Glaucoma

Glaucoma is a common disease that we treat at Eastside Eye Physicians.  Some individuals have a known family history of glaucoma, but in many cases, the only way it can be diagnosed is through a routine eye exam.

In our eyes, a clear fluid called aqueous circulates inside the font part of the eye.  To maintain a healthy eye pressure, your eye continually produces a small amount of aqueous while an equal amount of aqueous flows out of the eye.  If you develop glaucoma, it is typically because the aqueous humour does not flow out of the eye properly. Fluid pressure builds up in the eye and over time, the pressure is transmitted to the optic nerve fibers in the back of the eye, causing a gradual loss of peripheral vision. Ultimately in some cases, patients may have severe vision loss if their glaucoma is not detected early enough.

Signs and Symptoms

The early stages of open-angle glaucoma (the most common type) have no obvious symptoms, and half the people in the US with glaucoma are not even aware they have the condition.  Because there are no early symptoms, glaucoma can steal your sight very gradually over time.

Glaucoma can be diagnosed with a regular eye exam by measuring the pressure in the eye while the eyes are numbed with anesthesia.  Our ophthalmologists will inspect the eye’s drainage angle using gonioscopy, inspect the optic nerve once the eye is dilated, and perform tests such as corneal thickness, visual field testing, and ultrasound imaging of the optic nerve.  These tests are all used in the detection of glaucoma and are utilized to follow the disease once treatment is initiated.

Treatment

Treatment is tailored to your specific type of glaucoma and the severity of the disease.  We monitor initial response to treatment closely, and then make changes if necessary.  Medicated eyedrops are the most common way to treat glaucoma.  These drops lower the eye pressure in one of two ways – either by decreasing the production of aqueous humour or by improving the outflow of aqueous humour through the drainage angle.  In some patients, laser surgery known as Selective Laser Trabeculoplasty (SLT) may be recommended to help reduce the pressure.  In advanced cases, trabeculectomy surgery in the operating room may be necessary to help control the intraocular pressure and prevent vision loss.

A laser iridotomy is sometimes recommended for people with closed- angle glaucoma and those with a very narrow drainage angle.  This outpatient procedure is typically necessary only in a small percentage of glaucoma patients.

It is important that glaucoma patients understand there are many different ways to treat the disease.  While some patients may experience side effects from glaucoma medications or glaucoma surgery, the risk of any side effect should always be balanced with the risk of leaving glaucoma untreated and potentially losing vision.

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