Glaucoma is a disease that can cause serious damage to the eye, even blindness. And while this damage is largely preventable, unfortunately many people aren't aware they have glaucoma until it's too late.

How does glaucoma do its damage?

Glaucoma can take several forms. In the most common form of the disease, eye fluid that normally flows easily into and out of the eye to nourish it starts flowing too slowly. Unable to drain properly, the fluid begins building up, putting pressure on the optic nerve, which sends images from the retina to the brain. This pressure can cause the nerve to atrophy and lead to loss of vision.

Who is at risk for glaucoma?

Even babies can be born with glaucoma, although this is relatively rare. Young adults can get it, although it is more common after age 50. African-Americans are at particular risk. In fact, glaucoma is the most common cause of blindness in this ethnic group. Middle-aged African-Americans are 14 to 17 times more likely to go blind from glaucoma than Caucasians with the disease. People who have diabetes, are heavy smokers, or who have suffered injuries to the eye may also be more likely to get it than the general population.

How is glaucoma diagnosed?

It's not always easy. You may not have a clue that you have glaucoma until you experience vision trouble. "For the overwhelming percentage of glaucoma patients, there are no symptoms [until it's advanced]," says Dr. Israel Greenwald, professor emeritus at the State University of New York College of Optometry and past president of the New York State Optometric Association. According to Dr. Greenwald, optometrists will check eye pressure, look at the appearance of the optic nerve, examine the thickness of the cornea, and measure the patient's field of vision in order to make a diagnosis.

How can you treat glaucoma?

The best way to handle glaucoma is to prevent it in the first place, since any damage done is irreparable. Regular optometric exams will alert your optometrist if there's a problem. If he or she determines that you have glaucoma, you have several treatment options. Eye drops can help reduce the pressure in the eye and prevent further damage. Lasers can create a channel along the front of the eye to allow excess eye fluid to drain. And surgery is a last resort for those who don't respond to less invasive treatments.


Israel Greenwald, O.D., F.A.A.O., professor emeritus at SUNY College of Optometry.