Glaucoma is an eye disease that damages your eye’s optic nerve. It is a leading cause of blindness in people over 60 years old, but can affect people of all ages. In a majority of cases, the pressure in the eye is too high as fluid builds up in the eye. Earlier detection and treatment can often help prevent blindness, or slow the progression of vision loss over time. Vision loss associated with glaucoma often goes undetected until the disease is severe, so having regular eye exams is vital to preserving vision. Peripheral vision is often affected first, progressing to complete vision loss in the most advanced cases.
Open Angle Glaucoma is the most common type of glaucoma present in the United States. It generally occurs gradually over time, where the inside of the eye does not drain fluid as well as it should. As a result, eye pressure builds slowly and starts to damage the optic nerve. This type of glaucoma is painless and causes no vision changes at first, which is why it is usually diagnosed during a regular comprehensive eye exam.
Treatment for open angle glaucoma involves the use of eye drops to lower the eye pressure. This treatment is often very successful at lowering the eye pressure and stopping glaucoma damage. Laser surgery can also be utilized. This treatment is called Selective Laser Trabeculoplasty. In this instance, laser treatment is used to increase the outflow of fluid from the eye to decrease the eye pressure. This procedure may need to be repeated periodically to keep the eye pressure in check.
In severe cases of glaucoma, a referral to a glaucoma specialist for advanced glaucoma surgery may be required. Dr. Szeles will communicate the severity of the condition and the need for this type of referral.
Glaucoma treatment is a rapidly evolving field. New and less invasive surgical options are always on the horizon. In addition to traditional glaucoma treatment, Dr. Szeles has specialized training in Minimally Invasive Glaucoma Surgery (MIGS). During the time of cataract surgery, Dr. Szeles can offer a surgical procedure called iStent Inject© . During this procedure, two small stents are placed into the drainage passages of the eye in order to promote better outflow of fluid and lower eye pressure. This procedure has no additional risks to performing cataract surgery alone, and has the ability to lower eye pressure. In some instances, people with glaucoma may be able to stop eyedrops all together or take fewer eyedrops than they have needed in the past.
Another type of glaucoma less often seen is Angle Closure Glaucoma. Angle Closure Glaucoma is associated with eye pain, blurred vision, headache, nausea, glare, and halos around lights. In this disease the drainage passage of the eye becomes blocked and fluid inside the eye builds rapidly. Angle Closure Glaucoma can lead to vision loss very quickly without immediate treatment. Treatment includes eyedrops, oral medications, and a laser procedure called Yag Laser Iridotomy. The laser treatment creates an alternate pathway for fluid to drain through the eye, and can lead to rapid decrease in eye pressure to a normal range. Sometimes, this laser treatment will be offered in order to prevent an acute angle closure attack. Dr. Szeles will be able to determine if you would benefit from this type of laser procedure.
The only sure way to diagnose glaucoma is with a comprehensive eye exam and with special glaucoma diagnostic tests. It is important to know that just checking eye pressure alone is not enough to make the diagnosis of glaucoma. During your eye exam, Dr. Szeles will measure your eye pressure, inspect your eye’s drainage capability, evaluate your optic nerves for signs of damage, obtain pictures of your optic nerves, and formally test your peripheral vision for signs of vision loss. The diagnosis of glaucoma requires careful assessment of all these factors.