Glaucoma
Glaucoma is a disease of the optic
nerve. Glaucoma is a leading cause of blindness in the United States, especially for older
people. But loss of sight from glaucoma can often be prevented with early treatment.
Risk Factors for Glaucoma :
- Age
- Family history of glaucoma.
- African American.
- Past ocular injury.
- Increased eye pressure.
- Possibly corneal thickness (i.e., thin corneas may
underestimate true eye pressure).
It is important to understand that increased eye
pressure, although frequently associated with Glaucoma, is not necessary for the diagnosis
since the optic nerve can continue to lose function in the face of "normal
pressure" in many patients.
How is Glaucoma Detected?
Regular eye examinations are the best way to
detect glaucoma. An eye screening that checks eye pressure only is not sufficient. A
thorough glaucoma evaluation includes:
- Tonometry: Measures intraocular
pressure.
- Gonioscopy: Allows visualization
of the drainage angle of the eye.
- Optic nerve evaluation: To
evaluate if there is optic nerve damage. This can be done by direct visualization with
proper equipment. An additional method is with a new technically advanced optic nerve
analyzer using scanning laser tomography. This highly
advanced system is now available at the California Eye Medical Center.
- Visual Field Testing: This tests
the function of the optic nerve by mapping out the peripheral vision.
Glaucoma Treatment:
- Medications: Glaucoma is usually
controlled with eye drops taken on a daily basis. These medications decrease eye pressure.
- Laser surgery: Laser surgery
treatments may be recommended for different types of glaucoma. In chronic open angle
glaucoma, a procedure called a trabeculoplasty is performed to help facilitate fluid to
exit through the natural drain of the eye and therefore, decrease intraocular pressure.
This is done in an office setting, and usually takes less than five minutes. Dr. Sacks
performs Selective Laser Trabeculoplasty (SLT) in his office to lower
intraocular pressure. SLT is a safe and effective in-office procedure. It
usually requires only one treatment and may reduce or eliminate the need for topical
glaucoma drops. In many instances SLT can be used as a primary treatment, instead of
drops. Insurance covers the procedure in most cases. Ask Dr. Sacks if SLT is
right for your glaucomatous eye. In angle closure glaucoma, or narrow angles, a
laser peripheral iridotomy is performed to create a small opening in the iris. This too
takes less than five minutes in most cases and can be done in the office setting. Both
procedures are painless.
- Surgery in the operating room:
Microsurgical instruments are used to create a new drainage channel for the fluid in the
eye. This is typically done as an outpatient at a surgery center or hospital. This
procedure, called a trabeculectomy, or another procedure, called a "shunt"
procedure is usually done if medications or laser cannot control the pressure.
New Findings in Glaucoma:
A recent study, called the Ocular Hypertension
Treatment Study, revealed that measuring corneal thickness is an important variable in
helping the doctor to decide whether patients with ocular hypertension need to be treated
or not. Dr. Sacks performs this test with
Ultrasonic Pachymetry. Ask him!! |
