Glaucoma Suspect

What is a “glaucoma suspect?”

Let us start off by defining glaucoma.  Glaucoma is an eye disease where the internal fluid of the eye increases and causes a build-up of pressure.  This increased pressure causes damage to the optic nerve.  If left untreated, the disease will cause peripheral and, subsequently, central vision loss.  Glaucoma is one of the leading causes of blindness in the United States.

Glaucoma suspects have no proven optic nerve damage, but they have risk factors for the disease.  The great news is that the majority of glaucoma suspects will never develop glaucoma.  However, vision loss from glaucoma cannot be restored, so early detection is extremely important.

Why did your eye doctor diagnose you as a glaucoma suspect?

Your eye doctor at Vista Eye Care may diagnose you as a glaucoma suspect if you have one or more of these risk factors:

• Optic nerves that appear suspicious
• Elevated eye pressures
• Visual field defects
• Having eye conditions that may increase the risk of developing high eye pressures such as pseudoexfoliation syndrome or pigment dispersion syndrome

Other factors that can increase your risk for glaucoma include:

• Family history of glaucoma
• Thin corneas
• African-American ethnicity
• Myopia (nearsightedness)
• Corticosteroid use
• Age (although glaucoma can occur at any age, the older the patient the higher the risk)
• Narrow anterior chamber angle (narrow drainage channel)
• Existing systemic conditions such as sleep apnea, diabetes, and hypertension

What symptoms will a glaucoma suspect experience?

Glaucoma suspects usually do not experience any symptoms.  Primary open angle glaucoma develops slowly and during early stages there are no obvious symptoms or warning signs.  Individuals with possible angle-closure glaucoma, secondary to blockage of the drainage channel in the eye, may experience visual “haloes” around lights, blurred vision, pain, intermittent headaches, and red eyes.   By the time patients notice vision loss from glaucoma, significant irreversible optic nerve damage has likely occurred.

What additional tests are performed for glaucoma suspects? 

During your comprehensive eye exam at Vista Eye Care, your eye doctor will extensively assess your eye health, including your risk factors for glaucoma.  If risk factors are present, your eye doctor may diagnose you as a glaucoma suspect and ask you to return for further testing.

During this follow-up visit, thorough baseline glaucoma testing will be performed.  We will measure your eye pressures in more detail, assess your corneal thickness and anterior chamber (drainage) angle, and evaluate the optic nerve structure via digital photography and more extensive imaging.  Automated visual field testing will also be performed to assess for any visual field loss secondary to glaucoma.

What are the treatment options for a glaucoma suspect?

The diagnosis of glaucoma is usually made over time, as the progression of the most prevalent types of glaucoma (primary open angle glaucoma) is generally slow.  Therefore, the most important “treatment” for a glaucoma suspect is follow-up care.  Low-risk glaucoma suspects typically require follow-up visits every 6-12 months.  The frequency increases with increased risk.

The majority of glaucoma suspects may never require medical treatment.  Initial treatment for some patients involves prescription eye drops.  In certain cases, laser treatment or surgery is required.  The purpose of these treatments is to lower eye pressure.  If treatment is required and initiated early, the risk for significant vision loss is minimal.

If you have been told that you are a glaucoma suspect, the next step is to return to your eye doctor at Vista Eye Care to assess and monitor for changes of your optic nerve and visual field.