Diagnosing & Treating All Types of Glaucoma

Glaucoma is a group of eye diseases that gradually steals your sight without warning and often without symptoms. Every year, millions of people around the world develop glaucoma each day. Without treatment, glaucoma can cause blindness.

Nothing is more precious than your eyesight. Glaucoma services at the Moran Eye Center provide specialized diagnostic, medical, and surgical care for those diagnosed with glaucoma.

We understand being diagnosed with glaucoma can raise a lot of questions. Our specialists can help answer your questions and provide you with medical and surgical treatment options.

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What Is Glaucoma?

Glaucoma is a group of diseases that cause damage to the optic nerve. The optic nerve is the part of the eye that carries the images we see to our brains.

Glaucoma is often called the silent thief of sight, slowly stealing vision without warning and often without symptoms. If left untreated, glaucoma can lead to blindness.

It was once thought that elevated pressure inside of the eye was the main cause of optic nerve damage. Although elevated pressure is clearly a risk factor, we now know that other factors must also be involved because even people with “normal” pressure can experience vision loss from glaucoma.

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Services

  • Evaluation and treatment for both open-angle and narrow-angle glaucoma.
  • Glaucoma surgery involving glaucous, I-Stent, Solx, and more.

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What Causes Glaucoma?

Glaucoma is caused by a number of different eye diseases, which in most cases produce increased pressure within the eye. In an eye that has glaucoma, more fluid is produced than can be removed by the eye. With nowhere else to go, this fluid builds up in the front of the eye, causing an increase in pressure. Over time, this increase in pressure transfers to the rest of the eye.

The optic nerve, the weakest area of the eye, is most vulnerable to damage from this elevated pressure. Continuous elevated pressure, or spikes in pressure, can damage the optic nerve, which may result in vision loss and can also lead to blindness if left untreated.

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How Fluid Circulates in the Eye

To understand how glaucoma develops, we must first understand how fluid circulates within the eye. Fluid is produced inside of the eye by a structure known as the ciliary body. This structure is located just beneath the iris. The fluid then travels through the pupil and exits via the eye’s drainage system, called the trabecular meshwork.

In healthy eyes, there is a normal balance between the fluid that is made in the eye and the fluid that leaves the eye. Therefore, this fluid creates a relatively constant and healthy pressure within the eye. This pressure is needed to keep the eye inflated, nourished, and functioning properly. This is what we mean by the eye “pressure,” and your eye doctor measures it routinely.

What Are My Chances of Developing Glaucoma?

Glaucoma is one of the most common causes of blindness; therefore, everyone needs to be aware of this disease. However, certain people are at a greater risk of developing this disease than others.

High-Risk Individuals

Individuals who have a high risk of developing glaucoma include the following:

  • People over the age of 40.
  • Individuals who are severely myopic or nearsighted.
  • People who have diabetes.
  • People diagnosed with hypertension, long-term steroid, or cortisone users.
  • People of African or Mediterranean descent.
  • People who have family members with the disease.
  • Individuals who have experienced a serious injury or trauma to their eye.
  • Those who have high intraocular pressure.
  • People with enlarged optic nerves.

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Symptoms & Diagnosis

Glaucoma Symptoms

Most people who have glaucoma do not notice any symptoms until they begin to lose some vision. Because optic nerve fibers are damaged by glaucoma, small blind spots may begin to develop, usually in the side (or peripheral) vision. Many people do not notice the blind spots until significant optic nerve damage has already occurred. If the entire nerve is destroyed, blindness results.

Symptoms of Acute Angle-Closure Glaucoma

One type of glaucoma, acute angle-closure glaucoma, does produce noticeable symptoms because there is a rapid build-up of pressure in the eye. The following are the most common symptoms of this type of glaucoma. However, each individual may experience symptoms differently. Symptoms may include:

  • Blurred or narrowed field of vision
  • Severe pain in the eye(s)
  • Halos (which may appear as rainbows) around lights
  • Nausea
  • Vomiting
  • Headache

The symptoms of acute angle-closure glaucoma can resemble other eye conditions. Consult a physician for diagnosis immediately if you notice symptoms, as this type of glaucoma is considered a medical emergency requiring prompt medical attention to prevent blindness.

Glaucoma Diagnosis 

How Is Glaucoma Diagnosed?

In addition to a complete medical history and eye examination, your eye care professional may perform the following tests to diagnose glaucoma:

  • Visual acuity test – The common eye chart test, which measures vision ability at various distances.
  • Pupil dilation – The pupil is widened with eye drops to allow a close-up examination of the eye's retina.
  • Visual field – A test to measure a person's side (peripheral) vision. Lost peripheral vision may be an indication of glaucoma.
  • Tonometry – A standard test to determine the fluid pressure inside the eye.

Treatment

Glaucoma is a highly detectable disease. It is essential that high-risk glaucoma patients have annual eye examinations to ensure continued ocular health.

Your physician will help you determine the best treatment option for based on:

  • Your age, overall health, and medical history.
  • Extent of the disease.
  • Your tolerance for specific medications, procedures, or therapies.
  • How the disease might progress.

Treatment Options

While glaucoma cannot be cured, early treatment can often control it. Treatment may include:

  • Medications - Some medications cause the eye to produce less fluid while others lower pressure by helping fluid drain from the eye.
  • Conventional surgery - The purpose of conventional surgery is to create a new opening for fluid to leave the eye.
  • Laser surgery (also called laser trabeculoplasty) - Several types of surgical procedures can be performed with a laser that are used to treat glaucoma, including:
    • Trabeculoplasty. In this (most common) type of laser surgery to treat open-angle glaucoma, a laser is used to place "spot welds" in the drainage area of the eye (known as the trabecular meshwork), which allows fluid to drain more freely.
    • Iridotomy. In this procedure, the surgeon uses the laser to make a small hole in the iris—the colored part of the eye—to allow fluid to flow more freely in the eye.
    • Cyclophotocoagulation. This procedure uses a laser beam to freeze selected areas of the ciliary body—the part of the eye that produces aqueous humor—to reduce the production of fluid.
  • Tube shunt - This implantable drainage device creates an artificial pathway in the eye. It is made from a miniature, stainless steel tube and can be implanted in less than five minutes. A tube shunt is usually selected after considering conventional surgical treatments.

In some cases, a single surgical procedure is not effective in halting the progress the glaucoma, and repeat surgery and/or continued treatment with medications may be necessary.