Among the eye diseases that most commonly affect our older patients, glaucoma is one of the most serious. Many people who are at risk of vision loss due to glaucoma do not even know that they have the disease – one of the many reasons that regular checkups become even more important with age. Heritage Eye, Skin & Laser Center provides the latest treatments for glaucoma as a part of our commitment to senior eye health.
In patients with glaucoma, the eye’s fluids cannot drain properly. Pressure builds up in the eye over time, ultimately damaging the optic nerve and causing permanent vision loss. One of the most dangerous aspects of glaucoma is the fact that recognizable symptoms do not typically occur until after the disease has progressed enough to begin causing damage. For this reason, the eye doctors at Heritage Eye, Skin & Laser Center recommend that people aged 40 and over should have an yearly comprehensive medical eye exam – especially if they have a family history of glaucoma.
Who is Most At Risk for Glaucoma?
- Anyone over the age of 60
- African-Americans over 40
- People with a family history of glaucoma
- Steroid users
- Those who have sustained eye injuries
- People who have diabetes
Types of Glaucoma
There are two main forms of glaucoma: open-angle and narrow-angle. The majority of patients have open-angle glaucoma, which progresses slowly due to a partial blockage of the passageways that drain fluid from the eyes. Symptoms, once they occur, include mild eye aches, progressive loss of peripheral vision, halos, and reduced visual acuity that does not respond to vision correction. This form of glaucoma responds well to treatment, particularly when discovered early.
Narrow-angle glaucoma is less common than open-angle glaucoma and is caused by contact between the iris and the eye’s drainage system that leads to permanent scarring. Symptoms include inflammation, pain, and pressure in the eyes, nausea and vomiting, blurry vision, halos, and extreme light sensitivity. This form of glaucoma often progresses rapidly, requiring immediate treatment to prevent vision loss.
Glaucoma Treatment Options in Stockton
There is no cure for glaucoma, but there are treatment strategies such as medications and surgery, that can help control the disease and preserve the patient’s vision. Both medications and surgery are available at Heritage Eye, Skin & Laser Center to help Stockton, Modesto, and Sacramento-area glaucoma patients. Identifying the disease early, tracking its progress, and pursuing treatment is the best way to preserve vision, so individuals who are at risk of developing glaucoma or who already have it should maintain a regular checkup schedule.
Non-Surgical Glaucoma Treatment
Oral or topical medication (eyedrops, ointments, or medicated inserts) is usually the first treatment strategy for open-angle glaucoma. There are many different medications available, but almost all of them work by improving drainage or reducing fluid production in the eye. Our doctors will usually try a variety of medicines or combinations, fine-tuning the treatment to establish the most effective approach to each glaucoma patient’s condition.
Surgical Glaucoma Treatment
If medicine is not effective, surgery is another alternative. As part of our commitment to the most advanced eye care technology, Heritage Eye, Skin & Laser Center uses state-of-the-art laser equipment to treat glaucoma.
Laser trabeculoplasty is a treatment for open-angle glaucoma in which we use a surgical argon laser to remove tissue blocking fluid drainage in order to help reduce pressure in the eye. The laser is used to shrink parts of the trabecular network that drains the eyes, causing other parts to expand and increase drainage.
During the procedure our doctors will use a laser device to treat between 50 and 100 small areas of the eye over the course of about 15 minutes. In some cases, two treatments will be required. The procedure is painless, though patients typically experience bright flashes of light. Shortly after treatment, eye pressure will be checked and anti-inflammatories prescribed if necessary.
It is important to understand that this procedure is not a permanent glaucoma cure. After two years, about half of glaucoma patients begin to experience elevated eye pressure again
Patients with closed-angle glaucoma can undergo laser iridotomy, in which a small hole is made in the iris with a laser, opening a new drainage path. Like most other laser procedures, iridotomy can be performed in-office at Heritage Eye, Skin & Laser Center under local anesthesia.
To perform laser iridotomy, we first use an eye drop to constrict the pupil. Next we apply a special contact lens that helps to focus the laser onto the iris and to immobilize the eye during treatment. The treatment process itself is very brief. Patients experience a bright light and a small pinch while the laser is on, but the procedure is otherwise painless.
After treatment, we check the pressure within the eye and prescribe a series of eye drops that will keep the pupil contracted, control eye pressure, and reduce inflammation. The eyes are usually somewhat sensitive for a few days after treatment, but most patients are able to return to normal activities almost immediately.
Conventional Glaucoma Surgery
If medicinal and laser treatments are unsuccessful, conventional glaucoma surgery (also known as filtration surgery or trabeculectomy) is also available, in which a small portion of eye tissue under the upper eyelid is removed to create a new drainage channel. This is an option for patients with both open-angle and narrow-angle glaucoma.
Conventional glaucoma surgery is performed under local anesthesia. The surgeon removes a small amount of tissue from the eye to create a drainage channel, then covers the hole with a piece of the eye’s thin outer layer known as the conjunctiva. This layer is stitched into place in a way that allows better drainage while still covering and protecting the channel. Chemotherapeutic injections may also be applied to keep the channel open.
Most patients are able to return to normal activities within a few days of filtration surgery. Follow-up visits for fine-tuning the procedure and monitoring eye pressure are crucial to the success of trabeculectomy. Fine-tuning might include adjusting stitches, applying chemotherapeutic injections, using finger pressure to encourage drainage, opening the channel with a fine instrument, and placing a protective contact lens over the eye.
Schedule Your Glaucoma Consultation
Call us today at 209.465.5933 to schedule a glaucoma exam.