Glaucoma Consultation & Surgery
Glaucoma is the leading cause of blindness and visual impairment in the United States. A simple, painless eye exam can detect the disease. With early detection and treatment, glaucoma can usually be controlled and blindness prevented.
Glaucoma can affect anyone from newborn infants to the elderly. It has been estimated that up to 3 million Americans have glaucoma. At least half of those people do not know they have it because glaucoma usually has no symptoms. People who are at a greater risk for glaucoma usually have the following conditions:
- At least 45 years old without regular eye exams
- A family history of glaucoma
- Abnormally high eye pressure
- African descent
- Previous eye injury
- Regular, long-term use of cortisone/steroid products
To detect glaucoma, your physician will perform a comprehensive eye examination. Regular and complete eye exams help to monitor changes in your eyesight and to determine whether you may develop glaucoma. If your examination is highly suspicious for glaucoma, then you will be asked to have additional testing such as a visual field exam and/or a Optical Coherence Tomography (OCT). You will be asked to return for follow up evaluations.
Treatment to control glaucoma include medications in the form of either eyedrops or pills, laser surgery and conventional surgery.The high eye pressure associated with glaucoma can damage your optic nerve before you begin to experience any vision loss. The Optical coherence tomography (OCT) uses technology that is similar to CT scans of internal organs, using a scattering of light to rapidly scan the eye to create an accurate cross-section. Unlike other imaging techniques, OCT uses light to produce high resolution images, rather than sound or radiofrequency waves. Your doctor can evaluate and measure each layer of the retina through this image and compare it with normal, healthy images of the retina.
Some cases of glaucoma can be treated with medications. For others, laser or traditional surgery is required to lower eye pressure. Common surgeries include:
Laser Peripheral Iridotomy (LPI) – For patients with narrow-angle glaucoma or at high risk for developing narrow-angle glaucoma. A small hole is made in the iris to increase the angle between the iris and cornea and encourage fluid drainage.
Selective Laser Trabeculoplasty (SLT) – For patients with primary open angle glaucoma (POAG). The trabecular passages are opened to increase fluid drainage. ALT is effective in about 75% of patients, and SLT may be repeated.
Filtering Microsurgery (Trabeculectomy) – For patients who have not been helped with laser surgery or medications. A new drainage passage is created by cutting a small hole in the sclera (the white part of the eye) and creating a collection pouch between the sclera and conjunctiva (the outer covering of the eye).
Tube Shunt Surgery – May be recommended for patients with neovascular glaucoma, failed trabeculectomy, or susceptibility to developing scar tissue. A thin, flexible tube (a shunt) with a silicone pouch is inserted in the eye to facilitate drainage.
A few patients experience acute angle closure glaucoma, a sudden rise in intraocular pressure that frequently causes blurred vision, severe pain, colored halos, reddened eyes, and nausea or vomiting. Immediate treatment is critical. Eye drops or oral medications are usually prescribed to lower pressure and swelling and allow the physician to examine the eye. When the eye has been stabilized, an iridectomy or iridotomy may be performed.