Glaucoma is the name given to a group of conditions that lead to damage to the optic nerve – the nerve that connects the eye to the brain. It is a leading cause of irreversible blindness. Damage from glaucoma affects the peripheral vision first and as the disease progresses; it does so towards the center of the vision. Once vision is lost from glaucoma it cannot be regained so early detection is key. A simple, painless eye examination can detect the disease and with early detection and treatment, glaucoma can usually be controlled and blindness prevented.
Glaucoma can affect any from newborn infants to the elderly. It is estimated that up to 3 million Americans have glaucoma, with nearly half of these people not knowing they have the disease because there are no symptoms.
The most common form of glaucoma is related to elevated pressure in the eye, however this is not the only cause and glaucoma can develop at normal eye pressures. People who are at greater risk for developing glaucoma may have the following:
- Greater than 45 years old without regular eye exams
- A family history of glaucoma
- Abnormally elevated eye pressures
- African American decent
- Previous eye injury or trauma
- Regular, long term use of steroids/cortisone
To detect glaucoma, your physician will perform a complete dilated examination and test the pressure in your eyes. If there is any suspicion of glaucoma our office has sophisticated technology to help aid in diagnosing and monitoring glaucoma. Visual field testing requires active participation and tests for any areas of the visual field that have been damaged from glaucoma or other conditions. The test typically takes 15 to 30 minutes as the patient is asked to look into the perimeter (visual field machine) and to press a button once a stimulus of light is shown. The compute keeps track and reconstructs a visual field. This test is often performed on a yearly basis and is used to monitor stability or progression.
Photographs of your optic nerves can be taken to compare against over the years. Computer analysis of the optic nerve by OCT or GDx testing can analyze the nerve fiber layer around the optic nerve, looking for areas of subtle damage.
Eye fluid or aqueous is produced by the eye and needs to drain from the eye. If the balance between the production and drainage of the fluid is off, elevated intraocular pressure may develop. Glaucoma again comprises a host of diseases but treatment is tailored depending if your drainage network is open or closed.
There are two types of glaucoma:
- Open Angle Glaucoma - This is the more common form of glaucoma and simply means that the drainage areas of the eye appear open to your physician. First line treatment of this type of glaucoma is with eye drops or with an in office laser procedure called SLT (selective laser trabeculoplasty).
- Narrow Angle Glaucoma - If the drainage area appears narrow or crowded, a different laser procedure, a laser peripheral iridotomy (LPI) may be recommended. This office procedure also uses a laser but is used to create a small opening in the iris (the colored part of the eye) to act as a different passage for the eye fluid to reach the normal drainage area and protect you against an attack of angle closure glaucoma.
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