It is estimated that over two million Americans have some type of glaucoma and half of them do not know it. Glaucoma is a group of diseases that can damage the eye’s optic nerve and result in vision loss and blindness. Ninety percent of glaucoma patients have open-angle glaucoma. Glaucoma cannot be cured, but it can be controlled.
Glaucoma is caused by the drainage passage inside the eye being mechanically blocked or not functioning correctly. This causes a build up of clear fluid called aqueous humor which subsequently causes a rise in intraocular pressure. This pressure can damage the optic nerve over time and cause a loss of peripheral vision and eventually central vision. Even when the intraocular pressure is not above average, it may still be high enough to cause optic nerve damage. Average intraocular pressure in adults is 15 mmHg, but normal intraocular pressure is different for each individual. The higher the intraocular pressure, the more likely is the possibility of progressive glaucoma damage.
Unfortunately, the common kinds of glaucoma have no early symptoms. Once loss of vision is noticed by a patient, the damage is usually very severe and irreversible. Elevated pressure cannot be felt unless the pressure is very high. In order to preserve vision, glaucoma must be diagnosed early. Glaucoma is a lifelong disease, but can be controlled.
Glaucoma can occur in people of all races and at any age. However, factors that increase a person’s risk include:
- Increasing age
- African American Heritage
- High blood pressure
- Family History
- Diabetes
- Extreme Nearsightedness
- Long-term steroid treatment
- Injury of trauma to the eye
Glaucoma should be checked for routinely at annual eye exams. If your eye doctor finds elevated pressures or suspicious looking optic nerves, further tests should be done to assess the risk of glaucoma. Eye Center of Texas offers the latest Humphrey Visual Fields and OCT (Ocular Coherence Tomography) testing to assess damage to the optic nerve from glaucoma. OCT is the most effective way to diagnose glaucoma.
If the diagnosis of glaucoma is made, there are several different treatment options. These options include medication, laser surgery, or filtration surgery. The goal of treatment is to lower the pressure in the eye.
Medication:
Glaucoma medication comes in pill and eye drop form. The majority of patients are treated with eye drops. Most medications must be taken between one and three times a day. Today’s latest medications have very little side effects, but have to be used consistently to prevent blindness.
Laser surgery:
Selective Laser Trabeculoplasty is a non-invasive procedure which increases the outflow of fluid from the eye and lowers the pressure. It is effective in 80% of people and, many times, we can reduce the number of drops people use or eliminate the need for drops altogether. The average duration of effect is three to five years and can be repeated if necessary. The SLT is a painless procedure performed in the office and takes less than five minutes to perform. One eye is treated at a time and the second eye is usually treated a few days or a week after the first eye.
Endoscopic CycloPhotocoagulation (ECP) is another type of laser procedure. Instead of treating the drainage canal, ECP treats the ciliary body and reduces the amount of fluid production thereby reducing the intraocular pressure. ECP is usually preformed along with cataract surgery, but can be done on any patients who have had their cataract removed. This procedure is done on an outpatient basis and can usually reduce the number of drops people use or eliminate the need for drops altogether.
Filtration Surgery:
Filtration surgery is done when medication and/or laser surgery is unsuccessful at controlling the intraocular pressure. During this procedure, a new drainage channel is created to allow aqueous humor to drain from the eye.
It is important to understand these are all treatments for glaucoma but there is no cure. It is very important each patient continues to see their eye doctor for pressure checks every 3-6 months depending on the severity of the glaucoma and the pressure response to treatment.
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