What is glaucoma? Glaucoma is damage to the optic nerve that is related to blood flow. Although high pressure in the eye is a risk factor for glaucoma, and is important in treatment, it is not the definition of the disease.
What would I notice if I have glaucoma? The most common hronic glaucoma has no symptoms until it is very advanced. This is why routine eye examinations and screening is so important (especially if there is a history if glaucoma in the family). When glaucoma becomes advanced, you may notice gradually decreasing vision starting at the edges of your vision, then progressing toward the center.
How does my eye doctor diagnose glaucoma? There are three basic criteria that we use to diagnose glaucoma. The first is intraocular pressure. Although high pressure in the eye is not glaucoma, it is the greatest risk factor for developing glaucoma. If we are suspicious for glaucoma we also check a visual field test to determine whether there are areas of vision loss in the periphery, not noticed by you. Finally, and most importantly, we evaluate the optic nerve for evidence of damage. Besides 
our own examination of the nerve, there are several tools available to analyze the optic nerve and the nerve fiber layer. In our office we use the GDx Optic Nerve Fiber Layer Analyzer.
How is primary open angle glaucoma treated? Treatment is focused on lowering the intraocular pressure. We start with eye drops, usually once a day. The choice of drops is individualized for each patient based on side effects, other medical problems, and efficacy of the drops. The most important thing in this treatment is that YOU actually take the prescribed drop, and try not to miss doses. If we need more improvement in pressure or you want to try to avoid eye drop use, we can do Selective Laser Trabeculoplasty. A laser procedure done in the office that is generally very well tolerated. If drops and laser are not likely to be effective enough, surgical treatment would be pursued, often a trabeculectomy.
