Glaucoma
Glaucoma is a serious eye condition that can cause permanent vision loss if left untreated. Certain people are at higher risk for the condition than other people, such as women and people over sixty-five.
Although patients with glaucoma cannot regain the vision they have lost, there are a number of surgical and non-surgical options for preventing the progression of the condition. At North Valley Eye Care, our eye doctors have the training and experience necessary to help preserve your vision.
What is Glaucoma?
Glaucoma is an eye condition often related to the pressure created by an unregulated amount of fluid inside the eye. This fluid, which occupies the area in the front of the eye, provides nourishment.Also, because of the pressure it generates, it helps keep the eye inflated. The eye is constantly recycling intraocular fluid, draining away older fluid and creating new fluid to replace it.
This cycle normally maintains a constant, healthy pressure. Problems arise, though, if older fluid does not drain properly while the eye continues to generate new fluid. This causes higher-than-normal fluid pressure, which can eventually damage the eye’s optic nerve. There are many types of glaucoma.
However, two different important forms to know about are closed-angle and open-angle. Closed-angle is the more severe but also the rarer form of the two, occurring when the iris moves too close to the eye’s main fluid drain.
Should the iris block the drain opening, it can cause the sudden onset of symptoms like blurriness, severe eye pain, and headache, nausea, or rings or halos around lights. This is considered an emergency and must be treated promptly to avoid rapid and permanent vision loss.Open-angle glaucoma occurs gradually because of the eye’s inability to drain fluid efficiently. Think of this like a clogged house drain rather than one that is completely blocked.
Unlike closed-angle, open-angle glaucoma is not usually painful and does not cause any noticeable changes to vision early in its development. Instead, it causes gradual and unnoticeable vision loss, making it very dangerous to those who don’t get regular eye exams.
Are There Any Symptoms of Glaucoma?
With the exception of the closed-angle form, glaucoma is similar to other progressive eye conditions in the way that its symptoms may not be noticeable until the condition enters its advanced stages. In fact, if a glaucoma patient starts to notice vision changes, some irreversible damage has most likely occurred.
A patient may at first notice blurriness or other problems in their side (peripheral) vision. Later, those same symptoms may also begin appearing in their central vision.
How is Glaucoma Diagnosed?
Initial signs of glaucoma are often detected during a routine eye exam with a simple eye pressure test. High pressure does not necessarily indicate the presence of glaucoma, but it does call for a closer look with a more thorough glaucoma-focused exam.
This specialized exam involves:
This exam’s results can provide your eye doctor the information needed to make a definitive diagnosis. Alternatively, the results may indicate the need for continued monitoring.
How is Glaucoma Treated?
Because there is yet no definitive cure for glaucoma, the treatment goal is to minimize optic nerve damage by keeping the eye pressure within a normal range. The most basic way to achieve this goal is with medicated eye drops applied daily by the patient.
In recent years, however, other techniques have emerged that improve fluid pressure. Here are some of those more advanced glaucoma treatments offered by North Valley Eye Care.
Durysta
This tiny implant device contains medication to lower eye pressure. Designed to dissolve slowly over time, the implant releases its medication into the eye on a consistent basis for several months.
A Durysta® implant is an alternative for patients who cannot tolerate eyedrops or who desire freedom from the daily application.
Goniotomy
In this surgical procedure, the glaucoma surgeon makes a small incision through the cornea to access the eye’s primary drainage area, known as the trabecular meshwork, where more incisions are made to improve drainage flow. The procedure is often recommended for both open- and closed-angle glaucoma patients whose pressure has not responded well to other treatments.
SLT
Selective Laser Trabeculoplasty (SLT) helps lower eye pressure in open-angle glaucoma patients by directing laser energy onto the trabecular meshwork. This causes the meshwork tissue to change chemically and biologically, creating better fluid drainage.
Transluminal Dilation
Schlemm’s canal, a circular structure that surrounds the iris, collects and drains fluid from the space between the iris and the cornea called the anterior chamber. Transluminal dilation utilizes a microcatheter tube inserted into the canal to clear and widen it, thus improving drainage.
Tubes
These tiny, flexible drainage devices, composed of material that will not break down within the body, are surgically implanted into the eye’s drainage system. The tube then collects excess fluid and redirects or “shunts” it to other areas of the eye where it is absorbed.
Trabeculectomy
This traditional surgical procedure creates an alternate channel through which fluid can drain from the eye. The surgeon first creates a permanent bubble called a bleb, that rests just under the upper eyelid.
They then create a new drainage channel that directs fluid into the bleb where it is then absorbed into the patient’s bloodstream.
ECP
Endoscopic Cyclophotocoagulation (ECP) is a laser procedure intended to help lower eye pressure. The glaucoma surgeon directs laser energy to the ciliary body, the part of the eye that produces intraocular fluid, to cause it to decrease its fluid production.
Reducing fluid production is an alternate way to lower eye pressure from other techniques that improve drainage.
What is Minimally Invasive Glaucoma Surgery?
Eye surgeons have developed a new set of procedures known as Minimally Invasive Glaucoma Surgery (MIGS). These procedures employ microsurgical instruments and devices, which result in smaller incisions and less handling of eye tissues.
Because they are less invasive, MIGS procedures improve safety, result in fewer complications, and promote faster recoveries.
North Valley Eye Care offers their glaucoma patients the following MIGS procedures:
OMNI® Surgical System
This device contains a tiny tube called a microcatheter that a surgeon can insert into any one of three main drainage points in the eye. With Omni®, the surgeon can remove obstructions and help restore normal drainage flow.
Hydrus® Microstent
The Hydrus® Microstent is inserted near the juncture of the trabecular meshwork into Schlemm’s canal. About the size of an eyelash, the device holds open this pathway to consistently restore normal drainage flow.
Xen®
This tiny, flexible tube composed of gelatin creates a new pathway within the eye to drain excess fluid. About six mm in length, this microtube diverts fluid into a bleb created by your glaucoma surgeon under the eyelid, where it is then absorbed by the body.
iStent® and iStent® Infinite
These tiny titanium tubes are surgically implanted into the eye to improve drainage. Once in place, the iStent®creates a new opening between Schlemm’s canal and the anterior chamber of the eye, bypassing damaged portions of the drainage system.
Do you want to learn more about glaucoma or have your eyes screened? Schedule an appointment at North Valley Eye Care in Chico, CA, today!
