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JAMA Patient Page
May 14, 2014

Glaucoma

JAMA. 2014;311(18):1934. doi:10.1001/jama.2014.3983

Glaucoma damages the major nerve of the eye (the optic nerve) and eventually may cause permanent vision loss.

Types of Glaucoma

There are 2 main types of glaucoma: open-angle glaucoma and angle-closure glaucoma. These are descriptions of 2 different problems with eye anatomy. Both cause too much fluid to collect within the eye, which can increase pressure in the eye and eventually damage the optic nerve. Some patients with open-angle glaucoma do not have high pressure in the eye.

The May 14, 2014, issue of JAMA contains an article about glaucoma.

Who Gets Glaucoma?

Glaucoma affects more than 70 million people in the world. It is the leading cause of permanent blindness. Because in most cases there are no symptoms until the disease is fairly severe, most people with glaucoma are not aware that they have it.

People who are older than 60 years or have a family history of glaucoma are more likely to develop both types of glaucoma. African Americans are more likely to develop open-angle glaucoma; Asians are more likely to develop angle-closure glaucoma.

Symptoms

Open-angle glaucoma causes no symptoms early on. Later in the disease, when a large part of the optic nerve is damaged, some people notice loss of vision. This occurs first on the outer parts of their field of vision, resulting in “tunnel vision.”

Angle-closure glaucoma can cause symptoms earlier, but not always. When it occurs suddenly, it can cause pain and redness in the eye in addition to vision changes.

Tests for Glaucoma

Vision testing can be used to detect glaucoma by testing for tunnel vision. Also, testing for increased pressure in the eye with a special tool that gently depresses the surface of the eye can be helpful.

The best test for glaucoma is looking into the back of the eye with a special medical instrument to detect signs of optic nerve damage. This test usually requires the pupil to be dilated and is best performed by an eye specialist. Ask your primary care doctor if you have questions about whether you need testing for glaucoma.

Treatment

The goal of glaucoma treatment is to maintain a patient’s vision-related quality of life. Although glaucoma cannot be reversed once nerve damage is done, there are treatments that can slow the progression of nerve damage. These include several different types of eyedrops or, in some severe cases, eye surgery.

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For More Information

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at jama.com. Many are available in English and Spanish.

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Article Information
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

Source: National Eye Institute

Topic: Eye Diseases

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