Glaucoma is a condition in which the pressure in the eye becomes too high and causes damage to the optic nerve. There is an internal flow of fluid in the eye that consists of inflow and outflow mechanisms. Glaucoma is thought to be a result of a decrease in the outflow mechanism, which results in a rise in pressure.
In the early stages of open angle glaucoma, the most common type of glaucoma, there are no symptoms. Early optic nerve damage causes very subtle changes in the peripheral field of vision, which are not noticeable. However, if the glaucoma goes untreated, the visual field defects become larger, and by the time the patient notices a problem, the optic nerve has been damaged and it is irreversible. End-stage glaucoma results in tunnel vision.
Glaucoma is a leading cause of blindness in the United States, and effects approximately 3% of the general population. But loss of sight from glaucoma is often preventable if treatment is started early. Routine glaucoma checks are crucial in the detection and prevention of vision loss.
At the Northwest Eye Center we use applanation tonometry to check intraocular pressure, Our doctors perform a full dilated eye exam to observe the optic nerve and look for suspicious glaucomatous changes. If necessary, a computerized automated peripheral field of vision exam may be performed to detect early visual field defects, and a laser scan of the optic nerve to detect optic nerve thinning.
Glaucoma can usually be treated with eye drops, once or twice daily. There are a multitude of prescription eye drops available for the treatment of glaucoma.
Laser treatment is also available in the treatment of glaucoma for the patient who does not want to use eye drops or whose glaucoma is not responding to eye drops. At the Northwest Eye Center we offer Selective Laser Trabeculoplasty, or SLT. This procedure directs laser light to the angle of the eye where the outflow mechanism is located in an effort to increase the outflow of fluid, thereby decreasing the pressure.
SLT is effective in at least 85% of cases, and is a simple, low risk procedure that only takes minutes to perform in our office. This is a painless procedure with no post-operative restrictions. This technology is safer than previous forms of laser surgery used for glaucoma, and can be repeated if necessary.
If cataract surgery is necessary in a patient being treated for glaucoma, a micro iStent can be placed during the cataract surgery to decrease the eye pressure. This iStent allows for an alternative route for fluid to leave the eye, effectively bypassing the normal outflow mechanism that is not functioning properly in glaucoma. This may decrease the pressure in the eye enough to discontinue eye drops, and help the long-term prognosis of open angle glaucoma.
Narrow Angle Glaucoma
Narrow angle glaucoma is a much less common form of glaucoma that may lead to angle closure glaucoma. In this condition, the eye pressure builds up rapidly, and the eye becomes red and painful, with decreased vision.
This is a medical emergency and without treatment within hours, blindness may occur.
On a routine eye exam, our doctors may be able to detect a narrow angle, and a risk for a closed angle attack. If so, a preventive laser treatment, peripheral iridotomy, can be performed in the office at the Northwest Eye Center. This may prevent a closed angle, and the loss of vision.
Vision loss from glaucoma is in most cases preventable with appropriate treatment. Let the Northwest Eye Center evaluate your eyes to see if you are at risk for developing this treatable condition.