Glaucoma

Glaucoma, one of the leading causes of blindness, is estimated to affect 1 in every 50 adults. Although glaucoma can occur at any age, the risk of developing the disease increases dramatically after the age of 35. Glaucoma is also more likely to develop in persons who are severely nearsighted, those with a family history of the condition, diabetics and Black or African Americans. Because the symptoms of early glaucoma are so slight, the disease often goes unnoticed until permanent vision loss has occurred. However, with early diagnosis and careful treatment, visual damage from glaucoma can be prevented.

What is glaucoma?
Glaucoma is a group of diseases which damage the optic nerve. Damage to the optic nerve and retina causes blind spots in the field of vision. If the entire nerve is destroyed, blindness will occur. When light enters the eye, an image is focused onto the retina, the delicate nerve layer lining the inside back wall of the eye. The retina then transforms the light images into electrical impulses which are carried to the brain by the optic nerve.

What cases glaucoma?
Glaucoma is usually caused by an increase in the fluid pressure in the eye. However, over 30% of patients with glaucoma can have normal or lower than normal pressures. The front part of the eye contains a clear, nourishing fluid called the aqueous which constantly circulates through the eye. Normally, this fluid leaves the eye through a drainage system and returns to the blood stream. Glaucoma occurs from an overproduction of fluid or when the drainage system becomes blocked, causing the fluid pressure to increase. The high pressure causes damage to the optic nerve, resulting in permanent vision loss. The exact reason the fluid system in the eye stops functioning properly is not completely understood. Much research is being done in this area to further our understanding of glaucoma.

SYMPTOMS

What are the symptoms of open angle glaucoma?
The early symptoms associated with chronic open angle glaucoma, the most common type, are usually unnoticeable. At first, in most cases, the build-up of pressure is gradual without any discomfort or pain. Most people do not detect a change in their vision until substantial sight loss has occurred. Certain parts of peripheral (side) vision are affected first with the top, sides, and bottom of the field of vision becoming decreased. Later in the course of the disease central vision become affected, mild headaches and difficulty with night vision might be experienced. And if left untreated, total blindness will result.

What are the symptoms of acute closed angle glaucoma?
The patient stricken with acute closed angle glaucoma experiences more noticeable symptoms. The sudden onset of acute glaucoma can cause blurred vision, severe pain, nausea, and halos around lights.

DIAGNOSIS

How is glaucoma diagnosed?
In most cases, glaucoma is detected in a routine eye examination before the patient experiences any vision problems. An evaluation for glaucoma is painless and included checking the pressure or “hardness” of the eye with a tonometer. The optic nerve is checked for damage with an ophthalmoscope, an instrument which illuminates and magnifies the back of the eye. A special mirrored magnifying lens called a gonioscope is used to examine the drainage channels for proper fluid outflow. If any sign of glaucoma is detected, a series of tests are performed to determine the progression of the disease.

TREATMENT

How is glaucoma treated?
With early detection and treatment, glaucoma can almost always be controlled and vision preserved. However, glaucoma cannot be cured and once vision has been lost it cannot be restored. A combination of eye drops, medication, laser treatment and conventional surgery is used to treat glaucoma. Treatment is concentrated on lowering the pressure inside the eye to prevent damage to the optic nerve.

Selective Laser Trabeculoplasty (SLT)
Selective Laser Trabeculoplasty (SLT) is an advanced type of laser treatment to manage patients with open-angle glaucoma. SLT selectively stimulates or changes only specific pigmented cells to activate increased fluid drainage and reduce intraocular pressure (IOP). SLT results in a biological response that increases aqueous drainage without burning tissue.

SLT is performed in our office and only takes about 3 minutes. Use of the SLT in treating glaucoma may reduce the need for lifelong use of expensive eye drops or other medications. Because there is no damage or scarring from the SLT laser, the SLT may be repeated.

iStent Trabecular Micro-Bypass Stent accompanying Cataract Surgery
Patients with mild-to-moderate glaucoma and cataracts may benefit from an iStent implant accompanying cataract surgery. The iStent Trabecular Micro-Bypass Stent is the world’s tiniest FDA-approved medical device. For patients with glaucoma, over time the eye’s natural drainage system becomes clogged. The iStent creates a permanent opening though the blockage to improve the eye’s natural fluid outflow. By improving the outflow of fluid in the eye, iStent is designed to lower and control the pressure within the eye.

 

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Ventura Ophthalmology

3088 Telegraph Road
Suite A

805.648.6891

Lum Glaucoma Care Centerof Santa Barbara

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