Glaucoma

Glaucoma is the leading preventable cause of blindness in the U.S. It is estimated that over two million Americans have some type of glaucoma, and half of them don’t even know it. Although there’s no cure for glaucoma, the condition can usually be controlled, and if detected early enough, proper treatment may help minimize vision loss.

Glaucoma damages the optic nerve, the “cable” that carries messages from your eyes to your brain, allowing you to see. Glaucoma is typically caused by elevated eye pressure that results from an overproduction of fluid in the eye or a decreased ability of the eye to drain. The damage to the optic nerve is gradual, and there are often no warning signs.

Unlike other eye conditions, there is no pain, redness, or change in vision associated with glaucoma 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 of Texas can diagnose and detect glaucoma at an early stage before any vision is lost. By receiving regular check-ups, you can ensure your eye doctor is able to detect the earliest signs of glaucoma and deliver treatment that will keep the disease from progressing.

Symptoms of Glaucoma

In the early stages of glaucoma, patients rarely experience pain or any other outward signs of trouble. However, as the disease progresses, its symptoms may include:

  • Mild aching in the eyes
  • Gradual loss of peripheral vision
  • Seeing halos around lights
  • Reduced visual acuity (especially at night) that is not correctable with glasses

Are You at Risk of Glaucoma?

Certain groups, including people with a family history of glaucoma, older individuals, African-Americans, people with diabetes, and people taking steroid medications, are at a higher risk of glaucoma than others. And while everyone should be checked for glaucoma at age 35 and again at age 40, those considered to be at a higher risk — including everyone over the age of 60 — should have their eye pressure checked every year or two.

Diagnosing Glaucoma

Depending on the circumstances, the eye doctors at Kleiman Evangelista will use one (or more) of several approaches to determine whether you have glaucoma. These may include:

  • The use of tonometry to check your eye pressure. After applying numbing drops, a tonometer is gently pressed against your eye to measure and record your eye’s resistance and pressure.
  • An ophthalmoscope can be used to examine the shape and color of your optic nerve by magnifying and illuminating the inside of your 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 your field of vision. Looking straight ahead into a white, bowl-shaped area, you will be asked to 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, too, helps your doctor determine the type of glaucoma present.
  • Nerve fiber layer analysis is a new tool that helps doctors evaluate the nerve fiber layer that glaucoma often damages. It helps your doctor detect glaucoma as early as possible and provide close monitoring of the condition during follow-up visits.

Treating Glaucoma

There are a number of approaches to treating glaucoma, ranging from eye drops to surgery. Typically, treatment begins with glaucoma therapy that will preserve your current level of vision and prevent further vision loss. The rest of your unique treatment plan will depend on the type of glaucoma you have, the degree to which it has progressed, and an array of underlying risk factors. Additional treatment options include:

  • LPI: Laser Peripheral Iridotomy (LPI) is a laser treatment that targets the narrow angles between the iris and cornea in order to widen them. This increases fluid flow within the eye, allowing the eye to better regulate intraocular pressure.
  • SLT: Selective Laser Trabeculoplasty (SLT) is also a laser procedure, but one that’s used when patients have open-angle glaucoma. Results typically last from one to five years, and can be repeated as necessary. In some cases, SLT can eliminate the need for additional glaucoma medication.
  • iStent®: If you’ve been managing your glaucoma with medication and you begin to develop cataracts, an iStent® Trabecular Micro-Bypass may be an ideal option. This tiny implant has helped thousands of people with glaucoma manage their intraocular pressure while also reducing — or even eliminating — their need for hypotensive eye drops. If you’re considering cataract surgery, this once-in-a-lifetime opportunity can help manage both conditions at once.
  • CPC/ECP: Cyclophotocoagulation (CPC, or ECP if performed endoscopically) is an alternative glaucoma treatment that uses lasers to reduce fluid production in the eye. The procedure is most often used when medication and other surgical treatment options aren’t providing the desired results.

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