Glaucoma is the leading cause of preventable blindness in the United States, affecting more than 3 million people of which the majority are age 40 and above. Known as the "silent thief" of sight, it can quietly steal your vision by gradually damaging the optic nerve.
The optic nerve is responsible for carrying the images we see to the brain. The optic nerve can be damaged when the pressure within the eye increases, usually due to a build-up of aqueous fluid within the eye. Blind spots develop within the field of vision. These blind spots usually go undetected by the person who has glaucoma, until the optic nerve has suffered significant damage and some peripheral and central vision has been lost. More than half of the people who have glaucoma do not realize they have it for this reason. The damage caused by untreated glaucoma can result in irreversible blindness. A visual field evaluation can detect glaucoma damage in its very early stages-another very good reason to have regular eye exams.
Types of Glaucoma
Chronic open-angle glaucoma
In the most common type of glaucoma, the drainage "angle" (where fluids in the eye drain) is open but working less efficiently, much like an air filter that gathers dust over time and eventually becomes too clogged to work properly. The inability to drain causes pressure within the eye to rise, and results in a gradual loss of side vision.
Acute angle-closure glaucoma
This type of glaucoma occurs when the drainage angle is completely blocked, often by the eye's iris. This prevents any fluid from draining from the eye. Pressure within the eye suddenly and dramatically rises, causing blurred vision, headaches, severe eye pain, and the appearance of halos around lights.
Chronic angle-closure glaucoma
This more gradual and painless type of angle closure occurs most frequently in people of African or Asian descent.
This type of glaucoma, which progresses in much the same way as chronic open-angle glaucoma, occurs when scar tissue blocks the drainage angle. The first symptom is loss of side vision.
This birth defect affects the drainage angle and must be treated shortly after birth to prevent blindness. Symptoms include enlarged eyes, a cloudy cornea, light sensitivity, and excessive tearing.
Glaucoma Treatment Options
Have you been told by your eye doctor that you have high intraocular pressure and might have glaucoma? Don't be discouraged. There are a variety of advanced procedures that may reduce your dependency on glaucoma medications. Based on your condition, we may recommend one or more of these treatment options:
- Medication: Glaucoma is usually treated with daily eye drops that decrease eye pressure either by slowing the amount of fluid produced within the eye or by improving drainage of that fluid.
- Surgery: Options vary based on patient needs. See below.
The Colorado Springs Eye Clinic physicians offer several medical and surgical glaucoma treatments to lower the pressure within the eye.
Selective Laser Trabeculoplasty (SLT)
This non-invasive, low-energy procedure heats an area of the eye to help open the drainage system by targeting cells in the trabecular mesh system of the eye.
The Hydrus® Microstent is an tiny, flexible tube implanted in the eye of adult patients with mild to moderate primary open angle glaucoma to reduce eye pressure. It works by helping fluid in the front part of the eye flow more freely through the natural drainage pathway.
Canaloplasty involves implanting a tube in the eye's natural drainage pathway to enlarge the drainage canal, relieving internal eye pressure for patients with open angle glaucoma.
An innovative approach to treating glaucoma for those who have both cataract and glaucoma is the iStent®. iStent® is the smallest medical device ever approved by the FDA, and is placed in the eye during cataract surgery. It is so small, you won't be able to see or feel it after surgery, but it works continuously to help reduce eye pressure by improving outflow of fluid from the eyes. After implantation, many patients are able to control their eye pressure. In a U.S. clinical trial, iStent patients who achieved a target pressure of < 21 were more likely not to need their medications than patients with cataract surgery only.