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GLAUCOMA

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Huron Ophthalmology is a referral center for the diagnosis and management of glaucoma, the second leading cause of blindness and visual impairment in the United States. It is estimated that 3 million Americans suffer from this disease, but only half are diagnosed. Glaucoma is a neurodegenerative disorder, which can affect patients of all ages. Most do not experience any symptoms until they have lost a significant amount of vision. With early detection and treatment, vision loss can be prevented.

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Types of Glaucoma

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There are many different types of glaucoma; but the two main categories are: open-angle and angle-closure glaucoma.

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Open-angle glaucoma is the most common category of glaucoma where the fluid in the eye drains too slowly through a drainage network known as the trabecular meshwork. The pressure in the eye increases as the fluid in the eye continues to build. Loss of vision occurs gradually and the vision loss is not always noticed until late stages. About 95 percent of glaucoma cases are due to open-angle glaucoma. One form of glaucoma (Normal Tension Glaucoma) can exist without elevated eye pressure.

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Angle-closure glaucoma occurs when the trabecular meshwork is blocked by the iris which may cause a periodic or sudden rise in the eye pressure. This condition requires prompt medical or surgical treatment. Lens Replacement (or cataract) surgery and Laser Iridotomy  are the most effective ways to treat this condition.

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Risk Factors for Glaucoma

• Family history of glaucoma

• High eye pressure

• African, Latino, or Asian descent

• The elderly

• Nearsighted or Farsighted

• Thin corneas

• Diabetes

• Eye injury history

• Regular use of cortisone/steroid products

 

 

Diagnosis of Glaucoma

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To detect glaucoma, the physician will perform the following tests:

• Measure vision

• Perform a Visual Field test

• Eye pressure measurement

• Dilated-eye Examination

• Retinal evaluation

• Optic nerve evaluation

• Pachymetry (corneal thickness measurement)

• Gonioscopy (look at the drainage architecture of the eye)

• Optical coherent tomography (OCT)

 

Treatment of Glaucoma

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Once glaucoma has been diagnosed, treatment should begin as soon as possible to help minimize the risk of permanent vision loss. Treatment is successful in most patients, but there is no cure for glaucoma. Treatment objective is  prevention of any  or  further damage to vision. Treatment for each individual case depends on the type and severity of the glaucoma. Some of the treatment methods for glaucoma are:

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Medication

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Eye drops or oral medication may be used to either reduce fluid production in the front of the eye or to help drain excess fluid. Side effects of the medication may result in redness, stinging, irritation or blurry vision. While glaucoma often has no symptoms, regular use of the medication is needed to keep the eye pressure under control and prevent visual loss.

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Laser Treatments

 

In-office Selective Laser Trabeculoplasty (SLT)  and Laser Peripheral Iridotomy (LPI) are used to treat open angle and closed angle glaucoma, respectively. These modalities primarily decrease eye pressure by enhancing fluid outflow. 

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Surgery 

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We specialize in the medical and surgical management of glaucoma. 

Traditional glaucoma surgery include trabeculectomy and tube shunt placement.

More recently developed glaucoma surgeries are termed micro-invasive glaucoma surgery (MIGS).  i-Stent, CyPass, Kahook Dual Blade Goniotomy, and Xen gel stent are among the various surgical MIGS approaches utilized by Huron Ophthalmology glaucoma specialists to control glaucoma by decreasing the eye pressure.  Most approaches are designed to improve the outflow of fluid to lower the eye pressure. Surgery is usually performed after medication and laser treatments have been unsuccessful. 

The key to management of glaucoma is to:

• Get regular comprehensive eye examinations

• Avoid denial

• Follow the doctor’s recommended treatment plan

• Educate yourself about glaucoma

• Do not miss appointments

• See a specialist

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