Dr. Matthew Nutaitis of MUSC's Storm Eye Institute discusses the symptoms of glaucoma.
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Host: What are the symptoms of glaucoma? Okay, the primary open-angle glaucoma, there are no early symptoms. It's like high blood pressure. Sometimes, your first indication is you have high blood pressure when you have a stroke. So really, you need an eye exam and you need an eye exam where somebody sort of looks at your risk factor profile, knows what your interactive pressure is and looks at your optic nerve so that they can at least say that looks normal and are concerned about it. Then there is an ability to do a lot more testing to either confirm or at least get baseline data to watch over people because it -- primary open-angle glaucoma is a very slowly progressive disorder. It doesn't come on just overnight, this can take decades to show up. Since it's one of those chronic illnesses, people tend to worry about it. It doesn't really hurt, doesn't affect your vision till the very end. So you're not going to get -- the patients aren't going to come and say, I can't see. If they do, it's a very bad sign because it's too late for us to really offer much and they've probably lost 99% of their optic nerve, when they come in and say, I have a trouble seeing. So you can't rely on the vision. So anytime you do like a screening clinic and you people check your vision and your pressure, and say, Oh! You don't have glaucoma, that's not quite the best way to handle this. You need to look at the optic nerve, because vision is affected last, so you are going to miss all the people that have early or moderate disease and there is this group of patients that have low pressures anyway, so you're going to get known pressure in them and your pressures fluctuate during the day as well. A study was done where they looked at the first time pressure measurements in glaucoma patients. These are people that actually, honestly got glaucoma and their pressures tested in the doctor's office. What we found was, half of them had normal pressures on their first visit. From a statistical standpoint, you've got to get about three or four pressures in the patient's chart before you get a feeling that they are normal, because that one patient that comes in has a normal pressure. Well, if they have glaucoma, you check them again and on that visit 50% of them will declare themselves and will have a high pressure, the other half, another 25% will still be normal. So, once you get two or three visits out, then your false negative rate actually starts getting small. Are there symptoms of closed-angled glaucoma? Eye pain, deceased vision, halos around lights, headaches, especially in any circumstance where your pupil starts getting little bit bigger in mesopic conditions where it's kind of dim light that you pupil starts getting mid-dilated. Your iris is most floppy than it can kind of get up with the brain part of the eye. Certain medication that cause the people to dilate a little bit and there are some antispasmodics and some psychiatric medications that can give you little bit of dilation to your pupil. Then you can get a whole bunch of systemic symptoms with this. You can get nausea and vomiting, you can get abdominal pain, and you don't have to look too far into the general surgery literature where people are getting exploratory surgery, thinking they have appendicitis because of their abdominal symptoms. They actually remain in closure. It's just the pain gets sort of transferred into the abdominal system and for some reason people just don't complain about lot of eye pain but they complain about their stomach.

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