Glaucoma is an ocular disease most often caused by increased pressure in the eye. Fluid present in the eye drains in and out of the anterior chamber of the eye. Increased pressure occurs because the eye is producing too much fluid or the fluid is draining slowly.
There are in-office tests that can be performed to measure eye pressure. Glaucoma can be found during an eye examination by looking at the optic nerve through dilated pupils. We also offer the latest technology to measure the nerve fiber layer, which begins to thin in the early stages of glaucoma. This technology can also monitor any changes in your nerve fiber layer year to year. Visual field testing is also important to monitor visual changes over time.
Glaucoma is the second leading cause of blindness in the United States. Although glaucoma cannot be prevented, there are glaucoma treatments available to slow its progression. Prescription eye drops are the first line of defense. These medications will help to lower pressure inside the eyes by either slowing the flow of fluid into the eye or by improving drainage. Over time these drugs may not be as effective, therefore surgery may be performed to widen the opening or create a new opening for fluid to leave the eye. Regular eye examinations are important for everyone but particularly if you are older than age 40 and have:
· A family history of glaucoma
· Are African-American
· Diabetes or hypertension (high blood pressure)
· Taken corticosteroids or other medications that increase the pressure in your eye
· Experienced trauma to the eye, such as an eye injury
Some people have normal eye pressure but their optic nerve or visual field looks suspicious for glaucoma. These people must be watched carefully because some eventually develop definite glaucoma and need glaucoma treatment. At Southwest Eye Care our Optometrists take the time and necessary precautions to screen Glaucoma possibility with the most appropriate measures. We do extensive testing and follow up appointments to monitor Glaucoma suspect patients.
Types of Glaucoma Treatments
When considering glaucoma treatments, surgery is recommended for some patients. Glaucoma surgery improves the flow of fluid out of the eye, resulting in lower eye pressure.
Laser trabeculoplasty is often used to treat open angle glaucoma. There are two types of trabeculoplasty surgery: argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT). During ALT surgery, a laser makes tiny, evenly spaced burns in the trabecular meshwork. The laser does not create new drainage holes, but rather stimulates the drain to work better. SLT uses a newer, lower-energy laser which only treats specific cells in the drainage angle. SLT and ALT are equally good at lowering eye pressure.
Even if laser trabeculoplasty is successful, most patients continue taking glaucoma medications after surgery. For many, this surgery is not a permanent solution. Nearly half of the people who receive this surgery develop increased eye pressure again within five years. Many people who have had a successful laser trabeculoplasty will need additional glaucoma treatment in the future. This treatment may be another laser, more medication or surgery. Laser trabeculoplasty can also be used as a first line of treatment for patients who are unwilling or unable to use glaucoma eye drops.
Laser iridotomy is recommended for treating people with closed angle glaucoma and those with very narrow drainage angles. A laser creates a small hole about the size of a pinhead through the iris to improve the flow of aqueous fluid to the drainage angle.
Aqueous Shunt Surgery
If trabeculectomy cannot be performed, aqueous shunt surgery is usually successful in lowering eye pressure. An aqueous shunt, or glaucoma drainage device, is a small plastic tube or valve connected to a reservoir (a roundish or oval plate). The plate is placed on the outside of the eye beneath the conjunctiva (the thin membrane that covers the inside of your eyelids and the white part of your eye). The tube is placed into the eye through a tiny incision and allows aqueous humor to flow through the tube to the plate. The fluid is then absorbed into the blood vessels. When healed, the reservoir is not easily seen unless you look downward and lift your eyelid.
• With iStent, most patients are able to maintain normal eye pressure after the procedure
• iStent has an excellent safety profile
• iStent is covered by Medicare and most private insurance companies.
Have your Glaucoma Treatment and Cataracts addressed at the same time, if think you may be a candidate for iStent, talk to Dr. Krassin today to see if iStent is right for you.