Glaucoma

What is Glaucoma?

Glaucoma is not just one eye disease, but a group of eye conditions resulting in optic nerve damage, which may cause loss of vision. Glaucoma occurs when the internal pressure of the eyes increases enough to damage the nerve fibers in the optic nerve and cause vision loss. The optic nerve is the key to our sight. It is composed of around one million individual nerve fibers and transmits visual signals from the eye to the brain. Glaucoma is one of the leading causes of blindness in the United States. Glaucoma can damage your vision so gradually that you may not notice any loss of vision until the disease is at an advanced stage.

The most common type of glaucoma, primary open-angle glaucoma, has no noticeable signs or symptoms except gradual vision loss of side vision. It is related to an increase in fluid pressure around the eye. Acute angle-closure glaucoma occurs less often than primary open-angle glaucoma. A rapid increase of eye pressure occurs abruptly and causes this type of glaucoma. If you experience sudden eye pain, nausea, redness in the eye, visions of colored rings around lights or blurred vision, seek medical attention immediately. Unlike the type of glaucoma described above, this type can cause severe vision loss quickly.

The majority of glaucoma cases involve NO symptoms until peripheral vision and the optic nerve are greatly affected...
 
However, there are many ways to diagnose glaucoma through testing, including tonometry, pupil dilation, pachymetry, optic nerve imaging, patient history, supplemental testing, visual acuity measurements, and visual field testing.

What Causes Glaucoma?

The exact cause of glaucoma is unknown; however, some theories propose that it could be related to inadequate blood supply to the optic nerve. Primary open-angle glaucoma supports this theory, but others exist. For example, another theory is that the eye’s drainage system becomes inefficient once a patient reaches a certain age. 

Angle-closure glaucoma occurs when the drainage angle in the eye closes or is blocked. The drainage angle is formed by the cornea and the iris. Aqueous fluid is blocked from flowing out of the drainage system due to natural aging of the eye. The lens in the eye gets larger with age, which makes the space between the iris and cornea narrower. Angle-closure glaucoma can appear suddenly or progress over time. 

Secondary glaucoma is caused by outside factors, including injuries and other eye diseases. Eye surgery is sometimes necessary to correct it. Normal-tension glaucoma involves damage of the optic nerve, at a lower or "normal" eye pressure. 

Who is at Risk?

Common risk factors for glaucoma include race, family history, age, physical eye injuries, eye anatomy and other eye diseases and prolonged use of corticosteroids. African Americans are more likely to develop glaucoma than Caucasians and are more likely to suffer permanent vision loss. Patients of Asian descent have a higher risk of developing angle-closure glaucoma or low-tension glaucoma. Some patients have a thinner cornea than others, which can be a risk factor. Other eye issues like tumors, inflammation, and severe nearsightedness can heighten the risk of developing glaucoma.
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How is Glaucoma Treated?

Medications prescribed and monitored by your eye doctor can reduce elevated eye pressure. Selective Laser Trabeculoplasty (SLT) is a form of treatment for glaucoma that lowers intraocular pressure by 30%. Cataract & Laser Institute was the first in the region to acquire and incorporate both Optical Coherence Tomography testing to detect and monitor glaucoma and SLT to treat the disease. OCT scanning is similar to a CT/ CAT scan and can detect glaucoma up to 10 years earlier than by other means. OCT, along with digital optic nerve photography and Humphrey Visual Field Analysis, provide our staff and doctors with the tools necessary to provide state-of-the-art, comprehensive glaucoma care.

Istent Surgical Procedure

iStent is an invasive surgical procedure that can be performed at the same time as cataract surgery. To help control the increased pressure in your eye associated with glaucoma, iStent creates a bypass between the front part of your eye and its natural drainage pathway to increase the flow of fluid by creating a permanent bypass through the primary blockage site (trabecular meshwork). 
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Minimally Invasive Glaucoma Surgery

Minimally Invasive Glaucoma Surgery (MIGS) keeps eye pressure under control, prevents further damage to the optic nerve, and preserves the vision you have. However, this type of surgery offers a safer, less invasive way to lower pressure than other types of glaucoma surgery. It is performed at the same time as cataract surgery, so both conditions can be addressed in one combined procedure. In addition, MIGS may help reduce your need for topical glaucoma medication.

Endoscopic Cyclophotocoagulation (ECP)

Endoscopic CycloPhotocoagulation or ECP, is an exciting development in the management of many types of glaucoma including the more common open-angle glaucoma and narrow-angle glaucoma. ECP is performed on an outpatient basis. In this procedure, the ciliary body of the eye, which creates fluid, is treated with a laser. ECP can be performed at the time of cataract surgery or as a stand alone procedure.
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