Glaucoma

West Texas Eye Associates expertly treat patients with glaucoma using a variety of medical and surgical procedures.

It is estimated that over two million Americans have some type of glaucoma and half of them do not know it. Glaucoma is a serious disease which may cause blindness, but seldom does when diagnosed and treated early. There are several types of glaucoma, the most common being Open-Angle Glaucoma. The eye receives its nourishment from a clear fluid that circulates inside the eye called aqueous humor. As this fluid is constantly produced, it must also be constantly returned to the blood stream through the eyes drainage canal called the trabecular meshwork.
Glaucoma Vision Example

In the case of Open-Angle Glaucoma, something has gone wrong with the drainage canal. When aqueous fluid cannot drain fast enough, pressure inside the eye begins to build. This excess fluid pressure pushes against the delicate optic nerve which connects the eye to the brain. If the pressure remains too high for too long, irreversible vision loss can occur. In the early stages, a person will not experience any symptoms and there is no pain or outside sign of trouble. The early visual changes are very slight and do not affect the central vision, but rather the peripheral vision (the top, sides, and bottom areas of vision) can be lost.

Angle-Closure Glaucoma, can occur if your iris is too narrow and closed. If the pupil gets bigger than the iris can accommodate, or if the pupil’s size changes too fast, that causes the iris’s outer edge to bunch up and block the drainage canals. As with Open-Angle Glaucoma, blocked drainage canals cause the IOP to increase rapidly, which in turn damages the optic nerve. Symptoms include severe pain and nausea, as well as redness of the eye and blurred vision. If you have these symptoms, seek medical treatment immediately.

Safe and accurate evaluation for the presence of Glaucoma involves several tests. Tonometry is a simple test which measures eye pressure. Ophthalmoscopy is used to visually examine the shape and color of the optic nerve. Perimetry is a test that maps the field of vision, allowing the doctor to see any pattern of visual changes caused by the early stages of Glaucoma. Gonioscopy is used to check whether the angle where the iris meets the cornea is open or closed.

To control Glaucoma, your doctor will use one of three basic types of treatment: medicines, laser surgery, or filtration surgery. A newer type of filtration surgery involves the use of a valve implant to control aqueous drainage from the eye. The goal of treatment is to lower the pressure in the eye.

Glaucoma can occur in people of all races and at any age. The likelihood of developing glaucoma increases if you are African-American, have a relative with glaucoma, are diabetic, are very nearsighted, or if you are over 35 years of age. Even with modern treatments, Glaucoma is one of the leading causes of preventable blindness. Everyone should be checked for glaucoma around age 35 and again at age 40. Those considered to be at higher risk, including persons over the age of 60, should have their pressure checked every year or two. With early detection and treatment, vision can be preserved in most cases, and patients are able to lead normal lives.

What is Glaucoma?

Normally, an inflow and outflow of fluid occurs within the eye. When the outflow of this fluid becomes blocked, pressure builds up in the eye. This increased pressure may damage the optic nerve in the back of the eye causing reduced vision.

How Glaucoma Affects Vision

In the early stages of Glaucoma, there may be no affect on your vision. As the fluid pressure in the eye rises, peripheral vision will slowly be lost producing a “tunnel vision” effect. As the disease progresses, all vision may decrease until no vision remains.

Medications

Many types of medications can control glaucoma when used properly. Medications for glaucoma may be either in the form of eye drops or pills. Some drugs reduce pressure by slowing the flow of fluid into the eye and others help to improve fluid drainage.

Glaucoma Surgery

Laser Irodotomy – Laser iridotomy uses a very focused beam of light to create a hole on the rim of the iris to help decrease pressure in the eye.

Laser Trabeculoplasty – Laser can be used to open the “angle” of the eye, to decrease pressure.

Trabeculectomy – Surgical treatments include removal of a small portion of the “angle” area of the eye allowing aqueous drainage.

Valve Implant – New developments include placement of a small valve to control the pressure of glaucoma.