Glaucoma

Glaucoma is usually caused by an increase in fluid production or a decrease in fluid drainage in the eye. The change in fluid levels eventually destroys the optic nerve fibers and results in loss of vision.

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There are a few types of glaucoma:

Open-angle glaucoma, the most common type, often goes undiagnosed because there is no discomfort or pain, and no change in vision until there is already a significant loss. 

Angle-closure glaucoma is quite rare, but has much more pronounced symptoms that include blurred vision, pain, halos around lights, and even nausea. It is caused by a rapid increase of pressure inside the eye due to blocked fluid drainage channels.

Normal-tension glaucoma (NTG), is also known as low tension or normal pressure glaucoma. In this type of glaucoma, damage occurs to the optic nerve without eye pressure exceeding the normal range. 

When detected early, glaucoma can usually be treated and vision can be preserved. There is no cure, though-once vision is lost it cannot be restored.

Risk factors to consider:

Although glaucoma can occur at any age, the risk of developing glaucoma increases dramatically after age 40. That risk increases further after age 60.

African Americans are at a higher risk of developing glaucoma and should begin having their eyes checked earlier.

Asian Americans are at higher risk of developing angle-closure glaucoma.

Other glaucoma risk factors include:

  • Family history of glaucoma

  • Diabetes

  • High blood pressure or heart disease

  • History of eye injuries. Injury can also dislocate the lens, closing the drainage angle.

  • Retinal detachment

  • Eye tumors

  • Eye inflammations, such as chronic uveitis and iritis

  • Farsightedness

  • Prolonged use of steroid eye drops

Treatment Options

 

Medical

Traditional treatments for glaucoma are the use of eye drops on a regular schedule to control eye pressure and other medications. Both are safe and effective at treating glaucoma. Some work by slowing down the production of fluids or by improving drainage of fluid from the eye. Below are some common glaucoma medication types:

Prostaglandin Analogues - Xalatan®, Lumigan®, Travatan Z®

Beta-Blockers - Timolol®, Betimol®, Istalol®, Betagan®

Carbonic Anhydrase Inhibitors (CAI) - Azopt®, Trusopt®

Alpha-Agonists -  Alphagan

 Laser

An alternative to medications are laser treatments that may reduce or eliminate the need for medications or help them work better.

 

Selective Laser Trabeculoplasty (SLT) 

The laser is applied through a slit-lamp microscope, similar to what is used during eye exams. This painless procedure takes about 5 minutes and is performed in the clinic. The IOP should decrease within several weeks of the procedure. 

 

ECP (Endoscopic Cyclophotocoagulation) is a procedure in which the surgeon uses a laser to reduce the production of excess fluid in the eye and thus reduce pressure on the optic nerve. It's a relatively gentle procedure and is very precise, which prevents undesirable collateral tissue damage. ECP is an excellent choice for cases in which the eye is already undergoing surgery.

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