Glaucoma is the leading preventable cause of blindness in the U.S. today. It is estimated that over two million Americans have some type of glaucoma and half of them do not know it. Although it cannot be cured, glaucoma can usually be controlled and vision loss may be minimized with early detection and treatment.
Glaucoma causes damage to the optic nerve, which is the “cable” that carries messages from our eye to the brain and allows us to see. Generally, elevated eye pressure caused either by overproduction of fluid within the eye or a decreased ability of the eye to drain, damages the optic nerve. This damage is gradual and there are often no warning signs. Unlike other eye problems, there is no pain, redness or change in vision until the late stages of the disease. Because there are so few symptoms, many patients are unaware of glaucoma’s progression until the disease causes permanent loss of vision.
The good news is that the eye doctors at Kleiman Evangelista Eye Centers can help diagnose and detect glaucoma at an early stage before any vision is lost. Regular check-ups in adults over the age of 35 can detect the earliest signs of glaucoma and with proper treatment, can keep the disease from progressing. Certain groups, including people with a family history of glaucoma, older individuals, African-Americans, people with diabetes and those taking steroid medications, are more at risk than others, making regular eye examinations even more important.
It is important to keep in mind that everyone should be checked for glaucoma at age 35 and again at age 40. Those considered to be at a higher risk, including those over the age of 60, should have their eye pressure checked every year or two.
Symptoms of Glaucoma
In the early stages of glaucoma, there are no symptoms. There is no pain or outward sign of trouble, but as the disease progresses, other symptoms may appear, such as:
- Mild aching in the eyes
- Gradual loss of peripheral vision—the top,sides and bottom areas of vision
- Seeing halos around lights
- Reduced visual activity (especially at night) that is not correctable with glasses
Are you at Risk?
Glaucoma can occur in people of all races at any age. The likelihood of developing glaucoma is increased in African Americans, diabetics, people with a family history of glaucoma, people who are very nearsighted, and anyone over 35 years of age.
To diagnose glaucoma, the doctors at Kleiman Evangelista Eye Centers will use tonometry to check your eye pressure. After applying numbing drops, the tonometer is gently pressed against the eye and its resistance is measured and recorded.
An ophthalmoscope can be used to examine the shape and color of your optic nerve by magnifying and illuminating the inside of the eye. If the optic nerve appears to be cupped or is not a healthy pink color, additional tests will be performed.
Perimetry is a test that maps the field of vision. Looking straight ahead into a white, bowl-shaped area, you will indicate when you are able to detect lights as they move into your field of vision. This helps your doctor determine the type of glaucoma present: open-angle glaucoma or narrow-angle glaucoma.
Gonioscopy is used to check whether the angle where the iris meets the cornea is open or closed. This will help your doctor determine the typoe of glaucoma present: open-angle glaucoma or narrow-angle glaucoma.
Nerve fiber layer analysis is a new tool to help evaluate the nerve fiber layer which can become damaged from glaucoma. It can allow your doctor to provide early detection of glaucoma and provide close monitoring of the condition during follow-up visits.
In the past there were few treatments for glaucoma; those treatments that did exist often had side effects that were worse than the disease. Fortunately, the Kleiman Evangelista Eye Centers now has many new treatment options available, including several new medications, both drops and pills, that can be used or taken several times a day with minimal side effects. New studies have also shown that laser treatment of glaucoma may be as good or better than initial treatment with medications.
Medicines for glaucoma slow the production of fluid within the eye by improving the flow through the drainage meshwork. Keep in mind, however, that these medicines should never be stopped without consulting your doctor and you should always notify all of your other doctors about the medications you are taking.
Surgeries that treat the drainage canal include both Argon Laser Trabeculoplasty and Selective Laser Trabeculoplasty surgery. Both procedures require only a few numbing drops before applying a laser beam to the trabecular meshwork resulting in an improved rate of drainage. When laser surgery is successful, it may reduce the need for daily medication.
Another laser procedure, Endoscopic CycloPhotocoagulation (ECP) is used to treat the ciliary body, reducing the amount of fluid production and intraocular pressure. ECP is most often performed along with cataract surgery, but can also be performed on an outpatient basis. The majority of patients having ECP reduce or eliminate their need to take glaucoma medications.
The iStent Trabecular Micro-Bypass stent is a new surgical therapy for glaucoma that is designed to improve aqueous outflow and safely lower intraocular pressure. Discover more here.