Glaucoma is an eye disease usually associated with elevated intraocular pressure (IOP) inside the eye that damages the optic nerve, resulting in vision loss. It is a chronic disease that usually has no symptoms and may damage your optic nerve before you notice actual changes in your vision. Three million Americans suffer from glaucoma but only half know they have it. Risk factors include:
- Age over 40
- African American or Hispanic/Latino descent
- A relative with glaucoma
- Higher than normal eye pressure
- History of eye trauma
- Thinner than normal corneas
Types of Disease
Open-angle glaucoma is the most common form, but some people have other types of the disease:
- Low-tension or normal-tension glaucoma: Optic nerve damage and narrowed side vision occur in people with normal eye pressure. Lowering eye pressure at least 30 percent through medicines slows the disease in some people. Glaucoma may worsen in others despite low pressures. A comprehensive medical history is important in identifying other potential risk factors, such as low blood pressure, that contribute to low-tension glaucoma. If no risk factors are identified, the treatment options for low-tension glaucoma are the same as for open-angle glaucoma.
- Angle-closure glaucoma: The fluid at the front of the eye cannot reach the angle (location of the drain) and leave the eye. The angle gets blocked by part of the iris. People with this type of glaucoma have a sudden increase in eye pressure. Symptoms include severe pain and nausea, as well as redness of the eye and blurred vision. If you have these symptoms, you need to seek treatment immediately. This is a medical emergency. If your doctor is unavailable, go to the nearest hospital or clinic. Without treatment to improve the flow of fluid, the eye can become blind in as few as one or two days. Usually, prompt laser surgery and medicines can clear the blockage and protect sight.
- Congenital glaucoma: Children are born with a defect in the angle of the eye that slows the normal drainage of fluid. These children usually have obvious symptoms, such as cloudy eyes, sensitivity to light, and excessive tearing. Conventional surgery typically is the suggested treatment, because medicines may have unknown effects in infants and be difficult to administer. Surgery is safe and effective. If surgery is done promptly, these children usually have an excellent chance of having good vision.
- Secondary glaucomas: These can develop as complications of other medical conditions. These types of glaucomas are sometimes associated with eye surgery or advanced cataracts, eye injuries, certain eye tumors, or uveitis (eye inflammation). Pigmentary glaucoma occurs when pigment from the iris flakes off and blocks the meshwork, slowing fluid drainage. A severe form, called neovascular glaucoma, is linked to diabetes. Dr. Clary currently treats this with Avastin injections. Corticosteroid drugs used to treat eye inflammations and other diseases can trigger glaucoma in some people.
Although glaucoma cannot be cured, progression of the disease can be stopped if it is closely monitored. Early detection and treatment to lower IOP are the best defenses against vision loss. There are three ways to lower eye pressure: medication, laser, and surgery.
Selective Laser Trabeculoplasty (SLT) is our current laser treatment of choice. It is an easy, painless procedure to perform and allows the eye to drain more fluid, thus decreasing the IOP. Recent studies show the high success rate of this treatment, and many surgeons nationwide are now using SLT as their first line therapy. All three of The Eye Center physicians excel in SLT.