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 (IOP). 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 if untreated, 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, IOP 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 develops with age. IOP gradually increases causing the eye to work less effectively over time. There are no symptoms in the early stages of open-angle glaucoma. Peripheral vision decreased initially but is not usually detected by the patient. As the disease progresses, blank spots (scotomata) begin to appear in one’s vision. If left untreated, blindness can occur. The best way to avoid serious vision loss is early diagnosis and treatment.
Risk factors for chronic open-angle glaucoma include:
Family history of the disease.
Higher-than-normal intraocular pressure.
Certain ethnic races, particularly African Americans.
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 the pupil dilates and actually blocks off the drainage angles in the eye. This is considered a medical emergency and an ophthalmologist should be seen immediately to avoid any loss of vision.
Symptoms of closed-angle glaucoma include:
High risk factors for closed-angle glaucoma include:
Treatments for glaucoma:
Patients with glaucoma should see their eye doctors every 4-6 months where measurement of the pressure and various tests (visual fields, photography, OCT, pachymetry) will be performed. There are a wide range of treatments for glaucoma starting with eye drop medication. If drops are not effective, laser surgery or traditional surgery are considered. The treatment (or combination of treatments) is individualized for each patient.
Laser surgery has also become a common treatment option for glaucoma. For open-angle glaucoma we may recommend Selective Laser Trabeculoplasty (SLT), a brief, painless out-patient laser procedure which uses light to shrink 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.
There have been some amazing recent technologies in the surgical treatment of glaucoma spawning a new field called MIGS or Microinvasive Glaucoma Surgery. We offer the most common MIGS option called Glaukos istent which is effective in lowering IOP. The doctors at the Alabama Vision Center are involved in an FDA evaluation of a new MIGS called Supra. Other glaucoma surgeries include trabeculectomy where a tiny flap in the sclera (white part of the eye) is created and a small reservoir (called a filtration bleb) is created into which aqueous fluid drains further reducing IOP.
As one can see there are a number of treatments available for glaucoma patients. If diagnosed with glaucoma, we will help determine the proper treatment plan for you.
The American Academy of Ophthalmology recommends an annual eye examination for everyone over 50. Undetected glaucoma is one main reason for this recommendation. Call 888-841-EYES to schedule your appointment with one of our doctors.