OPHTHALMOLOGY

Q: I have two questions about glaucoma: How does glaucoma develop and how do glaucoma drops work? A: Glaucoma is an eye disease that can damage the optic nerve and result in vision loss or blindness if not treated. The optic nerve transmits information from the retina to the brain and when it becomes damaged, vision is impaired. To understand how glaucoma develops, it helps to understand how fluid circulates within the eye. Our eyes constantly produce a clear fluid called aqueous humor. This fluid then travels through the pupil and exits through the eye’s drainage system called the trabecular meshwork or drainage angle. The circulation of this fluid creates a relatively constant intraocular pressure, IOP, within the eye and is essential to keep the eye inflated, nourished, and functioning properly. In healthy eyes, there is a normal balance between the aqueous humor being made by the eye and the fluid that leaves the eye; as new aqueous flows into the eye, the same amount drains out. With glaucoma, the eye’s drainage system is either not working properly (open angle glaucoma) or is blocked (closed angle glaucoma), and the fluid cannot drain out at its normal rate. This in turn causes fluid build-up that increases the IOP and optic nerve damage can occur as a result. There is even another type of glaucoma, Normal Tension Glaucoma, whereby damage occurs to the optic nerve but the IOP remains within normal ranges. The cause for this type of glaucoma is thought to be a highly sensitive optic nerve or decreased blood flow to the optic nerve due to constricted or narrowing blood vessels. Eye drops for glaucoma, often the first choice of treatment, are used to decrease and control IOP thus protecting the optic nerve. They work by either helping the eye’s fluid to drain better and/or decreasing the amount of fluid made by the eye. It is important to use the eye drops regularly as prescribed to effectively control IOP. Your eye doctor will work closely with you to prescribe the best eye drop(s) for your needs and evaluate the results on an ongoing basis. While glaucoma cannot be prevented, it can often be treated and managed with eye drops, laser treatments, or special surgeries as needed so that both the IOP and flow of the eye fluid are at appropriate levels. If you are a glaucoma suspect or have a diagnosis of glaucoma, see your eye doctor for regular, dilated exams and/or testing as frequently as recommended by your doctor. Gregory Eippert, MD 9485 Mentor Ave., #110, Mentor 44060 440-255-1115 www.opivision.com

Gregory Eippert, MD