Glaucoma

Glaucoma is a disease that affects the optic nerve and involves loss of vision due to a buildup of pressure inside the eye (intraocular pressure).

Glaucoma has been nicknamed the “sneak thief of sight” because the loss of vision normally occurs gradually over a long period of time and is often only recognized when the disease is quite advanced. Once lost, this damaged visual field can never be recovered.

Glaucoma affects 1 in 200 people aged fifty and younger, and 1 in 10 over the age of eighty.

Worldwide, it is the second leading cause of blindness.

If the condition is detected early enough, it is possible to arrest the development or slow the progression with medical and surgical means.

Glaucoma can be divided roughly into two main categories, “open angle” and “narrow angle” glaucoma.

Open Angle Glaucoma

Open angle, chronic glaucoma tends to progress more slowly and the patient may not notice that they have lost vision until the disease has progressed significantly.

Narrow Angle Glaucoma/Closed Angle Glaucoma

Closed angle glaucoma can appear suddenly and is often painful; visual loss can progress quickly but the discomfort often leads patients to seek medical attention before permanent damage occurs.

The most common surgical treatment of glaucoma is a procedure to reduce the intraocular pressure. Regular eye checkups are essential for the detection and management of glaucoma.

Medications

Pills and eye drops can be used to treat primary open angle glaucoma. These are used to treat the pressure in the eye and although they won’t fully cure the patient, they can be used successfully to help the patient retain their vision. Drops and pills can also be used for angle closure glaucoma, in addition to medicine that may be administered through an IV. This will lower the pressure immediately.

Glaucoma Laser Surgery

Laser Trabeculoplasty

A surgery called laser trabeculoplasty is often used to treat open-angle glaucoma. During this surgery, a laser makes tiny, evenly spaced burns in the trabecular meshwork. The laser does not create new drainage holes, but rather stimulates the drain to function more efficiently.

Even if laser trabeculoplasty is successful, most patients continue taking glaucoma medications after surgery. For many, this surgery is not a permanent solution. Nearly half who receive this surgery develop increased eye pressure again within five years. Many people who have had a successful laser trabeculoplasty have a repeat treatment.

Laser trabeculoplasty can also be used as a first line of treatment for patients who are unwilling or unable to use glaucoma eyedrops.

Laser Iridotomy

Laser iridotomy is recommended for treating people with closed-angle glaucoma and those with very narrow drainage angles. A laser creates a small hole about the size of a pinhead through the top part of the iris to improve the flow of aqueous fluid to the drainage angle. This hole is hidden from view by the upper eyelid.

Surgery

A third treatment for glaucoma is surgery. This is usually reserved for patients that may not be a candidate for laser surgery. Surgery for glaucoma is called “filtering microsurgery.” During filtering microsurgery, Dr. Donelson will create a very tiny new drainage canal to allow the fluid to bypass the original canals and drain through the new canal. This process may be repeated if necessary. Talk to Dr. Donelson about the risks and benefits of various treatment options for glaucoma.

The most important thing about glaucoma is getting diagnosed and receiving treatment early. If you think you may have glaucoma, call us today to schedule an appointment with Dr. Donelson.

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