Glaucoma

Glaucoma Specialists

Glaucoma Surgeons combined extensive training in ophthalmology and advanced fellowship training in early detection and diagnosis of glaucoma, as well as, glaucoma surgery and complex cataract surgery. They are able to provide the most advanced glaucoma treatments and surgical procedures. Since early detection and treatment are paramount in the successful prevention of glaucomatous vision loss, this results in excellent patient care. Glaucoma specialists provide treatment plans that include:

Early Glaucoma Detection and Diagnosis

Glaucoma

Glaucoma is a leading cause of blindness that affects more than three million Americans, and only half of those diagnosed are under treatment. Even with treatment, 10 percent of patients can end up blind (estimates suggest 120,000 Americans are blind from glaucoma). As with any chronic condition, early diagnosis and appropriate treatment is critical. Typically, those who lose vision are diagnosed relatively late. Glaucoma is a disease of momentum. The later it is diagnosed, the more difficult it is to control and stabilize. Since most forms of glaucoma are completely symptom-free in early and even moderate stages, early intervention and regular comprehensive eye examinations are critical.

Glaucoma is a family of more than 30 diseases that affects pressure within the eye (intraocular pressure), and damages the optic nerve.  Often called the “sneak thief” of sight, people with most forms of glaucoma do not have symptoms until the optic nerve is already severely damaged.

What causes glaucoma? Glaucoma is a disease that damages your eye’s optic nerve. It usually happens when fluid (aqueous humor) builds up in the front part of your eye. Over time, this fluid buildup damages the optic nerve, the structure that sends visual signals from your eyes to your brain. Underlying reasons for this usually relate to the type of glaucoma you have.

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Glaucoma Risk Factors

Although glaucoma is most common in adults over the age of 40, susceptibility is not determined by age alone. A genetic predisposition of those with a family history of the disease and African-Americans, are at a particularly increased risk. Studies have shown individuals at greater risk for glaucoma may fit one or more of the following criteria:

  • Use long-term steroid medications
  • Have corneas that are thin in the center
  • Have thinning of the optic nerve
  • Have diabetes, migraines, high blood pressure, poor blood circulation or other health problems affecting the whole body

Symptoms Of Glaucoma

In most cases, glaucoma is asymptomatic (has no symptoms). By the time an individual experiences decreased vision, the disease is frequently in its later stages. Since early warning signs of glaucoma are rare, it is important, especially for those at risk, to have regular medical eye examinations every one or two years.

Patients with chronic glaucoma may not be aware of any symptoms because the disease develops slowly and they rarely notice loss of peripheral vision. Patients with an acute form of glaucoma (acute angle closure) may develop severe symptoms because ocular pressure rises quickly and they may experience:

  • Blurred vision, especially at night
  • Halos or rainbows around lights
  • Severe headaches or eye pain
  • Nausea

Common Types Of Glaucoma

Stamford Eye Associates
Stamford Eye Associates

Primary open angle glaucoma, or POAG, is the most common type of glaucoma. The drainage system, the trabecular meshwork, is open but does not drain fluid adequately. The pressure in the eye increases as fluid in the eye builds. Visual loss occurs gradually and is usually unnoticed by the patient until late stages of the disease.

Angle closure occurs when the drainage angle, the trabecular meshwork, becomes completely blocked which then causes a sudden increase in intraocular pressure and a red, painful eye. This condition is uncommon and is called an acute attack. It is a true, potentially blinding, eye emergency and requires immediate medical attention.

The iris obstructs the eye’s drainage angle (trabecular meshwork) in a slow, progressive fashion.

Low tension glaucoma, or LTG, is a form of open angle glaucoma. Glaucomatous optic nerve damage occurs despite a normal intraocular pressure.

Deposits of a fibrillary material clogs the trabecular meshwork and slows the drainage of fluid from the eye.

Pigment from the iris clogs the trabecular meshwork.

Scar tissue and or damage to the drainage angle from previous trauma obstructs the outflow of fluid.

Various disorders, such as diabetes, cause abnormal blood vessels to proliferate on the iris and blocks the eye’s drainage system.

Childhood glaucoma, also referred to as congenital glaucoma, pediatric glaucoma or primary infantile glaucoma occurs in babies and young children.

Early Detection And Treatment

Our glaucoma surgeons have advanced specialized training in glaucoma and complex cataract surgery.  To achieve an accurate assessment, our experienced ophthalmologists will perform a comprehensive glaucoma screening and tailor a specific treatment plan to meet your needs. Early diagnosis and detection are critical in controlling glaucoma and preventing permanent vision loss. Many times, an individual’s treatment will consist of:

This test measures the pressure inside your eye.

This test checks for vision loss in your side or peripheral vision.

Newer diagnostic studies using computer-imaging technology such as spectral domain optical coherence tomography (OCT), now permit precise measurements of the optic nerve and specifically the retinal nerve fiber layer that cannot be visualized by the unaided human eye. This test helps monitor and detect optic nerve loss over time.

Optic nerve photographs document the severity of damage to the nerve and are used to monitor changes over time.

Because corneal thickness can influence your eye pressure reading, this test measures the thickness of your cornea.

This exam looks at the drainage angle in your eye.

Glaucoma Surgery and Treatments

Our glaucoma specialists will customize a treatment plan for you.  This may include one or more of the following:

Certain prescription eye drops decrease intraocular pressure by reducing the amount of fluid your eye produces. Several different classes of glaucoma medications are available to provide pressure reduction including beta-blockers, prostaglandin analogues, alpha-adrenergic agonists, miotics, Rho kinase inhibitors, and oral and topical carbonic anhydrase inhibitors. These medications work by either reducing the rate at which fluid in the eye is produced or by increasing the outflow of fluid from the eye.

Like eye drops, oral prescription medications help reduce pressure inside your eye.

Using a laser beam, your ophthalmologist opens clogged channels inside the eye, releasing fluid build-up. Laser therapy is an outpatient procedure. Trabeculoplasty, iridotomy or cyclophotocoagulation are procedures that aim to increase the outflow, decrease the production of fluid from the eye or eliminate fluid blockages through laser.

Filtration surgery, a trabeculectomy, may be used to create a new passage for fluid drainage. Surgery is usually reserved for cases that cannot be controlled by medication and after appropriate laser treatment.

Filtration surgery, a trabeculectomy, may be used to create a new passage for fluid drainage. Surgery is usually reserved for cases that cannot be controlled by medication and after appropriate laser treatment.

MIGS

Micro-Invasive Glaucoma Surgery (MIGS) has been developed in recent years to lower eye pressure and prevent progression of glaucoma. Micro-Invasive Glaucoma Surgery (MIGS) is quickly becoming a widely accepted approach for treating mild-to-moderate glaucoma. MIGS procedures work by using microscopic sized drainage shunts and incisions in the drainage angle of the eye. The benefits of MIGS procedures include:

  • Minimally traumatic to delicate eye tissue
  • Effectively lowers IOP
  • Excellent safety profile
  • Rapid recovery