Procedures

Glaucoma

Glaucoma is a leading cause of vision loss and blindness in the US. The term Glaucoma actually refers to a group of diseases that cause damage to the optic nerve as a result of increased pressure in the eye, but it can also be caused by eye injury, blocked blood vessels, inflammation, or severe infection in the eye. Often glaucoma is asymptomatic until fairly advanced with irreversible optic nerve damage, so early diagnosis and treatment are essential. While glaucoma is generally not curable, it can be treated and controlled to prevent vision loss, especially when diagnosed early.

Glaucoma Vision

Open angle glaucoma is the more common form of this condition and involves failure of the fluid inside the eye to drain properly. This leads to a pressure buildup in the eye, which damages the optic nerve. The less common form of glaucoma is Angle Closure, which is caused by the drainage of the eye becoming more suddenly blocked off, resulting in a sudden buildup of pressure in the eye. While open angle glaucoma causes a very slow deterioration of peripheral (side) vision, which is usually asymptomatic until more severe, angle closure is often symptomatic with eye pain, redness and blurred vision with halos around lights.

Diagnosis of glaucoma requires a full eye exam. While many patients with glaucoma have high eye pressure, the eye pressure alone is usually not enough to diagnose or rule out glaucoma. About one third of glaucoma patients in the US will have normal pressures, and many patients with high pressure never develop glaucoma. An exam of the optic nerve, computerized nerve analysis, automated visual field testing, corneal thickness measurement (because corneal thickness affects eye pressure readings), and gonioscopy (a special lens is used to look at the drain of the eye) are all used to diagnose glaucoma.

If glaucoma is diagnosed, treatment should begin promptly to minimize the risk of permanent vision loss. Though angle closure glaucoma must be treated with laser or microsurgery, most patients with open angle glaucoma can be treated with eye drops alone. These drops decrease fluid production inside the eye or increase the outflow of fluid out of the eye. Sometimes laser (laser trabeculoplasty) or microsurgery (trabeculectomy or tube shunt surgery) are used to treat open angle glaucoma that has not responded adequately to drops. The goal of all of these treatments is to decrease pressure in the eye and preserve vision. Glaucoma treatment has a high success rate and can often prevent vision loss, but early detection is key since vision loss from glaucoma is irreversible.

Risk factors for glaucoma include age, family history, nearsightedness, history of elevated eye pressure, history of an eye injury, African descent, and steroid use. Regular eye exams for early diagnosis and treatment are the best prevention available for glaucoma-related vision loss.

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