Glaucoma

Glaucoma is a type of eye disease, usually associated with fluid build up in the front part of your eye, the results in damage to your Optic Nerve.  When this nerve is damaged, it can cause permanent vision loss.

Primary Open Angle Glaucoma (POAG)

By far the most common type of glaucoma, POAG is a gradual reduction in the eye’s ability to properly drain fluids, causing a build-up of intraocular pressure (IOP) and damage to the optic nerve.  This form of glaucoma is painless and causes no immediate vision losses.

POAG may also occur if a patient’s optic nerve is sensitive to normal IOP.  These patients are at higher risk for POAG when their pressure is higher than usual.

Usually no signs or obvious symptoms, as the disease worseness a blind spot develops in the peripheral vision.  This change in vision is usually not noticed until the damage is severe, earning this disease the nickname “silent thief of sight.”  The only way to determine if you have open-angle glaucoma is regular eye exams.

Angle-Closure Glaucoma

Also called “Closed-Angle Glaucoma,” and “Narrow-Angle Glaucoma,” this type of glaucoma is a chronic condition that occurs when the iris is too close to the drainage angle of the eye, causing a blockage.  This type of glaucoma is susceptible to acute attacks when the angle becomes completely blocked.

If you experience any of the below acute attack symptoms, you should contact your eye care provider immediately:

  • Vision becomes suddenly blurry
  • Severe pain in the eye of forehead 
  • Nausea
  • Vomiting
  • Rainbow-colored rings or halos around lights

This type of glaucoma occurs slowly and shows no symptoms until the damage is severe or at the onset of an acute attack.  If not treated quickly, Angle-Closure may cause blindness.

Normal Tension Glaucoma

Patients with normal tension glaucoma have a normal IOP but show other signs of glaucoma, such as blinds spots and optic nerve damage.

Glaucoma Suspect

Patients with no signs of damage, but with high IOP are considered glaucoma suspect and have a higher risk of eventually developing glaucoma.

Some patients are at higher risk for glaucoma than others, this would include those patients that are:

  • over 40
  • have a family history of glaucoma
  • are of African, Hispanic, or Asian Heritage
  • have high eye pressure
  • are farsighted or nearsighted
  • have had an eye injury
  • use of long-term steroid medications
  • have corneas that are thin in the center
  • have a thinning of the optic nerve
  • have a diet deficient in fruits and vegetables
  • excessive use of caffeine
  • have diabetes, migraines, high blood pressure, poor circulation, or other whole-body health problems.

Only a qualified eye care professional performing a complete eye exam, though we do encourage all patients to have glaucoma screenings on a regular basis.

During a complete exam, your eye care physician will:

  •  measure your intraocular pressure (IOP)
  • inspect your eye’s drainage angle
  • examine your optic nerve for damage
  • perform a visual field test
  • take a picture or computer measurement of your optic nerve
  • measure the thickness of your cornea

Eyedrop Medicines

Some patients may be prescribed glaucoma eye drops.  When used daily, these drops work to lower the IOP by either reducing the amount of fluid the eye produces or increase the rate at which it can drain.

Laser Surgery

Glaucoma may be treated by laser procedures that help the fluid drain from the eye; these procedures are usually performed either in an ophthalmologist’s office or in an outpatient surgical center, under light anesthesia.  Patients may experience some irritation in their eyes, but with usually short recovery time, can resume normal activities within one or two days.

Trabeculoplasty used mostly to treat open-angle glaucomas, a laser is used to treat the drainage area of the eye known as the trabecular meshwork, creating a biochemical change that makes it easier for the fluid to drain from the eye.

Iridotomy used to treat angle-closure and narrow-angle glaucomas.  The laser creates a tiny hole in the iris that allows fluid to drain from the eye through the trabecular meshwork.

Operating Room Surgery

If the use of eye drop medicines or laser surgeries are insufficient or not preferred, then the surgeon may elect to create a new drainage channel.

Trabeculectomy the surgeon creates a tiny flap in the white of the eye, and bubble in the conjunctiva called a filtration bleb, usually hidden under the upper eyelid.  The fluid drains through the flap, into the bleb, where it is absorbed by the surrounding tissue to lower the IOP.

Glaucoma drainage devices the surgeon implants a drainage tube into the eye that drains the fluid into a collection area, called a reservoir, created beneath the conjunctiva.  The fluid then absorbs into the nearby blood vessels.