GLAUCOMA DIAGNOSIS AND TREATMENT

Glaucoma is a disease of the optic nerve, which carries the images we see from the eye to the brain. Glaucoma results when there is slow damage to the optic nerve due to increased pressure in the eye. This pressure is usually caused by poor drainage of the aqueous fluid out of the eye.

The most common form of glaucoma is called “primary open-angle glaucoma.” This condition is painless and the patient can slowly lose vision and not be aware of the problem until it is very advanced.

Glaucoma is a leading cause of blindness in the United States, especially for older people. If untreated, glaucoma can lead to total loss of vision, which is why early detection through routine eye exams and treatment are so important.

 

Examination
 During your glaucoma examination, Dr. Chu will:

  • Measure intraocular pressure (tonometry)
  • Inspect the drainage angle of the eye (gonioscopy)
  • Evaluate any optic nerve damage (ophthalmoscopy)
  • Test the peripheral vision of each eye (visual field testing, or perimetry)
  • Take color stereoscopic photographs of the optic nerves which are used to follow the appearance of the optic nerve
  • Measure the thickness of the central cornea (pachymetry); abnormally thick or thin corneas can skew the true eye pressure measurement

 

Additional Testing
 At Montgomery Eye Center, we are proud to have the latest state-of-the-art technologies to help diagnose and manage glaucoma, including:

  • Humphrey Field Analyzer (HFA). This is a sensitive test to determine if any glaucoma damage is present.  It tests the health of the specific retinal cells that can be damaged in very early glaucoma.
  • OCT (Optical Coherence Tomography). This remarkable device uses ordinary light to create a CAT-scan-like cross-section of the optic nerve and nerve fiber layers to detect damage from glaucoma.

 

TREATMENT

In general, damage caused by glaucoma cannot be reversed once it has occurred.   However, prompt and early treatment can help slow or prevent further damage.  There are generally 3 types of treatment for glaucoma: Medication, Laser surgery (SLT), and Conventional surgery.  

 

Glaucoma Medications and Their Side Effects

Glaucoma may be controlled with eye drops taken several times a day, sometimes in combination with pills.  These medications decrease eye pressure, either by slowing the production of aqueous fluid within the eye or by improving the flow leaving the drainage angle.  For these medications to work, you must take them regularly and continuously. It is also important to tell all of your doctors about the eye medications you are using because glaucoma medications can have side effects and may interact with other medications you may be taking.  You should notify Dr. Chu immediately if you think you may be experiencing side effects.  Some eye drops may cause a stinging sensation, red eyes, blurred vision, headaches, and changes in pulse, heartbeat or breathing.

 

Laser Surgery

SLT (Selective Laser Trabeculoplasty) is used to improve the drainage of the aqueous fluid out of the eye and thereby reduce the eye pressure.  SLT is used to treat most types of open angle glaucoma.

 

Laser Peripheral Iridotomy (LPI) is used to treat most forms of narrow or closed angle glaucoma.  This type of laser treatment is also performed in our office. 

 

Conventional Surgery

In rare cases, conventional surgery (trabeculectomy) is the only effective way of reducing eye pressure.   During this procedure, a new drainage channel is created for the aqueous fluid to leave the eye.