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Glaucoma, often called the ‘Silent Thief of Sight,’ often develops gradually without immediate symptoms. It is a chronic, progressive disease in which the major nerve of the eye, the optic nerve, is permanently damaged. Major risk factors include elevated eye pressure, family history, age, low blood pressure and a thin cornea. 

Over 80 million people around the world have glaucoma and it is one of the leading causes of blindness and visual impairment in the United States today. It is estimated that over four million people have glaucoma in the U.S. but only half of them know it. The key to combating this silent thief of sight is early detection followed by ongoing management of the disease.

What is Glaucoma?

Glaucoma consists of a group of conditions that damage the optic nerve. This nerve transmits light signals from the retina and sends the impulses to the brain, which forms the vision. Damage to the optic nerve diminishes eyesight. In the early stages of glaucoma, the decreased vision is not noticeable, but late-stage glaucoma can cause blindness.

At Wheaton Eye Clinic, glaucoma doctors perform an initial comprehensive glaucoma evaluation to:

  • measure the pressure in your eye (tonometry)
  • inspect your eye’s drainage angle (gonioscopy)
  • measure the thickness of your cornea (pachymetry)
  • inspect your optic nerve and photograph it (ophthalmoscopy)
  • test your vision at the sides, center and in all directions (visual field test)
  • evaluate the thickness of the optic nerve fibers with nerve fiber analysis (eg. OCT)


The two most common types of glaucoma present themselves very differently. There are few or no symptoms of warning for Primary Open-Angle Glaucoma (POAG). On the other hand, some people with Angle-Closure Glaucoma (ACG) have pronounced symptoms including severe eye pain and headache, possibly nausea and vomiting, as well as blurred vision, halos around lights, sudden visual disturbances in low light and reddening of the eye. Others with ACG experience gradual loss of peripheral vision in both eyes similar to those with POAG.

Causes/Risk Factors

The most significant risk factors for glaucoma are increasing age and elevated internal eye pressure, which can only be detected during a doctor’s examination. People are six times more likely to get glaucoma if they are over 60 years old and the risk of glaucoma increases with age.

In addition, glaucoma is the leading cause of blindness among African Americans, who are six to eight times more likely to get glaucoma than Caucasians. African Americans should begin to have their eye pressure monitored before age 30. Hispanic populations and people of Asian descent also face an increased risk of glaucoma.

Family history can serve as an additional risk factor. Current medical findings indicate glaucoma may have a genetic link that causes members of some families to be unusually susceptible to the disease. Patients with a family history of glaucoma should be screened earlier to detect possible disease.

Medical conditions such as diabetes, heart disease or even nearsightedness can increase a person’s risk for glaucoma. Using corticosteroid medications for prolonged periods of time, especially in eye drop form, also appears to affect the risk of glaucoma. Major eye injuries can cause glaucoma to occur immediately after the injury or even years later.

Treatment Options

Depending on the type of glaucoma being experienced, your doctor may suggest treatment involving medication and/or surgery to lower the pressure in the eye and prevent further damage to the optic nerve.

If you are prescribed a medicine for your glaucoma, it is important to carefully follow your medication regimen daily in order to maintain a healthy eye pressure and prevent vision loss. There are several types of glaucoma medications, usually in the form of drops, that can be utilized. Your doctor may prescribe a combination of these medications or change your prescriptions over time, to reduce side effects or provide more effective treatment.

Many types of lasers are used to treat eye diseases. Your doctor may recommend a laser as an initial treatment for glaucoma or later after drops have been prescribed. Different forms of glaucoma can be treated with different laser procedures. For example, patients with POAG may benefit from a laser procedure used to treat the trabecular meshwork (the eye’s drainage system). This laser helps increase the flow of fluid out of the eye which lowers the intraocular pressure. A laser may also be recommended for patients with narrow or closed angle glaucoma to create an opening in the iris tissue to provide an additional path for aqueous humor (the fluid in the front of the eye). This can prevent or treat pressure build up in the eye. Generally, patients can resume normal daily activities the next day after laser surgery. The doctor will give instructions on medications to be used after laser surgery.

Minimally invasive glaucoma surgery (MIGS) procedures include a collection of surgeries used to lower eye pressure through smaller incisions than traditional glaucoma procedures. These procedures allow for quicker recovery and fewer complications though may not be suited for all patients. These surgeries can be performed both at the time of cataract surgery or as stand-alone procedures and aim to increase fluid outflow from the eye. This can be achieved by placing a stent (i.e. iStent, Hydrus), removing part of the trabecular meshwork (Kahook dual blade, Trabectome), or bypassing the trabecular meshwork altogether (Xen). Different procedures may be recommended based on the patient’s exam and anatomy, amount of vision loss, and what goal pressure suits the patient. These procedures may also be recommended for patients undergoing routine cataract surgery who have glaucoma or take glaucoma medications.

When medicines or lasers are not producing the desired reduction in eye pressure, your doctor may suggest surgery. The goal of surgical intervention is to maintain adequate pressure control; it cannot, unfortunately, reverse any vision loss. In addition to MIGS procedures, glaucoma surgeries include trabeculectomy, tube shunt implants, and cyclophotocoagulation. Each of these procedures has its unique advantages and disadvantages and may not be suited for every patient. The type of surgery recommended can vary depending on the type and severity of glaucoma, the health of your eye, and potential lifestyle modifications needed after surgery. 

Trabeculectomy: With this procedure, a flap door is constructed in the wall of the eye into the anterior chamber. This allows fluid to flow from the eye, underneath the conjunctiva (the skin of the eye), and then absorbed into the bloodstream. 

Tube shunt implants: A tube shunt implant is placed underneath the conjunctiva with a small tube that is then tunneled into the anterior chamber. Similar to the trabeculectomy, this allows fluid to exit the eye, into the shunt, and then into the bloodstream. 

Cyclophotocoagulation: This procedure utilizes a laser that targets the part of the eye producing aqueous humor. This can be done externally (without cutting into the eye) or internally (through an incision entering the eye). 

Similar to cataract surgery, all of these procedures are done on an outpatient basis. In most cases, there is minimal pain during the procedure with the use of local anesthetic and relaxing medications are provided. Afterward, you will have frequent follow-up appointments with your eye doctor to check eye pressure and look for any signs of infection or increased inflammation. Medications are prescribed for one to three months afterward to help the eye heal and prevent infection. Patients are expected to have restrictions on physical activity for 3-6 weeks, potentially longer, after surgery. 

Potential risk factors for all these surgeries include: infection, bleeding, light sensitivity, irritation and inflammation, too low or too high pressure, vision loss, or need for additional surgeries or procedures.

Want to Know More?

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Glaucoma Doctors


Wheaton Eye Clinic’s unparalleled commitment to excellence is evident in our continued growth. Today we provide world-class medical and surgical care to patients in six suburban locations—Wheaton, Naperville, Hinsdale, Plainfield, St. Charles, and Bartlett.

(630) 668-8250 (800) 637-1054
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