Glaucoma is a disease of the optic nerve. The optic nerve is made up of many nerve fibers, similar to an electric cable containing many wires. When damage to the optic nerve occurs, blind spots develop. The blind spots tend to go undetected until the optic nerve is significantly damaged. If the entire nerve is destroyed, blindness results. Early detection and treatment are the keys to preventing optic nerve damage and blindness from glaucoma.CAUSES OF GLAUCOMA
A clear liquid called aqueous humor circulates inside the front portion of the eye. In order to maintain a healthy level of pressure inside the eye, a small amount of this fluid is produces constantly while an equal amount flows out of the eye through a microscopic drainage system. Since the eye is a closed structure, if the drainage area for the aqueous humor is blocked, the excess fluid can not flow out of the eye. Fluid pressure within the eye increases, pushing against the optic nerve and causing damage.
TYPES OF GLAUCOMA
The most common form of glaucoma in the United States is Primary open-angle glaucoma. The risk of developing this type of glaucoma increases with age. The drainage angle of the eye becomes less efficient over time and pressure within the eye increases, which can then damage the optic nerve. With some patients the optic nerve becomes sensitive even to normal eye pressure and is at risk for damage. Treatment is necessary to prevent further vision loss. Open-angle glaucoma usually has no symptoms in the early stages and vision remains normal. As the optic nerve becomes more damaged, blank spots begin to appear in your field of vision. You may not notice these blank spots in the course of your day until the optic nerve is significantly damaged and these spots become large. If all the optic nerve fibers die, blindness results.
Closed-angle glaucoma. Some eyes are formed with the iris too close to the drainage angle. In these eyes, which are usually small and farsighted, the iris can be pushed forward, blocking the drainage channel completely. Since the fluid can not exit the eye, pressure builds quickly and causes an acute closed-angle attack. Symptoms may include:
- Blurred vision
- Severe eye pain
- Rainbow colored halos around lights
- Nausea and vomiting
If you experience any of these symptoms, call your ophthalmologist right away. Unless this type of glaucoma is treated quickly, blindness can result.
WHO IS AT RISK FOR GLAUCOMA?
The most common risk factors include:
- Elevated eye pressure
- Family history of glaucoma
- African or Hispanic ancestry
- Farsightedness or nearsightedness
- Past eye injuries
- Thinner central corneal thickness
- Systemic health problems including diabetes, migraines, and poor circulation
- Pre-existing thinning of the optic nerve
Regular eye exams by an ophthalmologist are the best way to detect glaucoma. A complete eye examination must be done in order to detect glaucoma. Your glaucoma evaluation will consist of the following:
- Measuring your intraocular pressure (tonometry)
- Inspecting the drainage angle of your eye (gonioscopy)
- Evaluate whether pr not there is any optic nerve damage (ophthalmoscopy)
- Test the peripheral vision of each eye (visual field)
Taking a photo or other computerized imaging of the optic nerve may also be recommended. Some of these tests may not be necessary for all patients. These tests may need to be repeated on a regular basis to monitor any changes in your condition.
As a rule, damage caused by glaucoma cannot be reversed. Lowering eye pressure is the only proven way to treat glaucoma. Eyedrops, laser surgery and surgery in the operating room are used to lower eye pressure and help prevent any further damage. In some cases, oral medication may also be prescribed. With any type of glaucoma, periodic exams are very important to prevent vision loss. Because glaucoma can progress without your knowledge, adjustments to your treatment may be called for from time to time.
Never change or stop taking your medication without first consulting with your ophthalmologist. Treatment for glaucoma requires teamwork between you and your ophthalmologist. Always follow the instructions and use your eyedrops as prescribed. If you are taking medication for your glaucoma, you can expect to visit your ophthalmologist every three to six months depending on your specific treatment needs.
LOSS OF VISION CAN BE PREVENTED
Regular eye exams can prevent unnecessary vision loss. People of any age with symptoms or risk factors for glaucoma such as those with diabetes, family history of glaucoma, or those of African decent should see an ophthalmologist for a complete exam.
At the age of 40 is when early signs of disease and change sin vision may begin. Based on the results of your initial screening, your ophthalmologist will let you know how often to return for follow-ups.
Adults 65 years or older should have an eye exam, every one to two years, or as recommended by your ophthalmologist.
WE ARE EXCITED TO OFFER A NEW TREATMENT FOR GLAUCOMA WITH THE SLT LASER!
We perform selective laser trabeculoplasty (SLT), a procedure that uses a low-level energy laser that targets the drainage channels in the eye, thereby decreasing pressure in the eye.
SLT can be an effective adjunct to medication therapy or used as a primary treatment to reduce or eliminate the need for topical glaucoma medications.
SLT is clinically proven to treat glaucoma by safely and effectively reducing intraocular pressure in a single, office procedure that only takes a few minutes.1,2 Unlike glaucoma drops, SLT has no systemic side effects and can be repeated. SLT has also been shown to be cost effective as compared to drops that must be taken daily.3,4
Our practice has acquired a new advanced technology Ellex laser to perform SLT. We are happy to offer this technology to our patients.
1) P Lanzetta, U Menchini, G Virgili. Immediate intraocular pressure response to selective laser trabeculoplasty. Fr. J. Ophthalmol, Jan 1999; 83:29-32.
2) Noecker RJ, Kramer TR. Comparison of the acute morphologic changes after selective laser trabeculoplasty and argon laser trabeculoplasty in human eye bank eyes. Ophthalmology, Apr 2001; 108(4):773-9.
3) Lee R et al. Can J Ophthalmol. 2006;41(4):449-456.
4)Cantor LB et al. Curr Med Res Opin. 2008;24(10):2905-2918.
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