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1. Does glaucoma always lead to blindness?

   No. Although glaucoma is a leading cause of blindness in the U.S., it can be controlled and vision maintained if it is caught early. Because the disease usually produces no symptoms until it has begun to steal a person's sight, many of those who have it don't know it. In fact, Prevent Blindness America estimates that one in every 30 Americans age 40 and older has glaucoma and half of them don't know it. That's why comprehensive eye examinations are recommended at least every two years for those at increased risk for the disease.

2. What are the risk factors for glaucoma?

   You are at risk of developing glaucoma if you are older than age 60, African American, have a family member who has glaucoma, are very nearsighted, are diabetic, had an eye injury in the past, or have been taking steroid or cortisone medications. In such cases, you should have an eye exam including tests for glaucoma every one to two years. If you are African American, your risk is especially great. The National Eye Institute reports that African Americans are five times more likely than Caucasians to develop glaucoma.

3. What's the difference between high eye pressure and glaucoma?

   Glaucoma is a group of eye diseases that damage the nerves carrying images from the eye to the brain. When the fluid inside the eye that nourishes the cornea and the lens can't flow properly through the eye, pressure in the eye builds. The pressure compresses the optic nerve, and can damage it. Whether you develop glaucoma depends on how much pressure your optic nerve can take without being damaged.

4. My eye pressure is 22 mm Hg. Does that mean I have glaucoma?

   Not necessarily. Eye pressure is measured in millimeters of mercury (mm Hg), and it varies, even throughout the day. Generally, eye pressure readings between 12 and 21 mm Hg are considered normal, although a person may have glaucoma even with pressures in this range. It's a common misconception that having high intraocular pressure means you're a victim of glaucoma. In fact, you can have high intraocular pressure, known as ocular hypertension, and not have glaucoma. In some people, the optic nerve can tolerate pressures higher than the range considered normal. The only way to determine whether you have glaucoma is to have a comprehensive eye examination.

5. What is the most common type of glaucoma?

   Open-angle glaucoma is the most common form of the disease, occurring in about 1 percent of all Americans age 50 and older, according to the Glaucoma Foundation. In open-angle glaucoma, the angle where the cornea and the iris meet in the eye is open, but the aqueous humor fluid passes too slowly through the meshwork drain. As a result, the pressure in the eye gradually increases, compressing cells in the optic nerve. If left untreated, the compression eventually will cause the optic nerve cells to die, producing blindness. This type of glaucoma is the leading cause of blindness among African Americans, reports the American Academy of Ophthalmology.

6. What is the most common treatment for glaucoma?

   Glaucoma is most commonly treated with prescription medications in the form of eye drops, and many of the prescriptions must be taken several times a day. Glaucoma medications, which can come in topical or oral form, are designed to lower pressure in the eye. Other topical medications may be inserts of thin wafers you place in the corner of the eye, or eye ointments and gels. Most topical medications reduce eye pressure by either increasing the flow of the aqueous humor fluid out of the eye, or reducing the amount of the fluid produced in the eye. Oral glaucoma medications come in pill and tablet form, and are aimed at slowing production of fluid in the eye.

7. Can surgery help my open-angle glaucoma?

   Possibly. If medications fail to lower your eye pressure, your health care professional may recommend surgery, either by laser or by conventional operative techniques. Sometimes, however, surgery is recommended as the first-line treatment. In a procedure called laser trabeculoplasty, a beam of concentrated light is used to open the drainage area in the eye, which allows the fluid in the eye to move more freely and reduces intraocular pressure. Laser trabeculoplasty has successfully lowered eye pressure in about 75 percent of treated patients, according to the Glaucoma Research Foundation. The effects of this treatment may wear off over time. Once the entire drainage area has been treated with the laser, further treatments may be ineffective. Conventional surgery for glaucoma, also called filtering microsurgery, creates a new opening for the intraocular fluid to leave the eye. It often is recommended after medications and/or laser surgery have failed to control intraocular pressure. The surgery involves removing a small piece of the white, outer shell of the eye, to create a channel through which the aqueous humor fluid can flow. This incisional surgery has been between 80 percent and 90 percent effective in lowering pressure, according to the National Eye Institute.

8. What can I do to prevent glaucoma?

   Although glaucoma can't be prevented, maintaining a healthy lifestyle and eating nutritious foods may help you generally avoid diseases. Eating a balanced diet is the best way to ensure your body receives the proper nutrients it needs to function. Some of the vitamins and minerals that may contribute to overall eye health include antioxidant vitamins A, C, and E, and minerals zinc, copper, and selenium. If you're concerned about your diet, talk with your health care professional about whether you should take nutritional supplements or make dietary changes.

9. I've heard people with glaucoma should take special vitamin supplements. What should I be taking and in what dose?

   Although glaucoma can't be prevented, maintaining a healthy lifestyle and eating nutritious foods may help you generally avoid diseases. Eating a balanced diet is the best way to ensure your body receives the proper nutrients it needs to function. Some of the vitamins and minerals that may contribute to overall eye health include antioxidant vitamins A, C, and E, and minerals zinc, copper, and selenium. If you're concerned about your diet, talk with your health care professional about whether you should take nutritional supplements or make dietary changes.

10. Can exercise help my glaucoma?

    Getting regular exercise also is a component of maintaining good overall health, and there is some evidence in the medical literature that regular aerobic exercise may help reduce eye pressure. Before starting any exercise program, make sure you discuss possible effects on your intraocular pressure with your health care professional. The Glaucoma Research Foundation reports that some forms of glaucoma, such as angle-closure, are unresponsive to exercise, or run the risk of increasing eye pressure, such as in glaucoma patients with pigment dispersion syndrome. Additionally, exercises or yoga movements that place the head upside down hold the potential for increasing eye pressure, and generally are discouraged for all glaucoma patients. Talk with your health care professional about what kind of exercise is best for you.

11. Is there any special way I should take my glaucoma eye drops?

    The most important thing to remember when taking glaucoma medications is to take them as directed by your health care professional. Make sure you understand how and when to take your medications, and how to properly store them. For the drugs to work effectively, they must be taken regularly and continuously, and you will need to take them as long as they control your eye pressure.