Glaucoma is a disease of the optic nerve of the eye. Most often, it is associated with elevated eye pressure which slowly and irreversibly damages nerve fibers over time.
Even today, glaucoma is one of the leading causes of preventable blindness in our country and world wide!
Cause:
The eye contains a drain called the trabecular meshwork which is responsible for allowing fluid to exit from inside the eye. In glaucoma, this drain becomes diseased causing fluid to build up and the pressure inside the eye to rise.
Over time, the chronically elevated pressure cause the optic nerve fibers to slowly die leading to irreversible vision loss.
Symptoms:
Unfortunately, the vast majority of patients cannot tell if they have glaucoma. This is because, glaucoma robs the eye of its extreme peripheral vision first, and we are not as sensitive to this type of vision loss. Also, elevated pressure normally does not cause pain. This is why glaucoma testing on routine examination is so important.
Risk factors:
- increased age
- Ethnicity including African American and Latin American patients
- Family history
- Trauma
- Steroid use
- Diabetes
Diagnosis:
Everyone should be screened for glaucoma with vision testing, eye pressure checks and optic nerve examination during a routine visit. However, a complete glaucoma evaluation is necessary for any patient who is a suspect as follows:
- Gonioscopy: direct exam of the drainage system using a lens
- Tonometry: using a device which touched the cornea to establish eye pressure
- Pachymetry: measurement of the corneal thickness to establish how accurate the pressure readings are
- Optic nerve exam: direct exam of the optic nerve in the back of the eye with a lens
- Optic nerve analysis with a machine such as HRT, GDX, OCT
- Visual field testing
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Treatment:
Once damaged, the optic nerve cannot be healed. Therefore, the key to glaucoma treatment is early detection and control of eye pressure to keep any further damage from occurring. This is achieved by 3 main methods:
Medications:
come in drop or pill form and work to lower eye pressure, many times more than one type has to be used simultaneously depending on how low the eye pressure needs to be.
Glaucoma Lasers
Quick 5 minute clinic procedure with virtually no side effects, aimed at the drainage system of the eye and causes the cells there to become more efficient in draining the fluid. Learn more...
Glaucoma Surgery:
Outpatient glaucoma surgery is aimed at either isolating the drainage canal and increasing its potential or bypassing the entire drainage mechanism all together by creating a filter on the outside surface of the eye. Learn more...
Procedures include:
These procedures are performed only when medications and laser are not enough in controlling glaucoma progression. |
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