Glaucoma

Understanding Glaucoma: The Silent Thief of Sight

Chart Showing How Glaucoma Affects the Eye

Read below for a better understanding of how glaucoma affects your eyesight, and the modern treatments available to help you save it.

Glaucoma is a dangerous disease of the eye that can slowly and painlessly steal your sight. Glaucoma is the second leading cause of blindness in the United States – Often called the ‘silent thief of sight’ because there are no symptoms. Over half of the people in the United States that suffer from glaucoma are not aware that they are going blind. Although the cause of glaucoma is still unknown, there are several known risk factors that may increase your risk of developing the disease. These risk factors include family history of the disease, high eye pressure (also known as intraocular pressure, or IOP), being African-American or Hispanic, and older age. Because glaucoma has no early symptoms, anyone with any of these risk factors should schedule eye exams on a regular basis so that glaucoma can be diagnosed and treated before vision loss occurs.

Often associated with pressure buildup in the eye, glaucoma damages vision by destroying the optic nerve – the nerve that connects your eye to your brain, and carries all visual information to your brain for processing. Those suffering from glaucoma will lose their peripheral, or side vision, first. If the disease continues untreated, this vision loss will move towards the center of the eye – first causing tunnel vision, and eventually, blindness. Although the cause for this nerve damage is unknown, the high IOP associated with glaucoma is likely to play a major roll. IOP is a measurement of the fluid pressure inside of the eye. Ideally, the eye is filled with a clear fluid that is drained through a spigot. However, with glaucoma the drain gets plugged and the fluid in the eye can no longer exit, causing a rise in IOP. Although, as some cases of glaucoma do not suffer high IOP, careful examination of the optic nerve and potential glaucoma damage is crucial. In this case, a Visual Field test should be performed. The visual field test can help determine if you’ve begun to lose eyesight as a result of glaucoma.

 

Treatment of Glaucoma

Fortunately, treatments are available to save the vision of those suffering from glaucoma. Reducing IOP is the goal for glaucoma treatments and saving the eye from nerve damage. Modern treatments include eye drops, laser therapy, and surgery.

 

Eye drop medications reduce the amount of fluid that enters the eye, or increases the amount of fluid that exits – both are used to reduce IOL. Several different medications available for glaucoma differ in their ability to lower IOP and may have side effects. When medications fail to lower IOP or cannot be tolerated by the patient, doctors often turn to laser therapy. Advances in laser therapy have made these tools so safe and effective, laser therapy may be considered instead of medication. If all of these methods fail to bring IOP down to a safe level, surgery to lower IOP is available. You and your doctor will work to develop a safe and effective treatment plan.

Glaucoma Treatment Options

Treatment for glaucoma focuses on preserving eyesight by slowing the damage to the optic nerve. Most treatment aims to prevent further damage to the optic nerve by lowering the pressure in the eyes. As a rule, damage caused by glaucoma cannot be reversed. Eye drops, pills, laser and surgical operations are used to prevent or retard further damage from occurring. At Regional Eye Associates we take pride in offering a variety of treatment options dependant on your needs.

Chart Showing How Open-Angle Glaucoma and Angle-Closure Glaucoma Affect the Eye

Narrow-angle glaucoma can be treated with a laser iridotomy. By using a laser, a small hole is made in the iris to create a new pathway for the aqueous fluid to drain from the eye. The new drainage hole allows the iris to fall back to its normal position, restoring the balance between fluid entering and leaving the eye and lowering eye pressure.

Open-angle glaucoma can be treated with laser trabeculoplasty. This procedure works by using laser light to stimulate the body’s own healing response to lower your eye pressure. Laser trabeculoplasty improves the flow of fluid in the eye, which in turns lowers your eye pressure.

Ex-PRESS Mini Shunt

A recent surgical advancement in the treatment of glaucoma is the Ex-PRESS Mini Shunt Glaucoma Filtration Device. It is a small stainless steel unit – similar in size to a grain of rice – and is typically used after medical and other surgical treatments have failed.

The Ex-Press is implanted between the inner region and the outer region of the eye and allows for a more controlled and consistent drainage of the aqueous humor, or fluid inside the eye, thus lowering the intraocular pressure of the eye to a healthy level.

Often glaucoma medication is not needed following recovery from the procedure.

Selective Laser Trabeculoplasty (SLT)

Selective Laser Trabeculoplasty (SLT) is a laser that treats the drain directly to help increase the outflow of fluid. It treats specific cells “selectively,” leaving the trabecular meshwork intact. For this reason, SLT may be safely repeated. It is not painful, and often can be an alternative to eye drops in early open angle glaucoma.

 

Glaucoma treatments and surgeries will help improve the patient’s vision. The purpose of these lasers is to help lower the eye pressure and prevent vision loss. If glaucoma progresses despite medications or laser therapy, other more involved surgery procedures such as a trabeculectomy or tube shunt placement may be necessary to control or lower the pressure and prevent vision loss.

*As with any surgical procedure there are risks along with benefits. It is important to discuss your surgical procedure with your surgeon to fully understand the risks and benefits.

Glaucoma Doctors

Dr. Allison Bardes
Allison Bardes, MD
Photo of Dr. Yearego
Joseph Yearego, OD
Dr. Lauren DiGiovine
Lauren DiGiovine, MD
Edgar Gamponia, MD
Edgar Gamponia, MD
Dr. James A. Genin
James A. Genin, MD
Dr. Heath L. Lemley
Heath L. Lemley, MD
Dr. Mark D. Mayle
Mark D. Mayle, MD
Dr. David McClure
David McClure, MD
Dr. Stephen R. Powell
Stephen R. Powell, MD
Dr. V.K. Raju
V.K. Raju, MD
Dr. Brian Wood
Brian Wood, MD

 

*As with any surgical procedure there are risks along with benefits. It is important to discuss your surgical procedure with your surgeon to fully understand the risks and benefits.

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