Glaucoma is the leading cause of blindness and visual impairment in the United States. A simple painless eye exam can detect the disease. With early detection and treatment, glaucoma can usually be controlled and blindness prevented.
There are two main types of glaucoma, open-angle and angle-closure. Open-angle glaucoma is the most common type of glaucoma and involves fluid in the eye not draining properly through the trabecular meshwork. Angle-closure glaucoma involves a sudden buildup of pressure in the eye and poor drainage because the angle between the iris and the cornea is too narrow.
Many patients do not experience any symptoms during the early stages of glaucoma, including no pain and no vision loss. This makes it difficult for many patients to know if they have the disease. But as glaucoma progresses, patients may experience a loss of peripheral or side vision, along with sudden eye pain, headache, blurred vision or the appearance of halos around lights.
Glaucoma can affect anyone from newborn infants to the elderly. It has been estimated that up to 3 million Americans have glaucoma. People who are at a greater risk for glaucoma usually have the following conditions:
- At least 45 years old without regular eye exams
- A family history of glaucoma
- Abnormally high eye pressure
- African descent
- A family history of glaucoma
- Previous eye injury
- Regular, long-term use of cortisone/steroid products
To detect glaucoma, we test your visual acuity, visual field, dilate your pupils and test the pressure in your eye. Regular and complete eye exams help to monitor the changes in your eyesight and will help to determine whether you may develop glaucoma.
Treatment to control glaucoma include medications in the form of either eye drops or pills, laser surgery and conventional surgery.
When eye drops do not adequately lower eye pressure enough to control a patient’s glaucoma, laser surgery or other glaucoma surgery may be recommended. Patients with a special condition called narrow angles can have angle closure glaucoma attacks, which can be prevented or treated with laser surgery to the iris.
Common surgeries include:
Laser Peripheral Iridotomy (LPI) – For patients with narrow-angle glaucoma. A small hole is made in the iris to increase the angle between the iris and cornea and encourage fluid drainage.
- Argon Laser Trabeculoplasty (ALT) – For patients with primary open angle glaucoma (POAG). The trabecular passages are opened to increase fluid drainage. ALT is effective in about 75% of patients, and treatment may be repeated.
- Nd: YAG Laser Cyclophotocoagulation (YAG CP) – For patients with severe glaucoma damage who have not been helped with other surgeries. The ciliary body that produces intraocular fluid is destroyed.
- Filtering Microsurgery (Trabeculectomy) – For patients who have not been helped with laser surgery or medications. A new drainage passage is created by cutting a small hole in the sclera (the white part of the eye) and creating a collection pouch between the sclera and conjunctiva (the outer covering of the eye).