Glaucoma
Glaucoma
Glaucoma is a serious eye disease that may result in permanent damage to the optic nerve. Glaucoma is considered the “silent thief” of sight, as the patient generally has no pain and cannot detect the impact on vision until they are almost completely blind. If left untreated, glaucoma can lead to total blindness.
Glaucoma occurs when the normal flow of fluid in the eye is blocked, which increases the intraocular pressure and causes impairment to the peripheral vision. Glaucoma can be hereditary, and it occurs more frequently later in life. Diabetes patients and African-Americans are at higher risk for glaucoma. An injury to the eye may also cause glaucoma.
Glaucoma testing is done by your ophthalmologist or optometrist. Many different instruments can be used to check the intraocular pressure, which is one of many ways the doctor will determine if an eye has glaucoma. A normal intraocular pressure number is generally around 10-20; however, the pressure reading is only one piece of the puzzle. A pressure reading of 24 may fall into the “suspicious for glaucoma” category, and a pressure of 12 might be considered normal. The next step the doctor takes is examining the optic nerve, which is where glaucoma damage takes place. Glaucoma damage can actually occur with any pressure reading, so allowing your doctor to get a good look through a dilated pupil is extremely important. Glaucoma generally takes years to create vision loss, so if you are considered suspicious for glaucoma, it may take a few visits for the doctor to determine if you actually have glaucoma or not. There are other tests your doctor will advise that will help test for glaucoma damage. A visual field test pinpoints your peripheral vision, and an OCT, or optical coherence tomography, can analyze the optic nerve and tissue around it to pick up even the slightest loss. Your doctor may perform gonioscopy to examine the anterior chamber
where the cornea meets the iris, and pachymetry to help assess the accuracy of the intraocular pressure readings, based on how thick your corneas are.
Unfortunately, there is no cure for glaucoma, but there are many treatment options. When used on a daily basis, eye drops have been found effective in controlling the intraocular pressure and thereby controlling glaucoma damage. Selective laser trabeculoplasty, or SLT, is also effective and may be repeated later if necessary. iStent® is a microscopic device implanted at the time of cataract surgery that is showing good results at controlling intraocular pressure. If necessary, an incisional surgery, also called filtering surgery, may be performed by a surgeon specializing in glaucoma treatment.