Glaucoma

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Glaucoma is a group of diseases that damage the eye’s optic nerve and can result in vision loss and blindness. However, with early detection and treatment, you can often protect your eyes against serious vision loss.

Eye pressure is a major risk factor for optic nerve damage. In the front of the eye is a space called the anterior chamber. A clear fluid flows continuously in and out of the chamber and nourishes nearby tissues. The fluid leaves the chamber at the open angle where the cornea and iris meet. When the fluid reaches the angle, it flows through a spongy meshwork, like a drain, and leaves the eye.

In open angle glaucoma  the fluid passes too slowly through the meshwork drain. Since the fluid builds up, the pressure inside the eye rises to a level that may damage the optic nerve. When the optic nerve is damaged from increased pressure, open-angle glaucoma-and vision loss—may result. 

Whether you develop glaucoma depends on the level of pressure your optic nerve can tolerate without being damaged. This level is different for each person. That’s why a comprehensive dilated eye exam is very important. It can help your ophthalmologist determine what level of eye pressure is normal for you.

Who is at risk for open-angle glaucoma? 

• anyone can develop glaucoma. 
• people at higher risk than others:
  • are over age 40
  • have family members with glaucoma
  • are of African, Hispanic, or Asian heritage
  • have high eye pressure
  • have had an eye injury
  • use long-term steroid medications 

At first, open-angle glaucoma has no symptoms. It causes no pain. Vision stays normal. Glaucoma can develop in one or both eyes. Because glaucoma has no symptoms when it is starting to develop it is very important to have yearly eye exams so that it can be detected early. 

 A glaucoma screening that only checks eye pressure  is not enough to find glaucoma.  The only sure way to diagnose glaucoma  is with a complete eye exam.

During a glaucoma exam,  we

• measure your eye pressure
• inspect your eye’s drainage angle
• examine your optic nerve for damage
• test your peripheral (side) vision
• take a picture or computer measurement of your optic nerve
• measure the thickness of your cornea

 Without treatment, people with glaucoma will slowly lose their peripheral (side) vision. As glaucoma remains untreated, people may miss objects to the side and out of the corner of their eye.  Over time, straight-ahead (central) vision may decrease until no vision remains.

A large determining factor in who develops glaucoma is genetics and age. Unfortunately there’s not much we can do to change either. However, there are some risk factors that can be controlled by:

• Maintaining proper blood glucose levels
• Maintaining proper blood pressure levels
• Avoid the long term use of steroid eye drops as well as systemic steroids

  We can’t completely prevent glaucoma, but we can prevent vision loss from glaucoma through early detection and appropriate treatment!  

There is no cure for glaucoma. Vision lost from the disease cannot be restored. For this reason, early detection is your best treatment!   

When glaucoma is detected, treatment options include

• eye drops to lower pressure in the eye
• in-office laser procedures

Drops and laser treatment are sometimes used in conjunction with each other. The type  of glaucoma as well as the degree to which it has progressed will dictate which options are best for a particular patient. Dr Johnson performs all available in-office glaucoma laser procedures. 

For patients who have glaucoma and cataracts,  glaucoma treatment in the form of a micro stent, the iStent , can be performed at the time of cataract surgery. If you are a candidate for both glaucoma and cataract surgery,, Dr Johnson will discuss the treatment most suitable for you.