Glaucoma

Glaucoma is actually a group of eye conditions that damage your eye’s optic nerve, which is vital for good vision. It usually happens when fluid builds up in the front part of your eye. That extra fluid increases the pressure in your eye, damaging the optic nerve. There are several types of glaucoma, caused by different factors but ultimately they all affect optic nerve function. The two most common types are:

• Open-angle glaucoma – the most common form, affecting about three million Americans. It occurs when the eye’s drainage canals become blocked over time, sometimes exhibiting no symptoms. In this case, the entrance to the drainage canals are clear and should be working correctly but are clogged further inside the drainage canals, similar to a clogged pipe below the drain in a sink.
• Narrow-angle glaucoma – also known as acute glaucoma or angle-closure glaucoma. It is much less common than open-angle glaucoma but still just as serious. In this case, the drainage canals get blocked or covered over, like a sink with something covering the drain.

In open-angle glaucoma, the blockages to the eye’s drainage canals happen gradually, over time, so symptoms slowly develop, and in many cases are not even noticeable. Some symptoms may include blurry vision and gradual loss of peripheral vision.

In narrow-angle glaucoma, the drainage canals quickly clog, causing the eye pressure to rise very quickly, and you may exhibit severe symptoms such as hazy or blurred vision, severe eye and head pain, nausea or vomiting, and sudden sight loss. If you exhibit any of these symptoms, you should seek immediate medical attention.

Regular eye exams, even if you are showing no symptoms, are an important part of maintaining good eye health. Your eye exam should include testing for glaucoma, among other conditions, and should be done at least annually, especially as you get older.

Glaucoma has no cure but if caught early, it can be treated to halt or slow the loss of eyesight. Early detection is vital to keeping the disease from developing into a more serious condition.

During your glaucoma consultation, your surgeon will discuss treatment options and which one is best for you. The treatment recommended by your surgeon depends upon the nature and severity of your case. While glaucoma cannot be cured, it can be controlled, and some options include eye drops, pills, laser procedures and surgical operations. Treatments aim to reduce the intraocular pressure and prevent further damage to the optic nerve. Intraocular pressure can be reduced by increasing the drainage of aqueous humor or reducing its production.

Eye drops and pills used in managing glaucoma decrease eye pressure by helping the eye’s fluid to drain better or decreasing the amount of fluid made by the eye. There are many types of medication available to manage glaucoma, classified by their active ingredient. Your eye doctor will examine your disease status and recommend a treatment program specifically tailored for you. Medication used to treat glaucoma is a lifetime commitment; it is important to remember that you must follow your surgeon’s medication program to effectively treat your glaucoma and keep it from developing into a much more serious condition.

For more advanced cases of glaucoma that may no longer respond to medication, there are two types of laser procedures available for treatment, both of which are performed in both the Covington and Athens office.

• Selected Laser trabeculoplasty (SLT) treats open-angle glaucoma, caused when fluid does not drain properly from the front of the eye, causing a dangerous increase in your eye’s fluid pressure. The procedure uses a laser to adjust the drainage angle at the front of your eye, so that fluid flows out of the eye as it should.
• Peripheral Laser iridotomy (YAG PI) treats narrow-angle glaucoma caused by the iris blocking the drainage from your eye and causing a sudden and dangerous increase in your eye’s fluid pressure. The procedure uses a laser to create a tiny hole in your iris, which helps the fluid flow naturally in and out of your eye and helps the iris return to its normal position.

Just before the procedure, anesthetic drops are used to numb the surface of the eye. A lens is then placed on the eye to perform the laser procedure. The procedure usually takes about 5 minutes and it is unusual for patients to experience even mild pain. After the procedure, the eye may be a little red, light sensitive, or uncomfortable, and there may also be a mild headache due to the eye drops given prior to treatment.

Since glaucoma and cataracts are both common diseases for seniors, medical technology has advanced with a way to combine treatment for both conditions in the same surgical procedure. For patients with mild-to-moderate glaucoma, your eye surgeon may recommend implanting an iStent during your cataract procedure. iStent works like the stents used to prevent heart attacks and strokes. When implanted in the eye’s drainage canal, it creates a permanent opening through the blockage to improve the eye’s natural fluid outflow, which then improves the outflow of fluid from the eye and thus lowers and controls the pressure within the eye.

A recent study showed a high success rate for iStent patients. After six months, 85 percent of cataract patients who also received iStents saw their eye pressure improve to the point that they didn’t need to use eye drops. These results persisted at the one-year time point.

While the implantation of iStent can reduce your use of glaucoma medications, this will be at the discretion of your eye surgeon, and regular eye exams are important to monitor your disease progress.

Glaucoma correctional appointments are an out-patient procedure performed onsite at Georgia Ophthalmologists’ eye procedure suites, located at both its Covington and Athens offices. Most glaucoma procedures take less than 5 minutes, but adding in pre-operative preparation and onsite recovery, you should plan to be at the surgery center for about 90 minutes.

Glaucoma treatments require only topical anesthetic drops. Recovery time after a glaucoma procedure varies per patient and per procedure, but most patients heal almost immediately after their procedure. Usually there are no limitations after glaucoma laser procedures and most patients return to their normal activities the following day.

The vast majority of patients report that their eye pressure has decreased after their  glaucoma procedure, improving their eye health overall. Recovery and success rates vary based on disease progression and treatment procedure.

• Selective laser trabeculoplasty (SLT) can take about 6-8 weeks to lower your eye’s pressure. It after three months, your eye’s pressure is still too high, your surgeon may recommend an additional laser procedure, more medication or another type of procedure.
• For Narrow-angle glaucoma, peripheral laser iridotomy (YAG PI) can show results within just a few hours after your procedure, and anti-inflammatory eyedrops are usually prescribed for a few days.

Most glaucoma treatments are covered by insurance. Our experienced counselors will discuss the details of your coverage prior to undergoing any treatment.