Glaucoma Treatments

TYPES, SYMPTOMS, DIAGNOSIS & TREATMENT

Benfield Eye Care provides the latest in Glaucoma detection, examination, treatment, lasers, and surgery.  Dr. Benefield offers the SLT and AIT lasers, ECP, and Trabeculectomy Glaucoma procedures. (read more below) You can’t turn back time with Glaucoma, but it can be slowed down.  Excellence in eye care is what it is about. 

Glaucoma refers to a group of eye conditions that lead to damage to the optic nerve. This nerve carries visual information from the eye to the brain.  In most cases, damage to the optic nerve is due to increased pressure in the eye, also known as intraocular pressure (IOP).
The second most common cause of blindness in the United States, it usually happens when the fluid pressure inside the eyes slowly rises, damaging the optic nerve. Often there are no symptoms at first, but a comprehensive eye exam can detect it.

A clear liquid called aqueous humor circulates inside the front portion of the eye. In open-angle glaucoma, this liquid does not flow efficiently through the eye’s sponge-like drainage system (known as the trabecular meshwork). When this liquid fails to drain properly, pressure builds within the eye.

A complete eye exam is needed to diagnose glaucoma. You may be given eye drop to widen (dilate) your pupil. The eye doctor can look at the inside of the eye when the pupil is dilated. A test called (tonometry) is done to check eye pressure. However, eye pressure always changes. Eye pressure can be normal in some people with glaucoma. This is called normal-tension glaucoma. Your doctor will need to run other tests to confirm glaucoma.

Early treatment can help protect your eyes against vision loss. Treatments usually include prescription eyedrops and/or surgery.

When is surgery necessary?  When medications or laser treatment cannot lower eye pressure enough, surgery is usually recommended.  Of the possible procedures, glaucoma filtration surgery, also called trabeculectomy, is the most common.

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People at risk should get eye exams at least every two years.  They include:
– African Americans over age 40
– People over age 60, especially Mexican Americans
– People with a family history of glaucoma

There are four major types of glaucoma:  (learn more)
– Open-angle (chronic) glaucoma
– Angle-closure (acute) glaucoma
– Congenital glaucoma
– Secondary glaucoma

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SYMPTOMS OF GLAUCOMA

OPEN-ANGLE GLAUCOMA
– Most people have no symptoms
– Once vision loss occurs, the damage is already severe
– There is a slow loss of side (peripheral) vision (also called tunnel vision)
– Advanced glaucoma can lead to blindness

ANGLE-CLOSURE GLAUCOMA
– Symptoms may come and go at first, or steadily become worse
– Sudden, severe pain in one eye
– Decreased or cloudy vision, often called “steamy” vision
– Nausea and vomiting
– Rainbow-like halos around lights
– Red eye
– Eye feels swollen

CONGENITAL GLAUCOMA
– Symptoms are usually noticed when the child is a few months old
– Cloudiness of the front of the eye
– Enlargement of one eye or both eyes
– Red eye
– Sensitivity to light
– Tearing

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TREATMENT
The goal of treatment is to reduce eye pressure. Treatment depends on the type of glaucoma that you have. If you have open-angle glaucoma, you will probably be given eye drops. You may need more than one type. Most people can be treated successfully with eye drops. Most of the eye drops used today have fewer side effects than those used in the past. You may also be given pills to lower pressure in the eye.

Other treatments may involve:

– Laser therapy called an iridotomy
– Eye surgery if other treatments do not work
– Acute angle-closure attack is a medical emergency. Blindness will occur in a few days if it is not treated.

If you have angle-closure glaucoma, you will receive:
– Eye drops
– Medicines to lower eye pressure, given by mouth and through a vein (by IV)

Some people also need an emergency operation, called an iridotomy. This procedure uses a laser to open a new pathway in the colored part of the eye. This relieves pressure and prevents another attack. Congenital glaucoma is almost always treated with surgery. This is done using general anesthesia. This means the patient is asleep and feels no pain. If you have secondary glaucoma, treatment of the underlying disease may help your symptoms go away. Other treatments may be needed.

OUTLOOK (PROGNOSIS)
Open-angle glaucoma cannot be cured. However, you can manage your symptoms by closely following your doctor’s instructions. Regular check-ups are needed to prevent blindness. Angle-closure glaucoma is a medical emergency. You need treatment right away to save your vision. Babies with congenital glaucoma usually do well when surgery is done early. How well a person with secondary glaucoma does depends on the disease causing the condition.

WHEN TO CONTACT A MEDICAL PROFESSIONAL
Call your health care provider if you have severe eye pain or a sudden loss of vision, especially loss of peripheral vision.
Call for an appointment with your health care provider if you have risk factors for glaucoma and have not been screened for the condition.

PREVENTION
All adults should have a complete eye exam before age 40, or sooner if you have risk factors for glaucoma or other eye problems. You are more likely to get glaucoma if you are African American or have a family history of open-angle glaucoma. If you are at high risk for acute glaucoma, talk to your doctor about having eye surgery to prevent an attack.