Prior to embarking into Glaucoma treatment you would have to be formally diagnosed with it. There are four different way to test for glaucoma known as Tonometry, Opthalmoscopy, Perimetry, and Gonioscopy.

            Tonometry is simply when your doctor numbs your eye and takes a small tool that will measure the pressure in your eye. If the pressure is high enough then you have glaucoma.

            Opthalmoscopy is when your doctor puts dilating eye drop in your eye so he can then look at the optic nerve. If your nerve is damaged then it is very likely that you have glaucoma.

            Perimetry is a visual field of tests, which indicate if you have lost vision or if the glaucoma has hurt your eye.

            Gonioscopy is when your doctor numbs your eye and uses a special contact lens that magnifies inside your eye. In order to diagnose you with glaucoma, the area where your iris and cornea meet is open either wide or narrow.

Once you are diagnosed, you will fall into the one of the four small categories of the type of glaucoma you have.  

First, there is Angle Closure Glaucoma where the angle of the canal is blocked by a part of the iris. This kind can only be treated with laser surgery to almost completely remove it.

Secondly there is, the type you are born is called, Congenital Glaucoma. Having this type comes with symptoms such as, cloudy eyes, excessive tearing, and sensitivity to light.

The third type is Pigmentary, which occurs when pigment from the iris flakes off and blocks the drainage canal.

Also there is Secondary Glaucoma, which can develop from things such as a tumor, diabetes, and a medical condition having something to do with your eye.

The last type is Open Angle Glaucoma, this is the most common and doesn’t have any symptoms and can cause you to go blind, which means you should get your eyes tested once every two years. If you have this kind, you vision will slowly start becoming like you are looking through a tunnel.         

Before seriously considering glaucoma surgery, At the Eye Center of Texas, Dr. Wade, M.D. and Dr. Mayo, M.D. may recommend medication for. There is no cure for this disease but with medication (usually in the form of eye drops), they will be sure to keep it under control.  There are several types of medication that can be taken to control glaucoma.      

Alpha-adrenergic agonist

These eye drops reduce aqueous humor production and increases its outflow. Examples include, Apraclonidine (Iopidine) and Brimonidine (Alphagan).

Beta-blockers

These eye drops work to lower eye pressure by reducing the production of aqueous humor and decreasing the rate at which the fluid flows into the eye. Examples include Timolo (Timoptiv Xe Ocumeter and Timoptic) and Levobunolol (betagan).

Prostaglandin analogs

 

These eye drops reduce pressure in the eye by increasing the outward flow of fluid from the eye. Latanoprost (Xalatan®) and Bimatoprost (Lumigan®)

Carbonic Anhydrase Inhibitors

Eye drops or pills used to reduce fluid production in the eye. Dorzolamide (Trusopt®) and Brinzolamide (Azopt®)

Miotics (cholinergic agents)

These cause the pupil to become much smaller in diameter and help increase the rate of fluid drainage from the eye. Examples include Pilocarpine (Isopto Carpine®, Pilocar® and Pilopine HS® ointment) Combinations of eye drops may also be used to achieve better results. Dorzolamide and Timolol (Cosopt®)

 

These medications will help control your glaucoma but might come with side effects which may include blurred vision, red eyes, headache, nausea or upset stomach; depending on your medication you doctor will go over thorough list of side effects.  

Once you have explored all of your options and nothing seems to make you feel better about your eyes, Dr. Wade and Dr. Mayo (at The Eye Center of Texas) will thoroughly explain a procedure called Selective Laser Trabeculoplasty (SLT) before going into the possibility of an incision surgery know as

Trabeculectomy (Filtration Surgery)

SLT is a non-destructive laser procedure to treat glaucoma by reducing pressure in your eye and controlling glaucoma without the need of eye drops. The SLT doesn't do any damage to the eye, unlike the older ALT lasers.

Before performing the procedure your doctor would measure pressure within your eye and examine the flow of fluid through the chamber of the eye and trabecular meshwork. Also, your doctor will record what the back of the retina looks like in order to document damage that may have been caused by the increased intraocular pressure and to demonstrate the improvement after your surgery.

SLT is one of the most significant and safest advanced in the treatment for glaucoma. Using a microscopic laser light, it will open the clogged drains of the eye and lower the pressure back to a safe level to prevent vision loss. SLT has an effective rate of about 80% and it is painless. Also it is very convenient as it only takes our doctors at the Eye Center of Texas, only about 5 minutes to perform this outpatient procedure. One application is usual for many people, but in some cases (depending on you individual circumstances and goals) another application may be needed at some point in the future.

During Trabeculectomy-sometimes also called Filtration Surgery-a piece of tissue in the drainage angle of the eye is removed, creating an opening. The opening is partially covered with a flap of tissue from the sclera, the white part of the eye, and the conjunctiva, the clear thin covering over the sclera. This new opening allows fluid (aqueous humor) to drain out of the eye, bypassing the clogged drainage channels of the trabecular meshwork.

As the fluid flows through the new drainage opening, the tissue over the opening rises to form a little blister or bubble, called a bleb. The bleb is located where the sclera, or white of the eye, joins the iris. During office visits after surgery, the doctor looks at the bleb to make sure that fluid is still draining out of the new opening. Not all blebs have to be easily seen to work. Before the procedure your doctor will check intraocular pressure, any areas of conjuctival scarring or sclera thinning, amount of visual field loss, and the presence of a cataract.

After going through all the information listed above with Dr. Wade or Dr. Mayo, you will be on your way to better vision.