Glaucoma
Glaucoma is an eye disease that affects the optic nerve. Increased pressure in the eye (intraocular pressure) is usually a primary indicator of glaucoma, although eye pressure is normal in some cases. Glaucoma is often associated with older patients, and while it is more prevalent over the age of 60, it can occur in people of all ages. Glaucoma affects approximately 3 million people in the United States, and it is one of the leading causes of blindness worldwide.
Early detection is critical to diagnose glaucoma, because many patients do not experience symptoms initially. Left untreated, glaucoma causes permanent damage to the optic nerve and loss of vision that cannot be recovered. Although there is no cure for glaucoma, treatment options are available to preserve vision and slow the progression of the disease. At Gordon Schanzlin New Vision Institute in San Diego, we are committed to preserving vision for patients affected by glaucoma.
Different Types of Glaucoma
Open Angle Glaucoma, also referred to as chronic glaucoma, is the most common type of glaucoma. People with this type of glaucoma often experience no symptoms at the onset of the disease. The drainage canal in the eye becomes blocked, which increases pressure in the eye and causes damage to the optic nerve. As the disease progresses slowly, there is a gradual loss of peripheral, or side, vision. This type of glaucoma is often referred to as the Sneak-thief-of-sight because people may experience permanent vision loss before they realize they are affected. Luckily, this type of glaucoma can be detected during a regular eye exam and your doctor can create a treatment plan to preserve your vision.
Narrow Angle Glaucoma, also called acute angle-closure glaucoma, comes on suddenly and may be referred to as a glaucoma attack. This type of glaucoma causes immediate pain that may be accompanied by blurred vision, red eyes, severe headache, nausea and vomiting. Narrow angle glaucoma is caused by a rapid increase in the pressure of the eye, usually because the iris is pulled or pushed back in a way that blocks drainage. This can occur as a result of the eye dilating in dim light. An occurrence of narrow angle glaucoma should be treated as a medical emergency and treatment should be sought immediately.
Normal Tension Glaucoma, also called low tension glaucoma, refers to a type of damage to the optic nerve that occurs when there is no increased eye pressure. The progression of the disease and lack of initial symptoms are similar to open angle glaucoma, but patients affected have consistently regular eye pressure. Less is understood about this form of glaucoma, so it is important that people with risk factors see an experienced eye doctor for regular examinations. People at higher risk for normal tension glaucoma include those of Japanese ancestry, with a family history of normal tension glaucoma, and people with a medical history of systemic heart disease.
What Are The Symptoms of Glaucoma?
People with the most common type of the disease, open angle glaucoma, will typically experience no symptoms until they notice vision loss, but by the optic nerve has been irreparably damaged. Vision that is lost due to glaucoma cannot be regained because the optic nerve has been permanently damaged, which is why glaucoma is often called the silent thief of vision. Narrow angle glaucoma is less common and patients will experience abrupt symptoms including pain, blurry vision, and nausea. If you suspect you have narrow angle glaucoma, you should seek medical treatment immediately.
Who Gets Glaucoma?
Glaucoma can affect anyone, which is why everybody should get regular eye exams, but there are some risk factors which may make you more likely to develop glaucoma:
- People over 60 years of age are at higher risk for glaucoma, although glaucoma occurs at all ages
- African Americans experience higher rates of open angle glaucoma and develop glaucoma at younger ages on average
- People of Japanese descent are at higher risk of developing normal tension glaucoma
- Very nearsighted (myopic) people may be predisposed to glaucoma
- Diabetes Type 2 may increase the risk of glaucoma
- People with a family history of glaucoma are at higher risk
What Are My Treatment Options For Glaucoma?
Although there is no cure for glaucoma, there are medical and surgical treatment options that can preserve vision and slow the progress of the disease.
Prescription Eye Drops To Treat Glaucoma
Eye drops are often the first type of treatment offered to glaucoma patients. There are several types of drops for glaucoma. Your eye doctor will help find the type that works best for you.
Procedures To Treat Glaucoma
The experienced surgeons at The Gordon Schanzlin New Vision Institute are dedicated to providing the best vision care possible to every patient. If prescription glaucoma drops are not sufficient in managing your glaucoma, or if your glaucoma is more advanced, we can help determine a surgical treatment that is right for you.
Laser Eye Surgery For Glaucoma
There are two types of laser eye surgery available – Selective Laser Trabeculoplasty (SLT) and Argon Laser Trabeculoplasty (ALT). They each utilize laser therapy to repair the drainage tissue in the eye to increase flow of aqueous through the trabecular meshwork and encourage better draining of eye fluid. SLT uses a lower power of laser and may be repeated if needed, while ALT is typically only performed once. Both procedures have an extremely low rate of complication. SLT and ALT are outpatient procedures performed with local anesthetic and patients are generally able to resume regular activities the day after surgery.
Minimally-Invasive or Micro-Invasive Glaucoma Surgery (MIGS)
Minimally invasive glaucoma surgery is commonly referred to as MIGS. This type of procedure utilizes microscopic equipment and tiny incisions to lower eye pressure and prevent the progression of glaucoma with minimal complications. At Gordon Schanzlin New Vision Institute, we offer two types of MIGS:
Hydrus™ Microstent
The Hydrus Microstent is designed to control eye pressure and reduce dependence on medications to manage glaucoma. This tiny device is the size of an eyelash and is inserted during cataract surgery. Hydrus is placed in Schlemm’s canal, which is part of your eye’s natural drainage system. Once in place it relieves pressure by encouraging excess fluid toward the drainage system and expanding the pathway for drainage. Studies show that 77% of Hydrus patients saw a reduction in eye pressure and
Trusted Source
A Schlemm canal microstent for intraocular pressure reduction in primary open-angle glaucoma and cataract: The HORIZON Study
Samuelson TW, Chang DF, Marquis R, et al; HORIZON Investigators
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78% were able to eliminate eye drops
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Trabecular Micro-Bypass Surgery using iStent
iStent is an innovative surgery that is performed in conjunction with cataract surgery, making it a great option for patients who are affected by both cataracts and glaucoma. In this procedure, the surgeon makes a tiny incision in the tissue near the base of the cornea that is responsible for draining fluid from the eye, this area is called the trabecular meshwork. The iStent is a tiny valve that is inserted to increase the eye’s ability to drain fluid. The iStent device is 20,000 times smaller than a contact lens and is the smallest device approved by the FDA. This procedure is best suited for patients with mild to moderate open angle glaucoma.
Contact Us To Learn More About Glaucoma Treatment Options
If you have been diagnosed with glaucoma and are interested in glaucoma treatments, please contact us to schedule a consultation.
Sources1 Samuelson TW, Chang DF, Marquis R, et al; HORIZON Investigators. A Schlemm canal microstent for intraocular pressure reduction in primary open-angle glaucoma and cataract: The HORIZON Study. Ophthalmology. 2019;126:29-37
The doctors at Gordon Schanzlin New Vision Institute have either authored or reviewed and approved this content.
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