American Medical Association Family Medical Guide - American Medical Association [739]
• Redness of the eye
• Blurred vision
• Severe eye pain
• Severe headache
• Rainbows or halos around lights
• Nausea and vomiting
Acute closed-angle glaucoma
In acute closed-angle glaucoma, the entrance to the drainage angle becomes blocked, causing a sudden, severe increase in pressure inside the eyeball. Acute closed-angle glaucoma is a medical emergency that requires immediate medical treatment to clear the blockage and prevent blindness.
Diagnosis
In most cases, chronic open-angle glaucoma is detected by an ophthalmologist during a routine eye examination. If the doctor suspects that you may have glaucoma, he or she will examine your eyes to determine if the disease has affected your vision and will perform a visual field test and an eye pressure test (see page 1029). The doctor then dilates (widens) your pupils with eyedrops and looks inside your eyes through an ophthalmoscope (a viewing instrument that projects a bright light onto the back of the eye) to evaluate the retina and the optic nerve. He or she also looks through the cornea of each eye to examine the structure and condition of the drainage angle.
The doctor may perform a test called gonioscopy, in which he or she anesthetizes the eyes with eyedrops and places a special contact lens called a gonioscope on the cornea to closely examine the drainage angle of each eye for any changes or signs of blockage. In some cases, the doctor may take photographs (called disc photos) of the optic nerve in each eye at various intervals, to monitor the progression of the disease.
Gonioscopy
In an examination called gonioscopy, an ophthalmologist anesthetizes the eye with eyedrops and places a special contact lens called a gonioscope on the cornea to examine the drainage angle for any changes or signs of blockage.
MY STORY Glaucoma
I never had any trouble with my vision until I was about 45 and needed reading glasses. When I went in for an eye exam, one of the tests showed that I had signs of an eye disorder called glaucoma. The test found that there was an increase of pressure inside my eye, which, the doctor told me, can damage the nerves in the eye and eventually lead to blindness. I was shocked. I had heard of glaucoma before, and I seemed to recall that one of my grand-parents had it, but I thought it happened just to older people.
Lucky for me, the doctor said that the glaucoma was at an early stage and that it could be treated by keeping the pressure inside the eye at a normal level. She prescribed some eyedrops for me to use every day, which, she explained, would lower the pressure in my eyes. She told me about the side effects of the medication—one of which is asthmalike symptoms. I put the eyedrops in my eyes religiously twice a day for about 2 months. Then I started having trouble breathing. I told the eye doctor about the breathing and she told me to stop taking the drops and to see my family doctor to be sure it was the medication and not a serious condition that was the cause of my breathing problems.
The eye doctor gave me different types of eyedrops to try that wouldn’t affect my breathing, but they either did not control my glaucoma or they irritated my eyes. The eye doctor then suggested that I have laser surgery to control the pressure in my eyes. She explained that the procedure is painless and can be performed right in her office. I decided to go ahead with the laser surgery because I was having so much trouble with the medication.
I’m glad I did. I no longer have to use eyedrops and my glaucoma is controlled. I see the eye doctor regularly to make sure everything is still OK. My brother was not so lucky—he has glaucoma and didn’t start his treatment early enough, and has lost some of his vision. But he is using eyedrops now to prevent the glaucoma