• Glaucoma Management

    Glaucoma is one of the leading causes of blindness in the United States

Glaucoma Management

Early diagnosis and treatment of Glaucoma can minimize or prevent optic nerve damage and limit vision loss.

Glaucoma is defined as elevated pressure in the eye that causes permanent damage to the optic nerve. Glaucoma is categorized into 2 different types, open angle and angle closure. Open angle glaucoma is the most common and has several sub types that your Ophthalmologist will determine during examination. Angle closure is an acute condition caused by the iris covering or partially covering the drainage mechanism located in the anterior chamber of the eye. Angle closure glaucoma must be treated quickly as pressure builds rapidly and can cause severe pain as well as partial or total blindness. Open angle glaucoma is not painful and has no symptoms until severe damage has occurred to your optic nerve. The loss of sight begins in the peripheral vision and is not readily noticed until it is significant. Patients with open angle glaucoma must be followed on a regular basis for testing and medication adjustments. Open angle glaucoma does not have a cure but proper diagnosis and treatment will slow down the progression of the disease.
Diagnosis and treatment of open angle glaucoma consists of: testing; monitoring of intraocular pressure; eye drop regimen and if necessary surgical or laser procedures. Testing consists of: visual field analysis; OCT and internal exam of the eye. The visual field tests the sensitivity of the retina and can pinpoint areas that have been lost to glaucoma. The OCT is a computer generated map of the retina and can demonstrate damage to the retinal nerve fiber layer before visual loss is noted. The internal exam of the eye is performed by the Ophthalmologist to see if all the inner structures of the eye are sound.

Once it has been determined that you have open angle glaucoma, the Ophthalmologist will usually begin a drop regimen that will either attempt to decrease production of aqueous humor (thin fluid that fills the anterior chamber of the eye) or increase drainage of aqueous humor through the drainage mechanism. You must keep all appointments in order to monitor the pressure in your eye and to see if the eye drop medication is controlling the pressure enough to limit damage to the optic nerve and your decrease of visual field. If the drops prescribed for you are successful, you may be on the prescribed regimen for life and there may be alterations in strength and type of drops used.

If the Ophthalmologist determines that eye drops alone are not controlling the pressure in your eye, a variety of surgical procedures can be performed. The procedures are: SLT laser; trabeculectomy; shunt devices and canaloplasty. All of these procedures are performed to achieve control of eye pressure and sometime eye drops must be continued to control eye pressure.