Glaucoma is a disease of the optic nerve that can diminish vision if left untreated. The condition is common, especially in patients with a family history of glaucoma.
How is glaucoma diagnosed?
During a routine eye exam your doctors at Physicians Eye Care will screen for glaucoma by assessing your ocular and family history, checking your eye pressure as well as examining your optic nerve after pupil dilation. The image below shows optic nerve cupping over time which is a sign of optic nerve damage.
Additional tests to assess one’s risk for glaucoma may be performed if your physician feels you are at risk. These tests may include the following:
-Corneal Thickness Testing
-Gonioscopy (a lens to assess the fluid drainage portion of the eye)
-Optic Nerve Scanning (This is a scan called OCT – Optical Coherence Tomography that measures your nerve fiber thickness and health.)
-Visual Field Testing (This is a test that will assess your peripheral vision to determine if you have damage from glaucoma.)
How is glaucoma treated?
Doctors at Physicians Eye Care Center utilize the most advanced techniques to treat glaucoma. Treatment involves lowering one’s eye pressure and is tailored to each individual patient. In most cases of glaucoma, surgery can be avoided if detected and treated early enough. Routine glaucoma screening and early detection is key.
The following are some of the modalities utilized to treat glaucoma:
Eye Drops – Your physician may prescribe you eye drops to lower your eye pressure. There are several eye drops available and each has its dosing schedule and profile.
Laser – Depending on what type of glaucoma you have, it may be amenable to laser treatment. Selective laser trabeculopasty (SLT) is a quick and painless laser that facilitates more efficient fluid drainage from the eye, which lowers eye pressure. SLT can often decrease or eliminate the need for eye drops. Alternatively, it can be used as a therapy to help lower eye pressure in more advanced cases of glaucoma and put off the need for glaucoma surgery. Laser peripheral iridotomy (LPI) is a laser used in narrow angle glaucoma to help prevent damage from angle closure which can cause pain and vision loss. Both SLT and LPI are performed in the office and do not require any post-procedure restrictions.
Glaucoma Treatment with Cataracts
With the newest advancements in glaucoma technology, our eye surgeons can help slow the progression of glaucoma for cataract surgery patients. There are several additional procedures that our eye surgeons can perform along with your cataract surgery to lower your eye pressure and help treat mild to moderate glaucoma. These procedures are collectively referred to as Micro-Incisional Glaucoma Surgery (MIGS). There can be several advantages of MIGS procedures, including the following:
- Lower intraocular pressure (IOP)
- Less risk compared to other traditional surgical glaucoma procedures
- Reduction in, if not complete elimination of, the use of expensive medication
Below is a list and brief description of MIGS procedures commonly performed by surgeons at Physicians Eye Care Center. Your eye surgeon will discuss the risks and benefits of these procedures as well as which MIGS procedure would be best for you.
Endoscopic Cyclophotocoagulation (ECP)
Endocscopic Cyclophotocoagulation (ECP) is a technology that involves using a laser to treat the fluid producing organ of the eye (the ciliary body) so that the fluid production is more appropriate for your eye and your eye pressure is lower.
The CyPass shunt is a minimally invasive shunt device designed to reduce IOP in adults with mild-to-moderate glaucoma. It’s inserted through the angle (the fluid drainage area of the eye) in conjunction with cataract surgery. The CyPass allows the eye to more effectively drain its fluid so that the eye pressure is lower, thereby decreasing the chances of glaucoma progression.
Kahook Dual Blade
The Kahook Dual Blade is a device used to create a goniotomy – which is an opening in the trabecular meshwork, creating a path through which excess fluid can drain from the eye, which results in an overall decrease in eye pressure.
Although glaucoma cannot be reversed, MIGS procedures can slow the rate at which the condition advances by lowering intraocular pressure. Patients may be unaware of their glaucoma until it gets worse and starts to impair their vision, which is why routine eye examinations are crucial for early detection and treatment of this common eye condition. During any pre-operative evaluation for a MIGS procedure, your surgeon at Physicians Eye Care will discuss the risks and benefits to each option and will help determine which will be most appropriate for the health of your eyes.