Glaucoma

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
• Nearsightedness
• Diabetes
• Previous eye injury
• Regular, long-term use of cortisone/steroid products

The only sure way to detect glaucoma is to have a comprehensive medical eye examination. During this evaluation, your physician will measure your intraocular pressure, inspect the drainage angle of your eye, evaluate whether or not there is optic nerve damage and test the peripheral vision of each eye.

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. A small hole is made in the iris to increase the angle between the iris and cornea and encourage fluid drainage.
• Argon Laser Trabeculoplasty (ALT) and 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.
• Nd: YAG Laser Cyclophotocoagulation (YAG CP) – For patients with severe glaucoma damage who have not been helped with other surgeries. The ciliary body that produces intraocular fluid is destroyed.
• 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.