Eye Diseases / Glaucoma Treatment
All About Glaucoma
The Second-Leading Cause of Blindness in the U.S.
Your eye has pressure just like your blood, and when this intraocular pressure (IOP) increases to dangerous levels, it damages the optic nerve. This can result in decreased peripheral vision and, eventually, blindness. Glaucoma is similar to ocular hypertension but with accompanying optic nerve damage and vision loss.
While most people are familiar with the eye disease Glaucoma, few are aware of why Glaucoma is such a significant threat to sight.
In general, most serious eye diseases, eye conditions or eye problems cause patients to experience symptoms that make them uncomfortable or disturb their vision. The most common type of Glaucoma is an exception to this rule. Glaucoma begins without any symptoms or obvious loss of vision. Glaucoma is quite insidious in onset and, if not diagnosed and treated early in its course, will lead to progressive, permanent, and unnoticed vision loss. This is what makes it essential to diagnose and treat Glaucoma as early in its course as possible.
Glaucoma is actually not a single disease but is a term that is used to describe a broad range of eye problems that damage the Optic Nerve and potentially cause loss of vision. The pressure inside the eye is called Intraocular Pressure (IOP) and generally falls within some range that is considered “normal”. Many patients are under the impression that Glaucoma is simply due to a high pressure within the eye. While an elevated Intraocular Pressure can be one cause of Glaucoma, and in fact is the most common cause of Glaucoma, a high IOP may not be the only cause of Glaucoma. There are many possible causes of Glaucoma. Regardless of the cause, the various types of Glaucoma share a common factor-if not diagnosed early, treated properly and controlled, it will result in permanent vision loss and potentially blindness.
Glaucoma is one of the leading causes of blindness for patients between the ages of 18-65 years of age. It is estimated that approximately 3 million people have Glaucoma, yet only half of those actually know that they have it. (http://www.glaucoma.org/). In the United States alone, there are approximately 100,000 patients who are believed to be legally blind from glaucoma.
Other estimates indicate that another 3-6 million people in the United States have higher than normal Intraocular Pressure (IOP), without obvious clinical signs of damage to the Optic Nerve. From this data, it is probable that there are another 1 million people who may have Glaucoma, but have not yet been diagnosed because they do not have access to eye care or even Glaucoma screenings.
The eye doctors at Thurmond Eye Associates find that the most disturbing attributes of Glaucoma are that it begins with a slow onset and there is a lack of visual symptoms. This makes Glaucoma easy to overlook unless patients are consistent about having routine eye examinations with Glaucoma testing. For that reason, we strongly recommend regular eye examinations and thorough Glaucoma testing.
How Often Should I be Tested for Glaucoma?
At Thurmand Eye Associates, our doctors recommend that all patients over 50 years of age who have no previous family history of Glaucoma or other general health conditions such as diabetes or high blood pressure, be evaluated for Glaucoma every two years.
If there is any family history of Glaucoma at all, or there are any other general health problems, we recommend patients be evaluated for Glaucoma every year beginning at age 40. In addition, we now also know that there is considerable risk for siblings of those who have Glaucoma. In the Nottingham Glaucoma Study (http://bjo.bmjjournals.com/cgi/content/abstract/90/1/59), it was found that the siblings of Glaucoma patients are 5 times the risk for developing Glaucoma by the age of 70 and therefore should be examined every year.
Glaucoma is a very complex eye disease, and not simply an elevated Intraocular Pressure (IOP). Nonetheless, when detected early it can be successfully treated. At Thurmond Eye Associates, our eye physicians and staff provide the full scope of advanced technology diagnostic testing and treatment, as well as taking the time necessary to give each patient the personal education needed to fully understand their condition in order to get the best possible outcomes for our patients.
Treatment of Glaucoma
Today, there are three main methods of treating Glaucoma: Medical Treatment of Glaucoma, Laser Treatment of Glaucoma and Surgical Treatment of Glaucoma. These treatment options for controlling Glaucoma are quite important, as Glaucoma has no cure. The good news is that in almost all cases, Glaucoma is treatable, but must be diagnosed as early as possible. Thanks to advances in Medical Treatment for Glaucoma, Laser Eye Surgery for Glaucoma and Surgery for Glaucoma, the eye doctors at Thurmond Eye Associates will be able to recommend an individual treatment plan that is best for you. The following information is limited to treatment of Primary Open Angle Glaucoma, as it is the most common type of Glaucoma. Primary Open Angle Glaucoma is treated by the three different approaches above depending on the severity of the disease and the ability of each treatment option to slow or halt the disease progression and preserve your vision.
Medical Treatment of Glaucoma
Primary Open Angle Glaucoma is most often treated with eye drops. There are many types of eye drops that can be prescribed to lower your Intraocular Pressure (IOP). By using a single type of medication or sometimes 2 eye drops in combination, more than 80% of the patients with Open Angle Glaucoma can be successfully treated. These eye drops work by either decreasing the amount of fluid being produced inside your eye or by increasing the rate of drainage of fluid from your eye. For most patients, using the eye drops as prescribed-1-2 times per day it is possible to control the Intraocular Pressure (IOP) and slow or even halt the loss of vision.
Unfortunately, some patients may experience side effects of these eye drops making the use of eye drops a poor treatment option. Also, some patients are unable to achieve adequate control with eye drops alone and require Laser Eye Surgery for Glaucoma in addition to the eye drops in order to maintain control.
Laser Treatment of Glaucoma
The use of Laser Eye Surgery for treatment for Glaucoma has become an important treatment option for many patients. In the past, Laser Eye Surgery for Glaucoma was considered a “last resort” before Glaucoma Surgery. Today, thanks to advances in lasers, using a laser treatment for Glaucoma in conjunction with the eye drop treatment or sometimes even using the laser treatment as the primary treatment are excellent options to help maintain control and slow or stop the progression of the disease. Laser Treatment for Glaucoma is widely used to help prevent vision loss and is becoming a Glaucoma treatment of choice for many patients who have problems with eye drops or are unable to use eye drops properly.
Selective Laser Trabeculoplasty (SLT) is a type of glaucoma laser treatment that helps to reduce the Intraocular Pressure (IOP) by creating more effective drainage of fluid through the Trabecular Meshwork. SLT is effective in reducing IOP by 20-25% in as many as 70-80% of patients undergoing this procedure. The effect of SLT may decrease over time, however, the benefit of SLT over an older treatment called Argon Laser Trabeculoplasty (ALT) is that SLT may be repeated with no damage to ocular structures.
Another type of Laser Eye Surgery, called Laser Peripheral Iridotomy, is a procedure used for the treatment of Anatomically Narrow Angles, Acute Angle Closure Glaucoma and Chronic Angle Closure Glaucoma.
The eye physicians and surgeons at Thurmond Eye Associates routinely perform Laser Eye Surgery for all types of Glaucoma. If Laser Treatment is the best option to help you control your Glaucoma, they will spend the time necessary to explain the risks and benefits so that you fully understand your treatment options.
Surgical Treatment of Glaucoma
For a small number of patients, even with the maximum medical therapy they can be achieved with Glaucoma eye drops and Laser Eye Surgery, it is still not possible to achieve stable control of their disease and stop the progression of vision loss. For these patients there are surgical procedures available to help achieve control of the Intraocular Pressure (IOP) and slow or stop the progression of the disease. These include removing a tiny piece of the Trabecular Meshwork, a surgical procedure called “Trabeculectomy”, “Sclerostomy” or “Filtering Procedure”, or even implanting a microscopic Glaucoma Valve to help reduce and stabilize the Intraocular Pressure (IOP) and prevent vision loss.