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Glaucoma

Glaucoma is a group of related diseases that damage the optic nerve resulting in vision loss and blindness. Glaucoma is a leading cause of blindness and visual impairment in the United States. Glaucoma can affect patients of all ages. Known as the "sneak thief of sight", many people affected with glaucoma do not experience any symptoms and may not be aware that they have the disease until they have lost a significant amount of vision. With early detection and treatment, eyes can be protected against the serious loss of vision or blindness.

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Types of Glaucoma

There are several types of glaucoma with two main types: open-angle and angle-closure.

  • Open-angle glaucoma is the most common type of glaucoma where the fluid in the eye drains too slowly through the network of tiny drainage channels, known as the trabecula. The pressure in the eye increases as the fluid in the eye continues to build. Loss of vision occurs gradually and the vision loss is not always noticed until it becomes irreversible. About 95 percent of glaucoma cases are due to open-angle glaucoma.
  • Angle-closure glaucoma occurs when the tiny drainage channels, known as the trabecula, become blocked which then causes a sudden rise in pressure in the eye. This condition is not common but when it occurs it requires immediate medical attention.

Symptoms of Glaucoma

Many patients do not experience any symptoms during the early stages of glaucoma, including no pain and no vision loss. This makes it difficult for many patients to know if they have the disease. But as glaucoma progresses, patients may experience some of the following symptoms:

  • A loss of peripheral or side vision
  • Sudden eye pain
  • Headache
  • Blurred vision
  • The appearance of halos around lights
  • Tunnel vision
  • Nausea
  • Vomiting
  • Red eyes

Diagnosing Glaucoma

While some patients may experience symptoms from glaucoma as the disease progresses, others do not realize they have the condition until they undergo a routine eye exam. There are several different exams performed to diagnose glaucoma, including:

  • Visual field
  • Dilated eye examination
  • Retinal evaluation
  • Gonioscopy
  • Visual acuity test
  • Tonometry
  • Pachymetry

Treatment for Glaucoma

Once glaucoma has been diagnosed, treatment should begin as soon as possible to help minimize the risk of permanent vision loss. There is no cure for glaucoma, so treatment focuses on relieving symptoms and preventing further damage from occurring. The best treatment for your individual case depends on the type of glaucoma and severity of the disease, and can be discussed with your doctor. Some of the treatment methods for glaucoma are as follows:

Medication

Medication, either as eye drops or oral medication, is used to either reduce fluid production in the front of the eye or to help drain excess fluid. Side effects of the medication may result in redness, stinging, irritation or blurry vision. Patients should advise their doctor about any medications they are taking or any allergies they have to minimize the risk of side effects. While glaucoma often has no symptoms, regular use of the medication is needed to keep the eye pressure under control.

Surgery

Some cases of glaucoma can be treated with medications. For others, laser or traditional surgery is required to lower eye pressure. Common surgeries include:

  • Laser Peripheral Iridotomy (LPI) - For patients with narrow-angle glaucoma. A small hole is made in the iris to increase the angle between the iris and cornea and encourage fluid drainage.
  • Argon Laser Trabeculoplasty (ALT) - For patients with primary open angle glaucoma (POAG). The trabecular passages are opened to increase fluid drainage. ALT is effective in about 75% of patients, and SLT may be repeated.
  • Filtering Microsurgery (Trabeculectomy) - For patients who have not been helped with laser surgery or medications. A new drainage passage is created by cutting a small hole in the sclera (the white part of the eye) and creating a collection pouch between the sclera and conjunctiva (the outer covering of the eye).
  • Tube Shunt Surgery - May be recommended for patients with neovascular glaucoma, failed trabeculectomy, or susceptibility to developing scar tissue. A thin, flexible tube (a shunt) with a silicone pouch is inserted in the eye to facilitate drainage.

Preventing Glaucoma

There is no way to prevent glaucoma from developing. To prevent glaucoma from progressing, you may want to incorporate some of the following suggestions into your life:

  • Get regular comprehensive eye examinations
  • Get an annual screening for glaucoma
  • Follow the recommended treatment plan from your doctor
  • Make healthy lifestyle changes
  • Protect your eyes from injury

If you have lost some sight or experience low vision as a result of glaucoma, there are services and programs available that will help you lead a normal, independent life. To learn more about glaucoma and how you can be tested for this serious condition, please call us today to schedule an appointment with one of our doctors.

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