What is glaucoma?

Glaucoma is a group of diseases that can damage the eye’s optic nerve, causing vision loss or blindness. With early treatment, you can often protect your eyes from serious vision loss.

There are several types of glaucoma:

  • Open-angle glaucoma – When clear fluid builds up at the open angle where the cornea and iris meet, pressure inside the eye can rise to a level that may damage the optic nerve.
  • Low-tension or normal-tension glaucoma – Optic nerve damage and narrowed side vision occur in people with normal eye pressure. Lowering eye pressure through medicines can slow the disease in some people, but glaucoma may worsen in others despite lower pressures.
  • Angle-closure glaucoma – This occurs when the fluid at the front of the eye cannot leave the eye through the angle because it is blocked by part of the iris. People with this type of glaucoma have a sudden increase in eye pressure, which can cause severe pain and nausea, as well as redness of the eye and blurred vision. This type of glaucoma should be treated as a medical emergency because blindness can result in as few as one or two hours.
  • Congenital glaucoma – Sometimes, children are born with a defect in the angle of the eye that slows the normal drainage of fluid. These children usually have obvious symptoms, such as cloudy eyes, sensitivity to light and excessive tears.
  • Secondary glaucomas – These can develop as complications of other medical conditions, such as advanced cataracts, eye injuries, certain eye tumors or eye inflammation. Pigmentary glaucoma occurs when the pigment from the iris flakes off and blocks the meshwork, slowing drainage. A severe form, called neovascular glaucoma, is linked to diabetes.

What are the symptoms of glaucoma?

At first, open-angle glaucoma has no symptoms, but if untreated, patients will gradually start to lose their peripheral, or side, vision. Eventually, this can lead to what is often called tunnel vision. Over time, straight-ahead vision can diminish as well until no vision remains.

What are the risk factors for glaucoma?

Risk factors for glaucoma include:

  • Age
  • Family history of glaucoma
  • African or Hispanic ancestry
  • Farsightedness or nearsightedness
  • Elevated eye pressure
  • Past eye injury
  • Having a thinner central cornea (the clear, front part of the eye covering the pupil and iris)
  • Low blood pressure
  • Conditions that affect blood flow, such as migraines, diabetes and low blood pressure

How is glaucoma diagnosed?

Glaucoma is detected through a comprehensive eye exam that includes:

  • Eye chart test – This test measures how well you see at various distances.
  • Visual field test – This test measures your peripheral, or side, vision.
  • Dilated eye exam – Drops are placed in your eyes to widen or to dilate the pupils. A magnifying lens is then used to examine your retina and optic nerve for signs of damage and other eye problems.
  • Tonometry test – An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for the test.
  • Pachymetry test – A numbing drop is applied to your eye, so an ultrasonic wave instrument can be used to measure the thickness of your cornea.

How is glaucoma treated?

Immediate treatment for early stage, open-angle glaucoma can delay progression of the disease, which is why early diagnosis is very important. Treatments include medicines, selective laser trabeculoplasty, conventional surgery or a combination of any of these. Selective laser trabeculoplasty uses a laser to help fluid drain out of the eye. Conventional surgery makes a new opening for fluid to leave the eye. This is often done after medicines and laser surgery have failed to control pressure. While these treatments may save remaining vision, there is no way to improve sight already lost from glaucoma. Your Nethery Eye Associates physician will recommend the best treatment option for you.

The iStent and Glaucoma

PennyIf you are in need of cataract surgery and currently take eye drops to manage your glaucoma, Nethery Eye Associates may have good news for you! The iStent, the smallest implant available in the world today, is an exciting new advancement in glaucoma technology that helps restore the eye’s natural drainage system (see video below) relieving pressure in the eye that can irreversibly damage vision. If you are a candidate, this tiny new medical device can be implanted in just minutes while simultaneously treating your cataracts. It’s pain free, the implant cannot be seen or felt in the eye and the procedure can potentially reduce your need for glaucoma drops. Although the device is tiny in size, the results it delivers can be life changing. If you have glaucoma and believe you have cataracts, please contact our office to schedule an evaluation.