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Glaucoma

Glaucoma

Glaucoma is a group of diseases than can damage the eyes optic nerve and result in vision loss and blindness. However, with early treatment, you can often protect your eyes against serious vision loss.

What is the optic nerve?

The optic nerve is the cable that takes information from the eye to the brain for interpretation. It is comprised of 1.2 million nerve fibers from the retina (film of the eye) compressed together to form a cross-sectional wire 1.5 mm in diameter.

How does open–angle glaucoma damage the optic nerve?

In the front of the eye is a space called the anterior chamber. A clear fluid flows continuously in and out of the chamber and nourishes the surrounding tissues. In the normal functioning eye the fluid leaving the chamber through the angle between the cornea and the iris, squeezing between a sieve-like tissue called the trabecular meshwork.

Sometimes fluid movement is blocked as it attempts to traverse the meshwork, and as the fluid builds up pressure in the eye elevates potentially damaging the optic nerve. This, in effect, is the basis of glaucoma and the reason controlling pressure is so important.

Does elevated eye pressure mean Glaucoma?

Not necessarily. High pressure in the eye increases the risk of damage to the optic nerve, but everyone eye is different and some eyes are more susceptible than others. If you have elevated intraocular pressure close follow-up is recommended.

Can glaucoma develop without elevated eye pressure?

Just as high pressure does not always lead to glaucoma, low pressure is not always protective. Glaucoma can develop without the elevated pressure. Although, it is not as common as open-angle glaucoma, Normal tension or even low-tension glaucoma does occur.

Who is at risk for glaucoma?

Anyone can be afflicted with glaucoma. There are certain risk factors to be considered:

Certain combinations of risk-factors are more concerning than others, and treatment is sometimes recommended to decrease the likelihood of progression to glaucomatous damage.

What are the symptoms of glaucoma?

Initially, there are no symptoms. Frequently referred to as the “silent thief”, glaucoma can go unnoticed until it is too late.

Should glaucoma remain untreated, peripheral vision (side vision) is first to go. Over time, a constriction of vision occurs leaving merely a central island.

How is glaucoma detected?

A thorough eye exam including:

Can glaucoma be cured?

No. To date, there is no cure for glaucoma. Therefore emphasis on early detection and prevention are the cornerstones of glaucoma care.

How is glaucoma treated?

Whether through the use of medication, minimally invasive laser treatment, or surgery the basis of glaucoma care lies in the reduction of intraocular pressure.

Eye drops are the most common early treatment for glaucoma. Some medicines decrease the production of fluid or increase the rate of drainage within the eye. Eye drops, like every medication, have potential side effect. Therefore it is important to inform your eye doctor of any adverse reaction after beginning a treatment. As is the case with pre-existing allergies, please inform you doctor before beginning new medications.

Canaloplasty is a new alternative for glaucoma patients

Canaloplasty is an advanced, non-penetrating procedure designed to enhance and restore the eye's natural drainage system to provide sustained reduction of IOP. Canaloplasty utilizes breakthrough microcatheter technology in a simple and minimally invasive procedure.

How is a canaloplasty performed?

To perform a canaloplasty, your doctor will create a tiny incision to gain access to a canal in the eye. A microcatheter will circumnavigate the canal around your iris, enlarging the main drainage channel and its smaller collector channels through the injection of a sterile, gel-like material called viscoelastic. The catheter is then removed and a suture is placed within the canal and tightened. This tightened suture ensures that the canal remains open. By opening the canal, the pressure inside your eye will be relieved.

What are the benefits of canaloplasty?

A canaloplasty procedure might be the optimal choice for patients whose medications aren't working but aren't quite ready to take on the risks of surgery. It may also be optimal for patients whose medications are working but are frustrated with the frequency of dosing.

Canaloplasty benefits compared to traditional glaucoma treatments:

SLT

Selective Laser Trabeculoplasty (SLT) is an advanced type of laser treatment to reduce the high intraocular pressure of glaucoma, which damages the optic nerve. Open-angle glaucoma is the most common type of glaucoma and occurs when there is an increase in fluid production or decrease in fluid drainage. With this imbalance of fluid flow, there is an increased intraocular pressure. This in turn decreases the blood flow to the tissues of the optic nerve. Untreated, optic nerve fibers gradually are destroyed, resulting in irreversible loss of peripheral vision. Commonly, glaucoma is treated with medications in the form of eye drops or pills, and laser treatments to lower the intraocular pressure.

Eye drops and other medications can cause undesirable side effects and sometimes do not control the eye pressure. When this occurs, laser treatment may be helpful. With the traditional Argon laser trabeculoplasty (ALT), the doctor places evenly spaced laser spots in the trabecular meshwork drainage system of the eye. This treatment improves the pressure but leaves scarring of the trabecular meshwork and limits its success and the availability to retreat the eye in the future. Selective Laser Trabeculoplasty (SLT) selectively stimulates or changes only the targeted pigmented cells in the trabecular meshwork to improve fluid drainage. The SLT is much more gentle than the ALT and produces less scar tissue, which in turn allows the doctor to the repeat the procedure if necessary. This advanced treatment for open-angle glaucoma may reduce or even eliminate the use of eye medications or drops.

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