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Glaucoma

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.  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 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, pressure 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 usually develops with age.  With this type of glaucoma, pressure gradually increases around the eye causing it to work less effectively over a period of time.  There are no symptoms in the early stages of open-angle glaucoma.  Peripheral vision is usually the first to deteriorate.  As the disease becomes more advanced, blank spots begin to appear in one’s vision.  If left untreated, it eventually develops to blindness.  The best way to avoid serious vision loss is early diagnosis and treatment.

Risk factors for chronic open-angle glaucoma include:

  • Advanced age.
  • Family history of the disease.
  • Higher-than-normal intraocular pressure.
  • Certain ethnic races, particularly those of African descent.
  • Certain diseases or conditions, especially diabetes, farsightedness or nearsightedness, or previous eye trauma or surgery.

 

 

Closed-angle glaucoma

Closed-angle glaucoma is not as common, but is considered a real emergency.  This type of glaucoma occurs when there is a blockage of the drainage angle in the eye which leads to a sudden rise in eye the pressure to a dangerous level.  The treatment for this is typically surgical and a closed angle attack usually results in some permanent vision loss.

Narrow-angle glaucoma

Narrow-angle glaucoma is the precursor to closed-angle glaucoma where the drainage angle in the eye is narrowed, but there is no blockage (yet).  When diagnosed at this stage a non-invasive procedure called a laser iridotomy can be done by the ophthalmologist to prevent a blockage.  This laser can, therefore, prevent the closed-angle attack from ever happening.  

Symptoms of closed-angle glaucoma include:

  • Severe eye pain.
  • Headache.
  • Blurred vision.
  • Nausea or vomiting.
  • Rainbow halos around lights.

High risk factors for closed-angle glaucoma include:

  • Extreme farsightedness.
  • An iris that is abnormally large or far back in the eye.
  • Advanced age.
  • Heredity.
  • Certain ethnic races, especially Asians.

Treatments for glaucoma:

There are a wide range of treatments for the disease, including medication, laser surgery and traditional surgery.  The treatment (or combination of treatments) for an individual is chosen based upon the type of glaucoma and other details of the particular case.  One option for open-angle glaucoma is medication such as prescription eye drops which help to reduce intraocular pressure.

Laser surgery has also become a common treatment option for glaucoma.  For open-angle glaucoma the doctor may choose a trabeculoplasty, a painless and non-invasive laser procedure which uses light to stimulate a cellular reaction which leads to more drainage of fluid.  Now with the advancements of Selective Laser Trabeculoplasty, this laser procedure can be repeated as needed to help lower the eye pressures.  For closed-angle cases, in which the iris is blocking drainage of aqueous humor, a laser surgery called iridotomy may be preformed.

Other glaucoma treatment options involve various traditional surgeries.  A common surgery for open-angle glaucoma is the trabeculectomy, where a doctor creates a small flap in the sclera (white part of the eye).  Underneath the surface of the sclera, the doctor creates a small reservoir, called a filtration bleb, into which aqueous fluid may drain and then be disbursed, further reducing intraocular pressure.

There are a number of treatments available for Glaucoma patients.  If diagnosed with glaucoma, your ophthalmologist will consult with you on your options in order to maintain the best possible health of your eyes.

If you are experiencing any symptoms of glaucoma, we encourage you to contact us today to schedule a consultation.