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, 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, pressure gradually increases around the eye causing it to work less effectively over a period of time. There are no symptoms in the early stages of open-angle glaucoma. Peripheral vision is usually the first to deteriorate. As the disease becomes more advanced, blank spots begin to appear in one’s vision. If left untreated, it eventually develops to blindness. Click here to see how glaucoma can affect your vision. The best way to avoid serious vision loss is early diagnosis and treatment.
A Visual Field test can be performed in the office to determine if your peripheral vision has been affected or deteriorated. View Video
An Optical Coherence Tomography (OCT) test, performed in the office, helps in early detection and management of glaucoma.
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.
Closed-angle glaucoma is less prevalent, but is considered a true eye emergency. This type of glaucoma occurs when a patient’s pupil moves or dilates and actually blocks off the drainage angles in the eye. This is considered a medical emergency in which an ophthalmologist should be contacted immediately to avoid any loss of vision.
Symptoms of closed-angle glaucoma include:
- Severe eye pain.
- 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.
- Certain ethnic races, especially Asians.
Treatments for glaucoma:
There are a wide range of treatments for the disease, including medication, laser surgery and traditional surgery. 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 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 choose a 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 performed.
Other glaucoma treatment options involve various traditional surgeries. A common surgery for open-angle glaucoma is the trabeculectomy, where a doctor creates a small flap in the sclera (white part of the eye). Underneath the surface of the sclera, the doctor creates a small reservoir, called a filtration bleb, into which aqueous fluid may drain and then be disbursed, further reducing intraocular pressure.
For patients with combined cataract and mild to moderate open-angle glaucoma, we are pleased to offer the latest technology in glaucoma treatment. The iStent is the smallest medical device ever approved by the FDA. It is placed in your eye during cataract surgery and is so small that you won’t be able to see or feel it after the procedure is over. iStent is designed to improve aqueous outflow of fluid from your eyes to help control eye pressure and may reduce your medication burden. Only your doctor can determine if iStent is right for you. For more information about iStent, click here.
If diagnosed with glaucoma, your ophthalmologist will consult with you on your options in order to maintain the best possible health of your eyes.