Glaucoma

Glaucoma is an eye disease characterized by damage to the optic nerve due to elevated intraocular pressure. It is traditionally diagnosed by combining three major tests: intraocular pressure measurement (tonometry), evaluation of the appearance of the optic nerve during the dilated eye exam, and visual field testing (perimetry). 

There is a higher-than-normal intraocular pressure in the primary form of open-angle glaucoma. 

Glaucoma in the Eye 

This elevation damages the nerve fiber layer of the retina that collects to form the optic nerve. An optic nerve affected by glaucoma will show “cupping” or extreme loss of nerve fiber tissue. A visual field test would then reveal some peripheral or side vision loss. 

Fortunately, several medical and surgical therapies for glaucoma successfully lower intraocular pressure and ultimately save vision in affected patients. Early diagnosis is the key to effective glaucoma treatment. 

In addition to measuring corneal thickness and using a Humphrey Visual Field machine, the  Optical Coherence Tomography (OCT) machine monitors the nerve fiber layer of the retina and the optic nerve. 

Using a scanning laser, the OCT is able to give our doctors both quantitative and qualitative data about the possible loss of nerve tissue and optic nerve damage. Studies have shown that up to 50% of nerve fiber must be lost before a visual field defect is noted on a visual field test. 

By utilizing baseline and yearly scans with the OCT, we can monitor for and address any small changes to the eye before further damage transpires. 

Glaucoma Treatment Options 

We offer many state-of-the-art laser and surgical options to treat glaucoma. 

During a comprehensive consultation with our doctors, if a procedure is decided upon, you may be offered one of the following techniques: 

• Selective Laser Trabeculoplasty (SLT): This laser technique is used for uncontrolled pressures in open-angle glaucoma. It works on the drainage filter in the eye to reduce fluid outflow resistance and lower intraocular pressure. 
• Laser Peripheral Iridotomy (LPI): For narrow-angle glaucoma, a small opening in the iris is created with a laser to prevent a sudden increase in pressure in the eye (acute closed-angle glaucoma). 
• Endoscopic Cyclophotocoagulation (ECP): For both open and narrow-angle glaucoma, an intraocular laser procedure focuses on the part of the eye that creates fluid. Treatment reduces fluid production, which, in turn, reduces intraocular pressure. 
• Mini-Express Tube Shunt Implantation: The implantation of a small drainage tube to increase the outflow of the eye fluid and maintain low intraocular pressure. 

iStent 

Controlling eye pressure is extremely important to reduce the risk of vision loss if you have glaucoma. The iStent, which is placed in your eye during cataract surgery, works to help control your eye pressure by improving the outflow of fluid from your eyes. 

If you have both glaucoma and cataracts, iStent may be right for you. Call our office or visit our cataracts page to read more. 

Schedule an Appointment  

If you are concerned about glaucoma or have been diagnosed, early detection and treatment are crucial for preserving your vision. Schedule an appointment at Total Eye Care to discuss your glaucoma care and learn the best solutions for managing your eye health.  

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