What is Glaucoma?
Glaucoma is often called the silent thief of sight because this degenerative eye disease slowly steals your vision and can lead to blindness. In the beginning stages of the disease there are typically no outward symptoms. Without regular eye exams, you will not realize this silent disease is damaging your vision.
Glaucoma is often caused by a build-up of fluid pressure in the eyes due to an overproduction of fluid or when the drainage system of the eye becomes blocked. This pressure can damage your optic nerve and cause an irreversible loss of vision. The optic nerve connects your eye to your brain and carries visual information to your brain for processing. Your peripheral vision—side vision—is lost first. If glaucoma remains untreated, vision loss creeps in toward the center, first causing tunnel vision, and then, eventually, blindness.
Glaucoma Risk Factors
The cause of glaucoma is unknown, but there are several risk factors that increase your risks of developing glaucoma. These include high eye pressure (intraocular pressure-IOP), older age, being of African-American or Hispanic descent or having a family history of glaucoma. Even if you don’t have any of these risk factors, you should still have regular eye exams.
Types of Glaucoma
This condition occurs in infants who experience birth defects or have neurofibromatosis. You may be able to see symptoms by looking in the child’s eye. They may have clouded eyes, excessive tearing, sensitivity to light and a protruding eyeball. If not diagnosed and treated immediately, it can result in blindness.
Chronic Open-angle Glaucoma (OAG)
The optic nerve is slowly damaged in open-angle glaucoma, also called wide-angle glaucoma or primary open-angle glaucoma (POAG). Peripheral vision is slowly diminished and eventually may lead to full blindness if not treated.
Closed-angle Glaucoma (CAG)
This type of glaucoma is characterized by a build-up of pressure stemming from blocked fluid in the eye. The fluid between the iris and the lens creates pressure that damages the optic nerve. It causes pain and sudden impairment of vision. Acute CAG requires emergency medical treatment because permanent vision loss can happen in a short period of time with this condition.
Glaucoma Treatment Options
If glaucoma is detected early enough, the progress of the disease can be halted with medical and surgical treatment options. Pacific Eye Institute offers different types of treatment options, depending on your unique condition.
Glaucoma Eye Drop Treatments
(Lumigan, Alphagan or Combigan)
Prescription eye drops for glaucoma help maintain a healthy pressure in your eye and are an important part of the treatment routine for many people with glaucoma. Be sure your doctor knows about any other drugs you may be taking (including over-the-counter items like vitamins, aspirin and herbal supplements) and about any allergies you may have. As with any medication, these eye drops have side effects which are tolerable for most patients. Sometimes, due to the general health of a patient, some types of eye drops cannot be given.
Selective Laser Trabeculoplasty (SLT)
In Selective Laser Trabeculoplasty (SLT), laser energy is delivered to the drainage system of the eye, known as the trabecular meshwork. This treatment is extremely safe and well-tolerated by patients. The SLT technique is very gentle and studies show that it does not damage the tissue of the drainage system. This glaucoma treatment takes only minutes to apply and there is usually no discomfort felt by patients. Following the laser treatment, patients usually continue taking any existing glaucoma drops. After several weeks, a follow up appointment at Pacific Eye Institute will be required to evaluate intraocular pressure. We will then determine how successful the procedure has been.
The iStent Trabecular Micro-Bypass Stent System is designed for people with glaucoma who also have a cataract. iStent is the first minimally invasive glaucoma surgery (MIGS) device that improves your eye’s natural fluid outflow to safely lower eye pressure by creating a permanent opening in the trabecular meshwork. The tiny iStent is placed into the eye during cataract surgery; it is so small that you won’t be able to see it or feel it after the procedure is over. This small stent works continuously to control eye pressure and prevent damage to the optic nerve. The iStent has been proven to be safe and effective.
Endoscopic CycloPhotoCoagulation (ECP)
Endoscopic CycloPhotoCoagulation (ECP) is a laser procedure performed at the same time or after cataract surgery. ECP has proven itself highly effective in reducing or eliminating the need to continue using glaucoma medications in the majority of patients who receive this treatment.
The ECP laser, particularly when combined with cataract surgery, is a minimally invasive and effective intervention for lowering intraocular pressure and controlling glaucoma. The recovery after the laser is typically rapid, like a person’s recovery after standard cataract surgery.
Surgical management of glaucoma has been forever changed with the introduction of minimally invasive glaucoma surgery (MIGS), allowing surgeons to better manage and control less advanced stages of glaucoma.
Gonioscopy is one of these MIGS procedures. Gonioscopy describes the use of a goniolens (also known as a gonioscope) in conjunction with a slit lamp or operating microscope to gain a view of the iridocorneal angle, an anatomical angle, formed between the eye’s cornea and iris. Gonioscopy is performed during an eye exam to evaluate the internal drainage system of the eye.
To learn more about glaucoma treatments in the Inland Empire, contact Pacific Eye Institute today to schedule an eye exam.