At first, there are no symptoms. Vision stays normal, and there is no pain. However, as the disease progresses, a person with glaucoma may notice his or her side vision gradually failing. That is, objects in front may still be seen clearly, but objects to the side may be missed. As glaucoma remains untreated, people may miss objects to the side and out of the corner of their eye. Without treatment, people with glaucoma will slowly lose their peripheral (side) vision. They seem to be looking through a tunnel. Over time, straight-ahead vision may decrease until no vision remains. Glaucoma can develop in one or both eyes. Glaucoma is an eye condition where the nerve at the back of the eye (the optic nerve) is damaged. This can lead to loss of vision. In most cases, the damage to the optic nerve is due to an increased pressure within the eye. There are different types of glaucoma.

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Primary glaucoma This is the most common type. It is characterized by slowly increasing eye pressure and the gradual loss of side vision. In medical term, eye pressure is called intra ocular pressure (IOP). It is the fluid pressure inside the eye.

Low-tension or normal-tension glaucoma The optic nerve is damaged but the eye pressure is normal.

Closed-angle glaucoma This type produces a sudden increase in eye pressure. Symptoms include severe pain and nausea, as well as redness of the eye and blurred vision. This is a medical emergency and requires immediate treatment. Without treatment, blindness may occur in 1 or 2 days.

Congenital glaucoma This type affects children who are born with eye defects that slows the normal drainage of fluid. These children usually have obvious symptoms, such as cloudy eyes, sensitivity to light, and excessive tearing.

Secondary glaucoma This type develops as a complication of other medical conditions. It may be associated with eye surgery or advanced cataracts, eye injuries, certain eye tumors, or uveitis (eye inflammation). Pigmentary glaucoma occurs when pigment from the iris flakes off and blocks the meshwork, slowing fluid drainage. A severe form, called neovascular glaucoma, is linked to diabetes. Corticosteroid drugs used to treat eye inflammations and other diseases can trigger glaucoma in some people.

Initially, glaucoma is usually treated with drops. Often the drops will be able to increase the outflow of fluid from the eye and reduce the pressure preserving vision. If medical treatment fails to achieve the “target pressure” your doctor may recommend a surgical procedure. There are several surgical options available including Laser Surgery, Filtration Surgery, Cyclodestructive Surgery and Drainage Device Surgery. The goal of all glaucoma surgery is to reduce the pressure of the eye and preserve vision.

Glaucoma eye drops are generally safe, but be sure to tell all your doctors that you’re using them. These eye drops are medicines. Like most medicines, they can have side effects (like dizziness or troubled breathing), or they might not work well with other medicines you may take. Keep your glaucoma eyedrops away from children.

It is imperative that you take your eye drops exactly as prescribed in order to best control your glaucoma. Eye drops can interact with other medications. Make sure you tell your doctor about any other medications or supplements that you are taking.

First, check the label on the bottle to make sure that you are using the right medicine.

Wash your hands
Before you open the bottle, shake it a few times.
Bend your neck back so that you’re looking up at the ceiling. Use one finger to pull down your lower eyelid (see drawing at right)
Without letting the tip of the bottle touch your eye or eyelid, squeeze one drop of the medicine into the space between your eye and your lower eyelid. If you squeeze in more than one drop, you’re wasting medicine.
After you squeeze the drop of medicine into your eye, close your eye. Then press a finger between your eye and the top of your nose. Press for several minutes. This way, more of the medicine stays in your eye. You’ll be less likely to have side effects.
Wash your hands again after you put the drops in your eyes.
Don’t let the tip of the bottle touch a table, the cabinet or anything else.

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The proper way to put in your glaucoma drops

Glaucoma is a leading cause of irreversible blindness throughout the world. The visual loss in patients with glaucoma results from damage to the optic nerve that carries sight from the eye to the brain. Although it most commonly affects the elderly, glaucoma occurs in about 1 in 25,000 babies born in the United States. In both adults and babies with glaucoma, the prevention of permanent blindness requires detection and proper treatment. Glaucoma that occurs in infancy and early childhood differs from most adult glaucoma in several ways. Because it is rare, most patients need to travel to a specialized medical center for treatment. Also, childhood glaucoma is usually treated with immediate surgery rather than with medication or laser. Infants who receive prompt surgical treatment will do well; 80 to 90% will have normal or nearly normal vision for their lifetime. Most babies who have glaucoma and cannot obtain specialized care quickly will lose their vision. Early detection and treatment means the difference between sight and blindness.
There are other ways to try to lower the pressure within the eye than with medications. Lasers have been shown to be effective in the treatment of glaucoma in a large percentage of patients. The number of different forms of laser surgery used in the management of glaucoma has been increasing with the development of new equipment. The most commonly used laser is called an Argon laser, which has been used to treat glaucoma for over 20 years. Newer forms of laser are now being used to treat glaucoma and may show some improvement in results. Many patients who undergo laser surgery must still continue to take their eye drops after the procedure. The effects of the laser have been found to be temporary in some patients. It is therefore important that patients continue to have routine eye examinations after laser surgery. Lasers have also been used to treat other forms of glaucoma by creating holes in the iris in an effort to prevent a form of glaucoma termed acute angle closure glaucoma. This procedure can normally be accomplished in the office with the use of topical anesthesia. Following placement of a special contact lens on the eye the doctor creates a new opening in the iris with one or two lasers and then the patient is sent home with eye drops to use following the surgery.
The final treatment for glaucoma involves surgical drainage of fluid from the eye in an effort to lower the pressure within the eye. Normally this is reserved for patients which have a poor response to eye drops and/or laser surgery. This can sometimes be combined with another eye operation, like cataract extraction surgery. When a patient has had successful glaucoma surgery they may not have to take further eye drops. Unfortunately, glaucoma surgery includes all of the risks involved with any eye surgery. There are two primary ways of draining fluid from the eye. One requires the surgeon to create a new drain in the eye called trabeculectomy, and the second method involves implanting a glaucoma drainage device. The choice of which technique to use is determined by the type of glaucoma the patient has and the number of previous surgeries on the eye. The important thing to remember, as with laser surgery, is that glaucoma is never cured, but rather controlled. With proper treatment over 90 % of patients can have their disease stabilized and less than 5 % will lose all vision.