnosis, Dr. Omphroy discusses all your treatment options with you before deciding which is best for you.

If you haven’t had a comprehensive eye exam in a while, it’s time to come into Omphroy Eye Care for an evaluation, including glaucoma testing. Give our office a call at 808-487-7700 to set up an appointment with Dr. Omphroy today.