Glaucoma

gluecoma Glaucoma is a group of diseases that damage the eye’s optic nerve and is characterized by loss of nerve tissue resulting in loss of vision. Studies show that eye pressure is a major risk for optic nerve damage. The most common form of glaucoma, primary open-angle glaucoma, is associated with an increase in the fluid pressure inside the eye. This increase in pressure causes progressive damage to the optic nerve and loss of nerve fibers. Vision loss may result. Not everyone with high eye pressure will develop glaucoma, and many people with normal eye pressure will develop glaucoma.

Glaucoma is the second leading cause of blindness in the U.S. and often occurs in people over age 40. People with a family history of glaucoma, African Americans over the age of 40, and Hispanics over the age of 60 are at an increased risk of developing glaucoma. Other risk factors include thinner corneas, chronic eye inflammation, and using medications that increase the pressure in the eyes.

Glaucoma cannot be prevented, but if diagnosed and treated early it can usually be controlled through medication or surgery to slow vision loss. Once vision is lost to glaucoma, it cannot be restored. See glaucoma facts for additional statistics and data on glaucoma. It is estimated that over two million Americans have some type of glaucoma and half of them do not know it.

If you are experiencing any symptoms of glaucoma, give us a call at 866-340-EYES today to schedule an appointment.

Open-Angle Glaucoma

Open-angle glaucoma is the most common form or glaucoma, accounting for 90% of all glaucoma cases. Although it cannot be cured, it can usually be controlled and your vision loss may be minimized with early detection and treatment.

Open-angle glaucoma is has a wide and open angle between the iris and the cornea and is caused by the slow clogging of drainage canals that results in increased eye pressure. This form of glaucoma is slow forming and a lifelong condition. If the pressure remains too high for too long, vision loss is likely to occur.

Symptoms

  • In the early stages, there are no symptoms.
  • Mild aching in the eyes
  • First signs include a gradual loss of side or peripheral vision
  • Reduced visual acuity or sharpness

Glaucoma can occur in people of all races at any age. However, the likelihood of developing glaucoma increases if you are African American or Latino, are a diabetic, over age 35 and have a family history of glaucoma.

Diagnosing

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We recommend all patients are checked starting at the age of 35 by having their pressures checked as part of their annual eye exam. The tests include:

  • Tonometry – used to test inner eye pressures – numbing drops are applied then a tonometer is gently pressed against the eye to test its resistance.
  • Ophthalmoscopy – used to test the shape and color of the optic nerve.
  • Perimetry – used to test the complete field of vision to look for any pattern of visual changes.
  • Gonioscopyused to check the angle in the eye where the iris meets the cornea to see if it’s open or closed.
  • Pachymetry – used to test thickness of the cornea

Treatments

To control glaucoma, Dr. Adelson will use: medicines, laser surgery or filtration surgery. These treatments are to lower the eye pressure.

1. Medicines

Medication, typically eye drops are usually the first treatment used in most patients. The drops work to slow the production of fluid in the eye and by improving the flow of the fluid. Other medications can be given in pill form as well depending on the severity of the glaucoma as well as the type.

2. Laser Surgery

Argon Laser Trabeculoplasty is a procedure to treat the drainage !canal. A laser beam is applied to the trabecular meshwork to create a pathway for fluid to exit the eye. Trabeculectomy is the most commonly performed glaucoma surgery.

Endoscopic CycloPhotocoagulation (ECP) is another type of laser procedure. This treatment aims at treating the ciliary body by reducing the amount of fluid production in the eye. This procedure is commonly performed along with cataract surgery but can also be done on an outpatient basis.

3. Filtration surgery

This is performed when medicines and/or laser surgery have been unsuccessful in controlling eye pressures. During this treatment, a new drainage channel is created to allow fluid to drain from the eye.

Narrow-Angle Glaucoma (also called Closed-Angle Glaucoma)

Narrow-angle glaucoma is much less common and typically results in eye pressures that increase rapidly when the drainage canals get blocked or covered over. With narrow-angle glaucoma, the iris is not as wide and open as it should be. The outer edge of the iris bunches up over the canals.

Symptoms

The onset of acute narrow-angle glaucoma typically fast and a medical emergency. If not treated promptly, this glaucoma produces blindness in the affected eye within 3-5 days. Symptoms may include:

  • Headaches
  • Eye Pain and Inflammation
  • Pressure over the eye
  • Rainbows around lights at night
  • Blurred vision with decreased vision sharpness
  • Extreme sensitivity to light
  • Nausea and/or vomiting

Causes

  • Defect in the eye structure, primarily the iris
  • Certain medications
  • Diabetes
  • Blow to the eye

Diagnosing

We recommend all patients are checked starting at the age of 35 by having their pressures checked as part of their annual eye exam. The tests include:

  • Tonometry – used to test inner eye pressures – numbing drops are applied then a tonometer is gently pressed against the eye to test its resistance.
  • Ophthalmoscopy – used to test the shape and color of the optic nerve.
  • Perimetry – used to test the complete field of vision to look for any pattern of visual changes.
  • Gonioscopyused to check the angle in the eye where the iris meets the cornea to see if it’s open or closed.
  • Pachymetry – used to test thickness of the cornea

Treatment

  • Laser iridotomy – is the most common treatment for narrow-angle glaucoma. This treatment involves making a hole in the colored part of the eye to allow fluid to drain normally in the eye.
  • Filtration surgery – is performed when medicines and/or laser surgery have been unsuccessful in controlling eye pressures. During this treatment, a new drainage channel is created to allow fluid to drain from the eye.