Glaucoma
Glaucoma is a progressive eye disease that causes irreversible damage to the optic nerve over time. The main types of glaucoma include Narrow Angle Glaucoma, Open Angle Glaucoma and Secondary Glaucoma. All of these types usually have abnormally high pressure in the eye called the intraocular pressure (IOP). Left untreated, glaucoma starts as peripheral vision loss and can progress to blindness
Open Angle Glaucoma, the most common type of glaucoma, occurs when fluid in the front of the eye builds up slowly over time, causing eye pressure higher than the optic nerve can withstand. Eye pressure can be in the normal range, but still cause damage to the nerve without feeling any symptoms. Routine eye examinations aim at early detection and treatment.
Angle-Closure Glaucoma occurs when the iris comes close and blocks the drainage angle in the front of the eye causing increases in eye pressure. Examination can determine if a patient is at risk. Patients at risk can undergo a treatment called Laser Iridotomy to prevent this from occurring.
Secondary Glaucoma can occur from other eye conditions or medications blocking the drainage system within the eye. Conditions such as uveitis, diabetic retinopathy or eye surgery can cause this type of glaucoma.
How is glaucoma diagnosed?
Glaucoma is diagnosed by evaluating different changes within the eye. The 3 most common tests include (1) checking the intraocular pressure, (2) evaluating the optic nerve with direct examination and pictures known as OCT, and (3) evaluating the peripheral vision known as Visual Fields.
What are the symptoms of glaucoma?
In most cases, glaucoma causes minimal to no signs or symptoms until vision loss occurs. This is why regular eye exams are so important in the early detection of glaucoma.
Who is at risk for glaucoma?
Glaucoma risk typically goes up after the age of 60, however many younger patients have been diagnosed with glaucoma. Other risk factors include a strong family history, chronic medical illnesses such as diabetes, and prior ocular surgery.
How is glaucoma treated?
While there is no cure for glaucoma, the treatments are targeted at slowing the progression of the disease and preventing any future vision loss.
EYE DROPS
When glaucoma is diagnosed, eye drops are usually used first to lower the eye pressure. Some eye drops help to decrease aqueous fluid production and others help increase aqueous fluid outflow. Eye drops are to be used like other medications, daily as directed. Each bottle usually lasts about 1 month, and refills will be available in the pharmacy to continue unless directed otherwise. Every medication has side effects, and it is important to contact your ophthalmologist if you experience any.
LASER
In Open Angle Glaucoma, Laser trabeculoplasty can help improve the drainage of fluid and lower the eye pressure.
In Closed or Narrow angle glaucoma, Laser Iridotomy is an important treatment to prevent or treat elevated eye pressures.
SURGERY
MICRO- INVASIVE GLAUCOMA SURGERY (MIGS)
A microstent can be placed during cataract surgery to help treat glaucoma. One microstent, called the iStent, has been an effective tool to lower the eye pressure in early or moderate glaucoma. If you are having cataract surgery and have glaucoma, ask your surgeon or the surgical coordinator if the iStent is right for you. More information can be found on our Cataract Page.
TRABECULECTOMY & GLAUCOMA DRAINAGE TUBE
There are some situations where eye drops and Laser are no longer effective or not sufficient to effectively treat glaucoma. In these advanced glaucoma cases, surgery can be performed to lower the eye pressure by improving drainage within the eye.