Glaucoma

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Glaucoma

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Glaucoma is a disease of the optic nerve. That is the nerve that carries the images from the eye to the brain. Glaucoma is one the most common causes of blindness. It is the leading cause of blindness for African-Americans. Glaucoma has been called the "Sneak Thief of Sight" because; in its most common form it has no symptoms; no blurred vision, no pain, no redness or swelling. People with glaucoma can go a long time with the disease and not know that anything is wrong until it is very late in the disease process.

Elevated pressure in the eye is the hallmark of glaucoma. There is fluid that is made in the eye that builds up because it can not get out through the internal drainage channels of the eye. Therefore, the pressure becomes elevated. This pressure slowly causes the death of nerve cells in the optic nerve, leading to loss of vision. Early diagnosis and treatment are essential in the prevention of visual loss due to glaucoma.

There are different categories of glaucoma:

Open Angle – This is the most common form of glaucoma which does damage slowly and silently.
Narrow Angle – This can also be a silent type of glaucoma or it can present as an acute closed angle attack which is characterized by blurred vision, pain, redness, and headache and even vomiting.
Secondary Glaucoma – This can develop following an eye injury, from disease and even from some medications such as Prednisone.
Congenital Glaucoma – This occurs when there is high pressure in the eye even at birth, causing visual loss.

The treatment of glaucoma involves drop therapy, laser (SLT, ALT, LPI, ECP, YAG CP), and filtering surgery.

Treatments and Addtional Information

Nd:YAG Laser Cyclophotocoagulation
Neodymium:YAG Laser Cyclophotocoagulation (YAG CP) is for patients with very severe glaucoma damage where all other procedures have failed. The ciliary body that produces the fluid inside the eye is destroyed.
Laser Peripheral Iridotomy (LPI)
For patients with narrow angle glaucoma, a small hole is placed in the iris to open up the angle between the iris and the cornea to facilitate fluid drainage.
Endocyclophotocoagulation (ECP)
For patients who are having cataract surgery and have glaucoma as well. This laser is applied to the ciliary processes (the area where the fluid is made in the eye) so that fluid production is slowed down. This in turn, lowers the pressure inside the eye.
Filtering Surgery (Trabulectomy)
For patients in whom medications and laser have not been helpful, a new drainage passage is created by cutting a small hole in the sclera (the white part of the eye) and a reservoir is made between the sclera and the conjunctiva (the thin clear covering of the eye)
Laser Trabeculoplasty
For patients who have open angle glaucoma, Selective Laser Trabeculoplasty (SLT) and Argon Laser Trabeculoplasty (ALT) are used to open the drainage system in these patients so that the internal drainage system of the eye functions better. In that way, the pressure is then lowered in the eye. This procedure is effective in 75% of patients.