Glaucoma Treatment Center
What Is Glaucoma?
Glaucoma is a disease of the optic nerve. It causes a
characteristic loss of nerve tissue manifested by loss of nerve
cells or axons going into the optic nerve. There are many different
types of glaucoma. Two of the most common are the primary open
angle glaucoma and angle closure glaucoma. Glaucoma is not a
lifestyle disease. Diet or lack of exercise is not a cause of Glaucoma like
so many other illnesses.
Glaucoma Causes
While we always recommend a healthy lifestyle, the cause of glaucoma
is largely due to genetics, family history, and simple aging. Over
100 genes have now been found to cause glaucoma. It is important to
realize that sometimes these genes can show up even without a family
history. Glaucoma continues to be one of the leading cause of
blindness worldwide. While there is no cure for glaucoma,
there are many treatments to manage and control glaucoma. All
of these treatments at Longwood
Eye require ongoing care.
Types of Glaucoma:
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Chronic or primary open-angle glaucoma
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Acute closed-angle glaucoma
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Congenital glaucoma
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Pigmentary glaucoma
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Secondary glaucoma
Glaucoma Treatment
Glaucoma treatment consists of three methods including medications,
laser, or surgery. The treatment is based on the type
of glaucoma and the severity. For mild “open angle” glaucoma, a
once a day drop may be all that is necessary. For “closed
narrow-angle” sometimes called acute glaucoma, a laser procedure is
often done called a laser iridotomy. This creates a small hole in
the iris and allows for fluid to easily pass through the eye into
the drainage canals and prevents the iris from blocking fluid in
this time of glaucoma. Another type of laser glaucoma treatment is
called Selective
Laser Trabeculoplasty (SLT) which is for “open
angle” glaucoma allows better fluid drainage from the eye. SLT has
a good safety record and can also be used in place of drops as a
good alternative. New laser option called Micropulse Laser
Trabeculoplasty (MLT) is now available in our Gardner location.
Trabeculectomy And Tube Shunt Procedure
Surgery for glaucoma Trabeculectomy
and Tube Shunt procedure typically involves making
a new drain. It is only done for more serious types of glaucoma
when vision is threatened. Some newer techniques of glaucoma
treatment such as stents and ciliary ablative procedures are
currently in development at Eye and Lasik Center and may be
available shortly. It is important to know that all medications,
lasers, and surgeries have unique benefits and risks. A discussion
with your doctor will help determine which glaucoma treatment is
best for you.
Glaucoma Symptoms
Early glaucoma has no symptoms. This
can be a problem because even though you have no symptoms, the
damage to your eye is being done. Often the
cause of glaucoma is high eye pressure but there are cases in which
the eye pressure is normal. These cases are known as low pressure
or normotensive glaucoma. Early detection is key to preventing
vision loss.
Glaucoma Diagnoses
Routine eye exams are important to check for
glaucoma and detect it in its earliest stages. A dilated exam and
check of eye pressure is done as well a variety of other tests such
as optic nerve function, imaging tests, and peripheral vision exams.
Glaucoma treatment is most effective in preventing further
deterioration of the nerve in the early stages.
Why Are There So Many Tests Necessary for Glaucoma?
Glaucoma treatment begins with a diagnosis, but Glaucoma is not easy
to diagnose in its earliest stages. Detecting progressing disease
can be tricky. Each test uses different methods to measure optic
nerve function. Imaging tests called retinal nerve fiber tests or Optical
Coherence Tomography (OCT) tests measure the thickness
of the optic nerve fibers. Visual field tests (VF) measure the
sensitivity of light seen in the peripheral vision. This is one key
finding in all glaucoma especially as it advances. A new technique
known as VEP or ERG testing is now available at the Eye and Lasik
Center. These tests measure the electrical signals from the optic
nerve or retina and can detect subtle abnormalities in function.
Advanced Testing is Now Available
A study from Bascom Palmer Eye Institute in Florida found this new
test can detect glaucoma 8 years earlier than our traditional ODT
and VF tests. All tests can have false positives and false
negatives and variability. The only way to know if a patient is
truly getting worse is to do these tests multiple times. With this
information, your doctor can develop a “rate of progression” and be
able to know how aggressively to conduct glaucoma treatment. This
allows your doctor to personalize your care to your particular
needs.
Diagnostic Equipment Used For Glaucoma Treatment
OCT
Ocular Coherence Tomography (OCT) is a state-of-the-art diagnostic
technology that provides direct, real-time, cross-sectional images
of the retina. This technology is much like ultrasound technology,
except it uses light waves rather than ultra-sound waves. The OCT
scans an infrared red light across the retina, which generates a
cross-sectional image of the tissues in great detail.
This test is quick, requires no dilation, and enables the doctor to
view and accurately measure structural changes in the retina, as if
it were under a microscope. The high-resolution images produced by
OCT allow for early diagnosis and treatment of a wide variety of
conditions, including glaucoma, macular edema, macular hole, and
age-related macular degeneration.
HVF
The Humphrey Visual Field (HVF) analyzer is a sophisticated
instrument used to provide a computerized measure of peripheral
vision. The analyzer can detect visual field defects before they
become symptomatic. It is an essential tool in the detection and
management of a variety of eye and central nervous system diseases,
including glaucoma, stroke, and brain tumors.
Risks of Glaucoma
Glaucoma is still the second leading cause of preventable blindness
in the USA despite all our treatments. The main reasons for this is
the fact that the disease has no symptoms at the beginning of the
disease, problems adhering to medications that may have side
effects, and compliance with difficult treatment regiments.
Uncommonly the disease itself is difficult to treat due to its
unique genetics. It
is important to know there is great variability in glaucoma.
It is important to know there is great variability in glaucoma. It’s
not really one disease but a disease of a thousand different causes
and the ones unique to you, we can treat. The good news is
that with today’s early diagnosis, better diagnostic instruments,
better medications, improved surgeries, and good follow up care, the
vast majority of patients will avoid any serious vision loss.
Glaucoma is clearly an illness that needs careful medical care to
optimize good results.
Schedule A Consultation
If you are in need of glaucoma treatment contact one of our
Massachusetts locations. Call (800)
676-5050 to schedule a
consultation today!