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Glaucoma

Glaucoma is a disease that causes damage to the optic nerve. The optic nerve transmits signals from the retina to the brain to produce an image. The damage to the optic nerve is most often the result of built-up intraocular pressure in the eye. Getting regular eye exams is important for the early detection of glaucoma. If diagnosed early, there is an improved chance of preventing or minimizing vision loss.  However, if left untreated, permanent vision loss may occur. 

What are the Types of Glaucoma?

There are two main types of glaucoma: open-angle and narrow-angle.

  • Open-angle is the most common form of glaucoma. In this type of glaucoma, the drainage system becomes clogged and is unable to drain the fluid properly out of the eye and, as a result, the eye pressure increases. 
  • Narrow-angle is a more rare form of glaucoma. It is also known as angle-closure or closed-angle. In this type of glaucoma, the drainage canal of the eye gets blocked by the iris. This prevents fluid from draining, causing eye pressure to rise rapidly.

What are the Symptoms of Glaucoma?

Open-angle glaucoma typically does not have symptoms early on. It is commonly known as the "silent thief of sight" because most people aren't even aware they have it until vision loss occurs. Open-angle glaucoma causes the gradual loss of peripheral, or side, vision.

Narrow-angle glaucoma differs in that it has noticeable symptoms which can occur quite quickly. If you experience these symptoms, you should immediately call your ophthalmologist or go to the emergency room. Symptoms include:

  • Headaches
  • Eye pain
  • Blurred vision
  • Nausea
  • Halos around light

How is Glaucoma Tested?

Our ophthalmologists and optometrists use several simple and painless tests to help with the diagnosing of glaucoma. These tests include:

  • Tonometry: Measures the intraocular pressure of your eye
  • Gonioscopy: Used to evaluate whether the drainage angle is open or closed
  • Visual Field: Evaluates your field of vision to determine if you have any loss in side vision
  • Optical Coherence Tomography: An image that measures the thickness of the optic nerve fiber layer
  • Fundus Photography: An image of the optic nerve, retina, and macula
  • Pachymetry: Measures the thickness of your cornea

How is Glaucoma Treated?

Glaucoma can be treated and managed using medications, lasers, and/or surgery. These treatments are available to help prevent further vision loss. Unfortunately, there are no treatment options to reverse vision loss that has already occurred. The main goal of these treatment options is to control eye pressure so that the optic nerve does not receive additional damage.

  • Medications: Eye drops are commonly used to manage glaucoma. They work to lower eye pressure by either reducing fluid production in the eye or improving fluid drainage from the eye.

  • Lasers: For open-angle glaucoma, laser trabeculoplasty is an in-office procedure effective at reducing eye pressure. This procedure uses a laser to target the eye's drainage system which helps improve drainage of fluid from the eye. In some cases, it may reduce the need to use eye drops.
    • For narrow-angle glaucoma, a laser iridotomy may be performed. This procedure works by widening the closed angle so that fluid may drain out of the eye. It can be performed either in-office or as an outpatient.

  • Surgery: If other treatment options haven't adequately lowered eye pressure, surgery may be required. Types of surgery include filtration surgery and tube shunt surgery.
    • Filtration surgery, or trabeculectomy, is an outpatient procedure which relieves eye pressure by creating a new drainage channel to drain fluid out of the eye. A small stent may also be implanted to assist in the drainage.
    • Tube shunt surgery is performed if filtration surgery has already been done but was not successful at lowering eye pressure. During this outpatient procedure, a tube is implanted in the eye which drains the fluid to a reservoir and results in reducing eye pressure.
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