Glaucoma

At Eye Site, we are able to detect, diagnose, and treat glaucoma.

What is glaucoma?
Glaucoma is an eye disease that causes progressive damage to the optic nerve, the part of the eye that carries visual information from the retina to the brain. If glaucoma goes untreated or undetected, a person will first lose their side vision and eventually may lose all of their sight. Glaucoma can be the silent stealer of vision, and annual eye exams are the best way to detect this disease.

Glaucoma occurs when the pressure in the eye is too high for the health of the optic nerve. The front of the eye constantly produces a fluid that supplies nutrients and maintains the eye’s shape. This fluid is constantly pumped in and drained out of the eye, causing the eye to have a fluid pressure known as intraocular pressure (IOP), which is measured at each annual eye exam. This pressure may be minimal, but if it persists in certain people, the blood supply to the optic nerve may be reduced, thus damaging vision.


Types of Glaucoma

  • Primary Open Angle Glaucoma (POAG): This is the most common type of glaucoma and usually is not associated with pain or vision loss until the more advanced stages.
  • Normal Tension Glaucoma (NTG): This type of glaucoma also has no pain or noticeable vision loss until the advanced stages, but NTG patients do not have an elevated IOP, making this type of glaucoma more difficult to initially diagnose.
  • Angle Closure Glaucoma: This type of glaucoma occurs when the anatomy of the eye causes a blockage in the fluid drainage system, which then causes an acute rise in IOP. Angle closure glaucoma usually has symptoms of pain, redness, and cloudiness in vision. This is considered a medical emergency and should be treated quickly before severe vision loss occurs.

Treatments

  • Medications (Eye Drops):  Eye drops are often prescribed for use once or several times a day to lower the IOP. 
  • Surgery:  This may be necessary if medications do not control the IOP. Surgery may be done with lasers or incisions.
  • Combination:  Some patients have more advanced or harder to control forms of glaucoma and may need both surgery and medications to control the disease.


Testing

  • Tonometry:  This is used to measure the IOP.
  • Visual Field Testing:  This is an automated test to evaluate peripheral vision.
  • Optical coherence tomography (OCT): This computerized machine measures the thickness of the nerve fiber layer in the retina, which usually thins overtime in patients with glaucoma. 
  • Gonioscopy: This technique is used to view and assess the anatomy of the eye and its drainage system.
  • Pachymetry:  This is a procedure that measures the thickness of the cornea.  Corneal thickness can affect the way in which we measure the IOP, as well as contributing to the risk for developing glaucoma.


Risk Factors for Glaucoma

  • Family history (highest correlation if a sibling has glaucoma)
  • Race (highest risk in African Americans)
  • Elevated IOP
  • IOP asymmetry
  • Thin cornea
  • Optic nerve cupping
  • Optic nerve asymmetry
  • Optic disc hemorrhage
  • Prior Trauma
  • Narrow angle anatomy
  • High myopia
  • Pigment dispersion syndrome
  • Steroid responder
  • Borderline screening

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