What is Glaucoma?
Glaucoma is a common eye condition that can permanently destroy vision. Typically, people with glaucoma do not know it unless it is detected upon routine eye examination. Often, vision is permanently lost before a diagnosis is made. Glaucoma effects the optic nerve which brings vision from the eye to the brain. It damages it by elevating pressure in the eye. In rare cases, people with normal or low pressure in the eye develop glaucoma.
Types of glaucoma
In narrow angle glaucoma, access to the structures that drain fluid from the eye are blocked as the human lens grows with age. This condition is more common with people that have short or farsighted eyes. This type of glaucoma can present with a patient suddenly develop a red, painful, eye with decreased vision. In some cases, the symptoms of angle closure are subtler and not noticed by the patient.
In open angle glaucoma, the access to the drainage structures of the eye if not blocked. Typically, loss of vision with open angle glaucoma is not evident to the patient until advanced stages of vision loss unless detected during an eye examination.
About half the people found to have open angle glaucoma don’t know that they have glaucoma when first detected on an eye examination. Your eye pressure, visual field, and optic nerves are inspected during an eye examination. Sometimes specialized tests are used to confirm the presence of glaucoma and stage its severity. Patients with blood relatives with glaucoma, or who have diabetes, and take medications such as, corticosteroids are at increased risk to develop glaucoma.
Glaucoma has been called the “sneak thief of sight” because in the most typical form, there are no symptoms. In chronic glaucoma, there is no pain, no swelling, or no redness. Simply, glaucoma destroys vision by putting pressure on the optic nerve. The optic nerve is the path which sends light signals to the brain where these signals are then changed into what we know as “sight.” Left unchecked to progress, the optic nerve is damaged by the high pressure in the eye, and central vision eventually is lost. If left untreated, glaucoma can result in blindness.
- Eye drop treatment
- Selective Laser Trabeculoplasty (SLT)
Eye drop treatment
The first line of treatment of open angle glaucoma is with prescription eye drops, which adequately control eye pressure in most patients. With regular follow up and effective treatment, most patients in the United States do not lose significant vision to open angle glaucoma. Eye drops must be administered daily–sometimes two to three times a day. Glaucoma medications can be expensive and often patients either forget to use the drops, have difficulty tolerating the medication or decide not to use the medication resulting in loss of vision.
Sometimes patients require oral medications, laser surgery or conventional surgery to treat open angle glaucoma. Surgical procedures have been considered as a last resort to control pressure inside of the eye for this type.
Selective Laser Trabeculoplasty (SLT)
Acute attacks of angle glaucoma in which the eye pressure can rise to dangerous levels is usually first treated with medications. After the eye pressure returns to normal levels and when eye inflammation is reduced, the Laser is generally used to make a new passageway for fluid to leave the eye called an Iridotomy.
Selective Laser Trabeculoplasty (SLT) uses laser technology to increase fluid drainage and reduce pressure inside of the eye. The procedure is quick, essentially painless, does not damage tissue and is generally very safe.. SLT has been show to be highly effective in the management of glaucoma.
Studies show that between 80% to 90% of glaucoma patients are either able to eliminate or significantly reduce their medications after undergoing laser therapy.
Dr. Sondheimer says, “I have seen excellent response from my patients who chose to undergo laser treatment for glaucoma. Many are relieved of the expense of medications, others were tired of trying to remember to administer eye drops several times a day, but above all, control of the disease is excellent, and these glaucoma patients are being managed very effectively with laser treatment.”
Sometimes conventional eye surgery is required to relieve eye pressure in angle closure glaucoma.