Glaucoma and Glaucoma Surgery

What is Glaucoma?

Glaucoma is a disease that if left untreated can lead to irreversible vision loss from damage done to the optic nerve. The most common form of glaucoma happens as a result of increased pressure in the fluid of the eye, known as increased intraocular pressure. There have even been instances of glaucoma reported where people have experienced optic nerve damage when the intraocular pressure has been normal, this is why it is so important to get regular eye exams.

What is the cause of glaucoma?

The exact cause of glaucoma is still unknown. We do know that the main contributing factor is a blockage of passages that normally allow the fluid within your eye to drain. When this happens the build up of fluid in the eye can put damaging pressure on the optic nerve that can, if left untreated, lead to loss of vision. The nerve fibers and blood vessels in the eye are very fragile and can be easily damaged by this change in pressure causing vision loss to occur.

Who gets glaucoma?

Over two million people in the United States are currently living with some form of glaucoma, making it one of the most prevalent conditions we treat. Risk factors include but are not limited to family history of glaucoma, low eye pressure, pre existing conditions like diabetes and heart disease, smoking, nearsightedness, and race. African Americans are more susceptible to open angle glaucoma and are fifteen times more likely to experience blindness as a result of this condition.

We highly recommend that from thirty years of age and on you schedule regular eye exams as an early prevention method and detection tool against glaucoma. Early detection promises better outcomes and greater ability to prevent damage that can lead to blindness.

How is glaucoma harmful to my vision?

We are able to see because the optic nerve takes information from the eye to the brain. When this information highway gets damaged by high pressure in the eye, caused by glaucoma, the brain is not able to receive the signals from the eye that gives us our sight.

Will glaucoma eventually make me go blind?

If left untreated, glaucoma can cause blindness, but thankfully with early detection, regular examination, and consistent treatment, glaucoma can be managed. If treatment is not initiated in enough time vision loss will start at the periphery and progress to the central vision eventually leading to total blindness. We can not stress the importance of early detection enough.

How can I tell if I have glaucoma?

We often call glaucoma the silent thief for its lack of noticeable symptoms that will damage eyesight without warning. Noticeable physical symptoms may not show up until it’s too late. Signs and symptoms will vary depending on the type of glaucoma you have.

If you have primary open-angle glaucoma, your first noticeable symptom may be vision loss.

If you have acute-angle closure glaucoma, your first sign may be blurred vision. You may also notice rings or halos around lights and eyes that get red and feel strained often.

How can I be tested to see if I have glaucoma?

At Perich Eye Center, we are highly trained to recognize and test for glaucoma. We use a painless procedure called tonometry to measure the internal pressure of your eye. It is important to come in for regular eye exams so that we can establish a history record that enables us to easily detect changes. Testing for glaucoma is always part of a complete eye exam.

How is glaucoma treated?

Glaucoma is first treated and maintained with prescription eye drops and medications which must be taken regularly to be effective. In some cases, we can treat glaucoma with therapy or surgery, but any vision once lost will unfortunately be lost for good. This is why the sooner glaucoma is diagnosed the better.

Will my vision be restored after I begin to treat my glaucoma?

Unfortunately, any vision loss that occurs can not be reversed. Any vision loss that happens due to glaucoma can not be restored with current medical advancements.

Can glaucoma be prevented?

The biggest thing you can do to prevent glaucoma is to maintain a healthy lifestyle and manage any chronic conditions such as diabetes to the best of your ability. Since the damage done by glaucoma can not be reversed, the best way to prevent loss of vision is through regular eye exams and early detection. You can also slow the progression of glaucoma by taking your eye drops and medications regularly.

What are the different types of glaucoma?

There are two types of glaucoma:

1.) Open-Angle Glaucoma: This form of glaucoma affects 70-90% of people with this diagnosis and results from a gradual rise in intraocular pressure due to a blockage in the trabecular meshwork of the eye.

2.) Angle-Closure Glaucoma:

This form of glaucoma is a result of a bulging iris that blocks or narrows out the drainage passages in the eyes and can either be acute or chronic.

What is normal eye pressure?

On average, we like to see your eye pressure to be around 12-22mg hg, but this may vary based on each individual's body composition. It helps us to have a solid history of consistent visits and exams so we can more easily tell when you are having changes that should be noted and looked into further.

What resources are available to help people with glaucoma and their caregivers?

Today we are lucky to have many vision resources at our fingertips. Please visit this directory for vision resources to find any help you or a caretaker may need. Each state provides organizational resources which help people find therapists and vision rehabilitation centers where you can learn to modify your environment and work with using the area of your vision that still remains. You can also use vision aids such as magnifiers and readers. You can also incorporate household items with larger numbers and talking features. Reading materials with large print and audio materials are also helpful.

What is the prognosis for glaucoma?

Each type of glaucoma has its own prognosis

Acute glaucoma:

If an episode of acute glaucoma is treated early enough, there is a good chance that the vision in the affected eye will be able to be recovered at a high percentage of what it was before. However if neglected, or not treated properly blindness can occur within two days or less.

Open-angle glaucoma:

Prognosis for Open-angle glaucoma is dependent on how well a person sticks to their eye drop and medication plan of care. If neglected, blindness can occur.

Can glaucoma be cured?

Unfortunately, there is no cure for glaucoma. The best way to slow the progression of this condition is to improve lifestyle habits and stick to your plan of care prescribed by your doctor.

What are my options if I need surgery for my glaucoma?

The need for surgery to treat your glaucoma will be determined by one of our doctors at Perich Eye Center. Depending on the type you have, we will recommend one of these options:

Trabeculectomy: This involves the doctor putting a tiny cut on the white part of the eye to let fluid build up drain which can be either a Xen Stent or an Ahmed Shunt.

Cyclophotocoagulation: This may be a suitable option if others are not recommended. A small laser is used in multiple settings to relieve pressure within the eye.

SLT (Selective laser trabeculoplasty):

In this laser surgery, the doctor will use a highly targeted but low-level laser on the spots where there’s a pressure build up.

Is SLT Painful?

No, cold laser technology opens up blocked drainage ducts in a way that minimizes discomfort as well as scar tissue development.

Will I see immediate results after my SLT procedure?

We will discuss how long it may take for you to see results after your SLT procedure at one of your pre-surgical appointments. Depending on the severity of your condition, results can be seen in as little as one month.

Are there any risks involved with glaucoma surgery?

Compared to some glaucoma medications, SLT offers better side effect rates, with only mild inflammation reported by post-operative SLT patients. Inflammation following SLT is managed with eye drops or NSAIDS.

How long does SLT continue stabilizing intraocular pressure?

SLT typically lasts for one to five years. In some cases the benefits of SLT last for more than five years. In rare cases, SLT patients may see a return of glaucoma-based pressure in their eyes within 6 to 12 months of surgery. If this happens, we will continue to work with you to find other workable options for your care.

After my SLT will I still need to take my glaucoma medications?

It depends. Some glaucoma patients find that SLT controls intraocular pressure completely. Others may need to take glaucoma medication as a supplement to glaucoma laser surgery. While Selective Laser Trabeculoplasty should not be considered as a glaucoma cure, SLT can definitely help reduce the severity of intraocular pressure..