Glaucoma is not a directly fatal disease, but a group of eye conditions that damage the optic nerve responsible for sending visual information to the brain. This damage is most often caused by high pressure inside the eye, known as intraocular pressure (IOP). While the condition itself is not fatal, its progressive nature can lead to irreversible blindness and introduce other life-altering risks if left unmanaged.
Glaucoma’s Impact on Vision
The issue in most common forms of glaucoma is a problem with the eye’s drainage system. Your eye continually produces a clear fluid called aqueous humor, which circulates in the front of the eye. In a healthy eye, this fluid drains out through a mesh-like channel, but when this system becomes blocked, the fluid cannot drain properly, causing the pressure inside the eye to rise.
This elevated intraocular pressure damages the delicate nerve fibers of the optic nerve. The optic nerve is a bundle of more than a million nerve fibers, and as they are destroyed, blind spots develop in your field of vision. This process is gradual and painless, with the initial damage occurring to peripheral, or side, vision.
Because central vision remains sharp in the early stages, many people do not notice the slow constriction of their visual field. The brain is effective at filling in the missing information, so the loss can go undetected for years. Once these nerve fibers are lost, they cannot be regenerated, and the associated vision loss is permanent.
Indirect Risks Associated with Vision Loss
The vision impairment from glaucoma can lead to dangerous situations. A narrowing visual field increases the risk of falls, particularly in older adults. A fall can result in hip fractures or head injuries, which carry their own serious health complications and potential for mortality.
The loss of peripheral vision also presents a hazard for driving. A driver with advanced glaucoma may not see a car approaching from the side or a pedestrian stepping off a curb, leading to a higher likelihood of accidents. This creates a risk for the individual with glaucoma and for others on the road.
Impaired vision can complicate personal health management. Difficulty reading small print on prescription bottles can lead to medication errors, such as taking the wrong drug or an incorrect dosage. Mismanaging medications for conditions like heart disease or diabetes can have serious consequences.
Acute Glaucoma as a Medical Emergency
A less common form of the condition is acute angle-closure glaucoma. Unlike the slow progression of the more common open-angle type, this condition occurs suddenly when the eye’s drainage angle becomes completely blocked. This blockage causes a rapid spike in intraocular pressure.
The symptoms of an acute attack include severe eye pain, nausea, vomiting, headache, and sudden blurry vision. These symptoms can be mistaken for a stroke or other systemic crisis, and this is a medical emergency for the eye.
The high pressure can destroy the optic nerve and cause permanent blindness within hours if not treated immediately. Prompt medical attention is required to lower the eye pressure and prevent irreversible vision loss. The emergency is centered on preserving sight, not saving a life.
The Importance of Treatment and Management
Early detection and consistent management are important for avoiding the dangers of glaucoma-induced vision loss. Regular comprehensive eye examinations are the most effective way to diagnose the condition before significant optic nerve damage occurs. These exams allow an ophthalmologist to measure intraocular pressure, inspect the eye’s drainage angle, and assess the optic nerve’s health.
The goal of glaucoma treatment is to lower eye pressure to a level that stops or slows nerve damage. This is most commonly achieved with medicated eye drops that either reduce the amount of aqueous humor the eye produces or improve its outflow. For some patients, these methods are not sufficient.
In cases where eye drops are not sufficient, laser therapy can help improve fluid drainage. Surgical procedures that create a new drainage channel for the aqueous humor are also an option to control the pressure. With proper diagnosis and treatment, most people with glaucoma can manage their condition and preserve their remaining vision.