Glaucoma Care

Glaucoma is a disease that affects the optic nerve, the part of the eye which receives images collected by the retina and sends them to the brain.  Every eye maintains a certain amount of internal pressure, called intraocular pressure.  When this pressure rises to abnormal levels however, it can put extra stress on the optic nerve, causing significant damage.  Optic nerve damage results in loss of vision, and ultimately blindness. The front of the eye is constantly producing a fluid called aqueous humor.  A healthy eye will continually produce small amounts of aqueous humor to ensure consistent pressure within the eye.  When normal drainage becomes slowed or blocked, pressure increases, and may lead to glaucoma.  There are several different types of glaucoma the two most common types being chronic open-angle glaucoma and closed-angle glaucoma.

Chronic open angle glaucoma is the most common form of the disease and usually develops with age. With this type of glaucoma, the optic nerve gradually deteriorates for a variety of factors including stress from elevated intraocular pressure. There are no symptoms in the early stages of open-angle glaucoma. Peripheral vision is usually the first to deteriorate. As the disease progresses, blind spots appear within one’s vision. Without treatment, glaucoma results in total blindness. Early diagnosis and treatment of glaucoma are critical for preventing serious complications including blindness.

Risk Factors for Chronic Open-Angle Glaucoma Include:

• Advanced age.

• Family history of the disease.

• Higher-than-normal intraocular pressure.

• Certain ethnic races, particularly those of African descent.

• Certain diseases or conditions, especially diabetes, farsightedness or nearsightedness, or previous eye trauma or surgery.

Acute angle closure glaucoma is an uncommon but emergent form of glaucoma. This occurs when the pupil blocks the normal flow of fluid within the front of the eye. Symptoms of acute angle closure include red eye, severe brow or eye ache, nausea and vomiting, and blurred vision with rainbows around lights. This is considered a medical emergency in which an ophthalmologist should be contacted immediately to avoid any permanent vision loss.

Symptoms of closed-angle glaucoma include:

• Severe eye pain.

• Headache.

• Blurred vision.

• Nausea or vomiting.

• Rainbow halos around lights.

High Risk Factors for Closed-Angle Glaucoma Include:

• Extreme farsightedness.

• An iris that is abnormally large or far back in the eye.

• Advanced age.

• Heredity.

• Certain ethnic races, especially those of Asian Descent.

Treatments for Glaucoma:

There are a wide range of treatments for glaucoma, including medication, laser surgery and traditional surgery. All glaucoma treatments are aimed at reducing intraocular pressure to slow down the disease. There is no way to reverse any damage or vision loss from glaucoma. The treatment (or combination of treatments) for an individual is chosen based upon the type of glaucoma and other details of the particular case.  One option is medication such as prescription eye drops which help to reduce intraocular pressure, or pills called carbonic anhydrase inhibitors which slow down fluid production within the eye.

Laser surgery has also become a common treatment option for glaucoma.  For open-angle glaucoma the doctor may recommend selective laser trabeculoplasty (SLT), a painless laser procedure which uses light to shrink and stretch eye tissue to allow more drainage of fluid.  For closed-angle cases, in which the iris is blocking drainage of aqueous humor, a laser surgery called iridotomy may be preformed.

Other glaucoma treatment options include various incisional surgeries ranging from minimally invasive glaucoma surgeries (MIGS) to trabeculectomy. There are numerous MIGS procedures which are often combined with cataract surgery to result in further pressure lowering. These procedures may be added to your pre-existing eye drop therapy and, at times, may also allow you to stop some or all of your eye drops. Trabeculectomy is the most powerful pressure lowering surgery available. During trabeculectomy, your doctor creates an alternate outflow pathway for the fluid in the front of your eye to lower your eye pressure.

Another newer surgical option is something called iStent.  If you have been managing your glaucoma ​with medication, and are now preparing ​for cataract surgery, iStent may be an ideal ​option for you. iStent is not only the world’s ​smallest medical device known to be ​implanted in the human body—it also started ​a revolution in glaucoma treatment as the first Micro-Invasive Glaucoma Surgery ​(MIGS) device.

There are a number of treatments available for Glaucoma patients.  If diagnosed with glaucoma, your ophthalmologist will consult with you on your options in order to maintain the best possible health of your eyes.

If you are experiencing any symptoms of glaucoma, we encourage you to contact us today to schedule a consultation.