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Medical Services - Glaucoma

Glaucoma

Glaucoma is one of the leading causes of blindness in the United States. It’s known for being the sneak thief of sight, because it usually shows no symptoms in its early stages.  The best way for early detection and treatment is through regular eye examinations.  Elevated intraocular pressure (IOP) is the most common risk factor, but some glaucoma patients have normal intraocular pressure. Increased eye pressure damages the optic nerve and leads to permanent vision loss.  If diagnosed with Glaucoma the goal is to lower the intraocular pressure so that further progression of the disease and visual loss is decreased.  Treatment options include laser treatment, eye drops and surgery. There are genetic predispositions for glaucoma.

Anatomy

In the normal anatomy of the eye, fluid is produced in the ciliary body and then travels in front of the lens, through the pupil and into the drainage area of the eye, which is called the angle. If the drain mechanism of the eye does not work properly, the intraocular pressure builds up. The increased pressure then leads to optic nerve damage and eventually, vision loss. 

Major Types of Glaucoma

Two main types of glaucoma are open-angle glaucoma and angle-closure or narrow angle glaucoma. 

Vision loss also can occur with a normal IOP that is called normal tension glaucoma.

Open angle glaucoma is the most common form of glaucoma. Narrow angle glaucoma is ~5% of all glaucoma.

Glaucoma Work-up

During a glaucoma evaluation, several tests will be conducted including: a formal peripheral vision test, Intraocular pressure measurement, thickness of cornea, visualization of the drainage at the angles, and imaging of the optic nerve.  These tests are done to follow and compare over time to monitor for progressive damage or stabilization of the disease.

There is no cure for glaucoma, but there are effective treatments.  The majority of cases can be controlled and therefore, reducing the loss of vision.  Glaucoma does require long term ongoing eye care.

Management of Glaucoma at the time of Cataract Surgery: With the advancement of technology, microinvasive techniques can be used to lower intraocular pressure (IOP) with patients who have mild to moderate glaucoma. The iStent Trabecular Micro-bypass Stent improves the eye's natural fluid outflow and controls the pressure within. It can be implanted into the eye's drain system at the end of a cataract surgical procedure. Results indicate most patients need less drop medications afterwards. For more advanced cases of Glaucoma a variety of other drainage devices and techniques exist. Since each patient is different, we recommend a comprehensive discussion about the options and expected outcomes with your surgeon.

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