Comprehensive Care for Glaucoma
What is Glaucoma?
Though there are various forms of glaucoma, they all result in a loss of vision due to nerve fiber damage in the retina and optic nerve. It may be associated with high intraocular pressure though this is not always true. We take glaucoma very seriously because the vision loss is slow, progressive and most importantly irreversible.
How is Glaucoma Diagnosed?
Many things are taken into consideration when diagnosing glaucoma. Family history, age, race, prescription, and overall health can all affect one's risk of developing glaucoma. During the eye examination, observation of the optic nerve and the nerve fiber layer, the drainage system, the intraocular pressure, corneal thickness and visual fields are all assessed. There are also many technological advances in the field of glaucoma that are allowing us to assess changes at a cellular level and detect changes earlier than years past.
The most advanced technology, called ocular coherence tomography (OCT), is utilized at Gaddie Eye Centers to assess changes in the optic nerve and nerve fiber layer. Think of the optic nerve as the conduit for nerve impulses between the retina and the brain. We look at many characteristics of the optic nerve, most importantly the cup to disc ratio.
This is a number between 0 and 1 of greater risk. As glaucoma progresses, the number gets larger as more and more of the nerve fibers that travel through the optic nerve are damaged. In later phases of the disease, various specialized peripheral field tests are also employed. Tonometry, or more commonly "eye pressure", is also assessed. We know that IOP is only one of the risk factors for the development of glaucoma and "normal" pressures are very specific to each person's situation.
What do we notice?
Unfortunately, for most forms of glaucoma, there are no symptoms. Because it is a slow and progressive disease, most people are unaware they have glaucoma until significant damage has already occurred. Because of this, we recommend annual exams to monitor the optic nerve for change.
How often should I be seen?
Due to the slow and lack of symptoms, patients who are at greater risk will be seen at least annually. Patients who are diagnosed with glaucoma, may be seen as often as 6 week intervals, depending on the severity of the disease.
How do we treat this?
The primary method of treatment is eye drops. There are various forms of eye drops that can be used to reduce the pressure in the eye. Currently, there is no medical treatment to protect the optic nerve or reverse damage that has already been done.
As the disease progresses, surgery may be necessary. There are various forms of surgery that may be recommended, depending on the type or severity of glaucoma. The non-invasive procedures include laser therapy, called either Selective Laser Trabeculoplasty (SLT) or Argon Laser Trabeculoplasty (AL). Both of these procedures facilitate an increase in the rate of fluid draining from within the eye without ever actually opening the eye. Invasive procedures include a trabeculectomy. Ask one of our doctors for more details on these and other surgical options.