Glaucoma

Early detection and treatment is the key to preventing vision loss with Glaucoma. More than three million Americans have glaucoma, but only half are actually aware that this "silent thief" is slowly and without warning stealing away their vision, sometimes without any noticeable symptoms.

What is Glaucoma?

Glaucoma is a disease of the optic nerve and is the leading cause of blindness in the United States, especially for older people. However, loss of sight from glaucoma is preventable if you receive treatment early enough.

The optic nerve carries the images we see to the brain. It acts like an electric cable containing a huge number of wires. Glaucoma can damage nerve fibers, causing blind spots to develop. Often people don’t notice these blind areas until much optic damage has already occurred. If the entire nerve is destroyed, blindness results. Early detection and treatment by your ophthalmologist are the keys to preventing optic nerve damage and blindness.

glaucoma-chart

What Causes Glaucoma?

Clear liquid, called the aqueous humor, flows in and out of the eye. This liquid is not part of the tears on the outer surface of the eye. You can think of the flow of the aqueous fluid as a sink with the faucet turned on all the time.

If the drainpipe gets clogged, water collects in the sink and pressure builds up. If the drainage area of the eye—called the drainage angle—is blocked, the fluid pressure within the inner eye may increase, which can damage the optic nerve.

What Are the Different Types of Glaucoma?

Chronic Open-angle glaucoma: This is the most common glaucoma. It occurs as a result of aging. The “drainpipe” or drainage angle of the eye becomes less efficient with time.

Angle-closure glaucoma: Sometimes the drainage angle of the eye may become completely blocked. It is as though a sheet of paper floating near the drain suddenly drops over the opening and blocks the flow out of the sink.

The symptoms include:

  • Blurred vision
  • Severe eye pain
  • Headache
  • Rainbow halos around lights
  • Nausea and vomiting

If you have any of these symptoms call your ophthalmologist immediately.

Who is at Risk?

High pressure alone does not mean that you have glaucoma. The most important risk factors include:

  • Age
  • Near-sightedness
  • African ancestry
  • A family history of glaucoma
  • Past injuries to the eye

How is Glaucoma Treated?

Damage caused by glaucoma cannot be reversed. However, we may recommend eye drops, pills, and/or laser and surgical operations to prevent or slow further damage from occurring. With any type of glaucoma, periodic examinations are very important to prevent vision loss. Because glaucoma can worsen without your being aware of it, your treatment may need to be changed over time.

  • Laser Glaucoma Treatment

    We routinely perform laser glaucoma procedures with our SLT (selective laser trabeculoplasty) equipment. This state-of-the-art laser treatment is quickly becoming one of the preferred treatment for glaucoma nationwide.

    SLT selectively targets certain cells in the trabecular meshwork that drain eye fluids, regulating fluid pressure, and using laser beams to “unclog” the drains. Treating this drainage area with a combination of low-frequency lasers, eye fluid drainage is increased without burning any surrounding tissues. SLT is quick and virtually painless. In fact, the procedure itself only takes about 10-15 minutes. The laser is so precise it doesn’t damage or scar surrounding tissue, and quickly improves drainage and reduces intraocular pressure. The procedures can sometimes be repeated if necessary and can reduce or eliminate the need for costly eye drops.

  • MIGS (Micro-Invasive Glaucoma Surgery)

    MIGS, or micro-invasive glaucoma surgery, is performed at the same time as cataract surgery. With this procedure, a small stent is placed into the eye to relieve pressure and preserve your long-term vision. In fact, the stent is the smallest medical device currently known to be implanted in humans.

    Our eye doctors only perform the safest and most effective FDA-approved procedures. They know how clear vision enhances everyday life, and they and our whole team strive to protect and prolong great vision for every patient.

  • Endoscopic CycloPhotocoagulation (ECP)

    Endoscopic CycloPhotocoagulation (ECP) is a laser procedure performed at the same time or after cataract surgery and has proven to be highly effective in reducing or eliminating the need to continue using glaucoma medications in the majority of patients who receive this treatment. Endoscopic cyclophotocoagulation (ECP) is a versatile MIGS procedure that uniquely lowers IOP through the reduction of aqueous humor production. As with other MIGS procedures, ECP is accomplished from an ab interno approach and can be easily performed at the time of cataract surgery or as a stand-alone treatment.

  • Goniotomy

    Goniotomy is a surgical procedure in which the eye doctor uses a lens called a goniolens to see the structures of the front part of the eye (anterior chamber). An opening is made in the trabecular meshwork, the group of tiny canals located in the drainage angle, where fluid leaves the eye. Goniotomy is used to treat congenital glaucoma if the clear covering (cornea) over the iris (the colored part of the eye) is not cloudy.

What to Expect at Your Appointment

Our experienced ophthalmologists work with you to evaluate the severity of your glaucoma and will recommend a personalized treatment plan. During your initial appointment, a trained technician will perform several diagnostic tests. These may include:

  • A standard eye chart test to measure visual acuity
  • A visual field test to measure peripheral vision
  • A tonometry test that measures the pressure in the eye
  • An OCT (optical coherence tomography) test performs cross-sectional imaging using light to measure layers of the retina and optic nerve in order to detect changes in pathology
  • A corneal pachymetry test will measure the thickness of the cornea
  • Pupil dilation, which increases the size of the pupil and allows for assessing the health of the entire eye