~ Evaluation and Treatment
Glaucoma is one of the leading causes of blindness in the United States. The risk of glaucoma increases with age. Family history is also a strong risk factor. The most common type of glaucoma, chronic open-angle glaucoma, causes a slow, "silent" loss of vision. With routine eye exams, early signs of glaucoma can be detected and appropriate testing and treatment can be implemented. Treatment options include eye drops, laser surgery, or more complex surgical procedures. We offer the latest in diagnostic technology including the Humphrey Visual Field Analyzer and the Optical Coherence Tomographer.
Many patients do not experience any symptoms during the early stages of glaucoma, including no pain and no vision loss. This makes it difficult for many patients to know if they have the disease. But as glaucoma progresses, patients may experience a loss of peripheral or side vision, along with sudden eye pain, headache, blurred vision or the appearance of halos around lights.
While some patients may experience symptoms from glaucoma as the disease progresses, others do not learn they have the condition until they undergo a routine eye exam. There are several different exams performed to diagnose glaucoma, including a visual field and visual acuity test. These tests measure peripheral vision and how well patients can see at various distances. Other tests may also be performed, such as tonometry to measure the pressure inside the eye and pachymetry to measure the thickness of the cornea.
Treatment for Glaucoma
Once glaucoma has been diagnosed, treatment should begin as soon as possible to help minimize the risk of permanent vision loss. There is no cure for glaucoma, so treatment focuses on relieving symptoms and preventing further damage from occurring. Most cases of glaucoma can be treated with eye drops, laser or microsurgery. The best treatment for your individual case depends on the type and severity of the disease, and can be discussed with your doctor.
- Eye drops are used to reduce fluid production in the front of the eye or to help drain excess fluid, but can lead to redness, stinging, irritation or blurry vision. Patients should tell their doctor about any allergies they have to minimize the risk of side effects.
- Laser surgery for glaucoma aims to increase the outflow of fluid from the eye or eliminate fluid blockages through laser trabeculoplasty, iridotomy or cyclophotocoagulation.
- Microsurgery involves a surgical procedure called a trabeculectomy, which creates a new channel to drain fluid from the eye and reduce the pressure that causes glaucoma. Surgery is often performed after medication and laser procedures have failed.
While there are no ways to prevent glaucoma from developing, regular screenings and early detection are the best forms of protection against the harmful damage that the disease can cause. While anyone can develop glaucoma, some people are at a higher risk for developing disease. These people may include those who:
- Are over the age of 60
- African Americans over the age of 40
- Have a family history of glaucoma
- Have poor vision
- Have diabetes
Patients should have a comprehensive dilated eye exam at least once every year, especially if they have a higher risk of developing glaucoma. Older patients may be encouraged to be tested more frequently.
To learn more about glaucoma and how you can be tested for this serious condition, please call us today to schedule an appointment with one of our doctors.
Glaucoma is an eye disease in which pressure inside the eye (intraocular pressure) damages the optic nerve and causes vision loss. In a healthy eye, fluid is produced in the ciliary body and then drains through tiny passages called the trabecular meshwork. In people with glaucoma, this drainage is inadequate and intraocular pressure rises.
Many cases of glaucoma can be treated with medications. For others, laser or traditional surgery is required to lower eye pressure. Common surgeries include:
- Laser Peripheral Iridotomy (LPI) – For patients with narrow-angle glaucoma. A small hole is made in the iris to increase the angle between the iris and cornea and encourage fluid drainage.
- Argon Laser Trabeculoplasty (ALT) and Selective Laser Trabeculoplasty (SLT) – For patients with primary open angle glaucoma (POAG). The trabecular passages are opened to increase fluid drainage. ALT is effective in about 75% of patients, and SLT may be repeated.
- Nd: YAG Laser Cyclophotocoagulation (YAG CP) – For patients with severe glaucoma damage who have not been helped with other surgeries. The ciliary body that produces intraocular fluid is treated.
- Filtering Microsurgery (Trabeculectomy) – For patients who have not been helped with laser surgery or medications. A new drainage passage is created by creating a small hole in the sclera (the white part of the eye) and forming a collection pouch between the sclera and conjunctiva (the outer covering of the eye).
- Tube Shunt Surgery – May be recommended for patients with neovascular glaucoma, failed trabeculectomy, or susceptibility to developing scar tissue. A thin, flexible tube (a shunt) with a silicone pouch is inserted in the eye to facilitate drainage.