Glaucoma is usually caused by an increase in fluid production or a decrease in fluid drainage in the eye. The change in fluid levels eventually destroys the optic nerve fibers and results in loss of vision.
Risk factors to consider:
- Although glaucoma can occur at any age, the risk of developing glaucoma increases dramatically after age 40. That risk increases further after age 60.
- African Americans are at a higher risk of developing glaucoma and should begin having their eyes checked earlier.
- Asian Americans are at higher risk of developing angle-closure glaucoma.
- Family history of glaucoma
- High blood pressure or heart disease
- History of eye injuries. Injury can also dislocate the lens, closing the drainage angle.
- Retinal detachment
- Eye tumor
- Eye inflammations, such as chronic uveitis and iritis
- Prolonged use of steroid eye drops
Types of Glaucoma
Angle-closure glaucoma is quite rare, but has much more pronounced symptoms that include blurred vision, pain, halos around lights, and even nausea. It is caused by a rapid increase of pressure inside the eye due to blocked fluid drainage channels.
Open-angle glaucoma, the most common type, often goes undiagnosed because there is no discomfort or pain, and no change in vision until there is already a significant loss.
Normal-tension glaucoma (NTG), is also known as low tension or normal pressure glaucoma. In this type of glaucoma, damage occurs to the optic nerve without eye pressure exceeding the normal range.
Traditional treatments for glaucoma are the use of eye drops on a regular schedule to control eye pressure and other medications. Both are safe and effective at treating glaucoma. Some work by slowing down the production of fluids or by improving drainage of fluid from the eye.
Common glaucoma eye drops:
- Prostaglandin Analogues - Xalatan®, Lumigan®, Travatan Z®
- Beta-Blockers - Timolol®, Betimol®, Istalol®, Betagan®
- Carbonic Anhydrase Inhibitors (CAI) - Azopt®, Trusopt®
- Alpha-Agonists - Alphagan
Selective Laser Trabeculoplasty (SLT)
The laser is applied through a slit-lamp microscope, similar to what is used during eye exams. This painless procedure takes about 5 minutes and is performed in the clinic. The IOP should decrease within several weeks of the procedure.
Micropulse Cyclo-G6 Glaucoma Laser System
A non-incisional procedure designed to lower eye pressure by applying short bursts of laser energy directly to the fluid-producing cells in the eye. This new and innovative technology is a variation of an earlier procedure called "diode laser cyclophotocoagulation." Due to the shorter micro-bursts of energy, the post-operative inflammation and post-operative recovery time are minimized with the Cyclo-G6 Laser procedure.
Endoscopic Cyclophotocoagulation is a procedure in which the surgeon uses a laser to reduce the production of excess fluid in the eye and thus reduce pressure on the optic nerve. It's a relatively gentle procedure and is very precise, which prevents undesirable collateral tissue damage. ECP is an excellent choice for cases in which the eye is already undergoing surgery.
Minimally Invasive Glaucoma Surgery
This group of surgery options have been developed in recent years to reduce some of the complications of most standard glaucoma surgeries. MIGS procedures work but making smaller incision and using smaller equipment then before. This reduces the complications and increases the recovery time. They tend to have little effect on VA and quality of life.
- OMNI Surgical System (Canaloplasty and trabeculectomy)
- iStent® Inject
- Kahook Dual Blade
- ABiC (Ab-Interno Canaloplasty)
- Hydrus microstent
Tube shunts lets aqueous humor out of the eye and are designed to work when the normal outflow of fluid has been scarred or is no longer working. The device has a tiny tube of flexible plastic that goes into the front chamber of the eye and leads back to a plate that is secured to the sclera. Fluid drains out of the eye into a bleb or pocket that is formed around the plate to help lower the eye pressure.
In this procedure, a tiny drainage hole is made in the sclera (the white part of the eye). This new hole allows fluid to flow out of the eye into a filtering area called a bleb which is hidden under the eyelid. When successful, the procedure will lower your intraocular pressure (IOP), minimizing the risk of vision loss from glaucoma.