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Glaucoma

What is Glaucoma?

Glaucoma is a disease of the optic nerve which is made up of approximately 2 million nerve fibers that transmit images from the eye to the brain. It usually damages the optic nerve by causing elevated intraocular pressure because of an abnormality in the drainage of the aqueous humor (a clear liquid that normally flows in and out of the eye). The elevated intraocular pressure damages the optic nerve and can lead to visual loss.

The following are the different forms of Glaucoma:

  • Open Angle Glaucoma: This is the most common form of glaucoma and causes no visual symptoms. In this type, the drainage canals do not allow the aqueous to flow out of the eye at a normal rate.
  • Angle Closure Glaucoma: Glaucoma in which the iris (the colored part of the eye) interferes with the drainage apparatus of the eye by closing it off and causing elevated intraocular pressure. An acute angle closure can occur suddenly and cause a severe rise in pressure which can lead to blindness within 24 hours. In this condition there are symptoms such as nausea, vomiting, halos around lights and severe eye pain.
  • Low Tension Glaucoma: This form of glaucoma is much less common than the others. In this condition, the intraocular pressure is normal but the optic nerve can still be damaged. Lowering the eye pressure, however, seems to help prevent the progression of optic nerve damage.
  • Congenital (Childhood) Glaucoma: This form of glaucoma can start in infancy, childhood, or adolescence. This is a rare form of glaucoma and if left untreated, it can result in blindness. Some common symptoms, especially in infancy, include clouding of the cornea, excessive tearing, and an enlarged eye.
  • Steroid Induced Glaucoma
  • Traumatic Glaucoma

Risk Factors for Glaucoma Include:

  • High Intraocular Pressure (IOP)
  • Family History of Glaucoma
  • African-American, Hispanic, and Asian ethnicity
  • Advanced Age

Glaucoma Treatments:

Glaucoma can be treated with specific eye drops, pills, laser surgery, traditional surgery or a combination of these methods. The goal is to lower intraocular pressure to prevent permanent visual loss because vision loss due to glaucoma is irreversible.

  • Selective Laser Trabeculoplasty (SLT) is a laser procedure used to lower the intraocular pressure (IOP) of patients with open angle glaucoma. It treats the eye’s drainage system, known as the trabecular mesh work, and thereby improves the flow of fluid out of the eye helping to lower its pressure. It works at very low levels and treats specific cells selectively, leaving untreated portions of the trabecular mesh work intact. For this reason, the SLT laser can be safely repeated multiple times unlike other lasers. SLT is performed in the office by one of our Ophthalmologists’ and generally takes about 5-10 minutes for the actual procedure. Most patients can resume their normal activities the same day of the procedure, but may experience transient blurring of their vision.
  • Yag Laser Peripheral Iridotomy (YAG PI) is a laser procedure used specifically to treat patients with narrow angles, narrow angle glaucoma, or acute angle closure glaucoma. This laser creates an opening in the iris of the eye to allow fluid to flow from behind the channels of your eye in order to prevent angle closure glaucoma. The opening is extremely small and cannot be seen by the naked eye. The YAG PI Laser is performed in the office by one of our Ophthalmologists’ and generally takes about 5-10 minutes for the actual procedure. Most patients can resume their normal activities the same day of the procedure, but may experience transient blurring of their vision.
  • Glaucoma Surgery – If you have glaucoma and the medications and laser do not adequately control the intraocular pressure (IOP), the next step is to perform glaucoma surgery known as a TRABECULECTOMY. During this procedure, a small drainage hole is created in the sclera which allows fluid to flow out of the eye into a filtering area located under the conjunctive, referred to as a Bleb. Usually, this area, or Bleb, will be underneath your upper eyelid and will not be noticeable. If successful, it will lower the IOP and prevent permanent visual damage caused by glaucoma.

Frequently, antimetabolites are used during glaucoma surgeries to prevent scarring during the healing stages, which can later cause the filtering procedure to fail.