GLAUCOMA
Glaucoma is a condition that affects the optic nerve. This nerve connects the eye to the brain, carrying the image that was captured by the eye to be processed in the brain. The optic nerve can be affected by an increase in intraocular pressure.
RISK FACTORS
01
ETHNICITY
Asians are more predisposed to develop angle-closure glaucoma than other ethnic groups.
African Americans older than 40 years old.
Hispanics older than 60 years old have a higher incidence of developing open-angle glaucoma.
02
AGE
As a person ages the risk increases, especially if one is over the age of 60.
03
OTHER RISK FACTORS
Family history of glaucoma.
Increase in intraocular pressure.*
Having myopia or severe hyperopia.
Having fine corneas.
Chronic steroid use.
Previous eye trauma.
Systemic health conditions such as diabetes, high blood pressure, low circulation, etc.
* Although this is an important risk factor, it should be noted that only half of patients present with an elevated pressure at the time of their eye exam. This occurs because the intraocular pressure varies during the day. Therefore, it is important to monitor the eye pressure over time.
TYPES OF GLAUCOMA
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It is the most common type of glaucoma. This occurs when the trabecular mesh work becomes less efficient at draining intraocular fluid (aqueous humor). This fluid usually maintains an adequate intraocular pressure. A normal eye is like a sink. The faucet and the drain are both open. In open-angle glaucoma, the drainage system is not working well, and the fluid builds up.
The accumulation of fluid causes an increase in intraocular pressure, which in turn affects the optic nerve. The pressure level that causes damage to the optic nerve is different in each patient.
In Horta-Santini Eye Care, a target pressure will be established in order to try to avoid further damage to the optic nerve.
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The acute subtype of this type of glaucoma is a medical emergency and you may experience some of the symptoms below. This type of glaucoma occurs when the iris gets too close to the internal drainage of the eye, the trabecular meshwork. You could compare it to a piece of paper plugging the drain of a sink. When the iris causes a complete blockage of intraocular drainage, the pressure of the eye increases. Asian patients and people with hyperopia have a higher risk of developing this type of glaucoma.
You should call Horta-Santini Eye Care if you are feeling any of the following symptoms:
- Sudden blurry vision
- Extreme eye pain
- Headache
- Nausea and dizziness
- Vomiting
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In this condition, the optic nerve demonstrates changes consistent with glaucoma, but the intraocular pressure is normal or low. No one exactly knows why this occurs, although it is considered to be secondary to low blood flow to the optic nerve. The diagnosis is usually made when the vision is already affected. Treatment for open-angle and low/normal pressure glaucoma is the same.
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This type of glaucoma occurs in childhood, and it is genetically transmitted. It is less common than other types of glaucoma, and if it is not treated in time, it can result in blindness quickly.
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This glaucoma occurs due to other eye conditions or systemic disease. Examples include: a patient who has received eye trauma, a chronic steroids user or someone who has an intraocular, etc.
SYMPTOMS
ANGLE-CLOSURE GLAUCOMA
Presents with a sudden increase in intraocular pressure causing eye pain, redness, blurred vision and halos. The person may experience nausea, dizziness, and vomiting. This condition requires urgent medical treatment to prevent vision loss.
OPEN-ANGLE GLAUCOMA
Patients have blind spots in their peripheral vision, usually in both eyes. Patients who with severe illness may have tunnel vision and almost complete vision loss.
Normal vision
Early-Stage
Advanced-Stage
Late-Stage
Unfortunately, the most common type of glaucoma – open-angle glaucoma – has no symptoms until it is too late. The only way to prevent irreversible visual loss is through an eye exam. If you have any risk factors for the development of glaucoma, you should not wait get an eye exam. If you do not have any risk factors and do not have any symptoms, you should be tested at 40 years old. At this age, glaucoma can occur and cause irreversible vision loss. Based on the evaluation and test from the most advanced technology at Horta-Santini Eye Care, you will be told how frequent your visits will be.
DIAGNOSIS
At Horta-Santini Eye Care, we will review your medical history and complete ophthalmological exam. In addition, the following tests will be carried out:
01.
Tonometry
Measurement of intraocular pressure.
02.
Dilated Eye Examination and Imaging
Evaluation of glaucomatous optic nerve damage.
03.
Visual Field
Evaluation of areas of glaucomatous visual field loss.
04.
Goniotomy
Inspection of the angle of intraocular drainage of the aqueous humor.
TREATMENTS
Most types of glaucoma can be controlled, but not cured. The glaucoma damage is irreversible. The treatment is designed to prevent disease progression and further damage to the optic nerve.
If you have glaucoma, preserving vision requires teamwork. At Horta-Santini Eye Care you will have a treatment plan, but you need to strictly follow it. Using your medications properly and going to your follow-up appointments is paramount to controlling your intraocular pressure and thus preventing irreversible visual loss.
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The most common glaucoma treatment is the use of medicinal drops. Pills are also used, but temporary measure until surgery is done. The purpose of these medications is to lower intraocular pressure. Even if their purpose is achieved, these drugs can have side effects, difficulty applying them or poor adherence of the patient in using them with the correct frequency.
At Horta-Santini Eye Care, you will be offered the most compatible medicine that will serve you in your specific case. In addition, you will be offered other alternatives if the medicines do not work for you, or you wish to avoid them.
The health insurance companies usually covers the cost of this type of intraocular lens.
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Laser trabeculoplasty is used to treat open-angle glaucoma. This stimulates the intraocular drainage system to work more efficiently and thus decrease intraocular pressure. A laser with a slight energy is applied to the trabecular meshwork (where intraocular fluid drains). This laser has an effectiveness of 85%. The procedure does not cause pain and takes less than 5 minutes. Recovery is quick and there are no restrictions on your activities of daily living.
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Iridotomy is used to treat angle-closure glaucoma. With this laser a small hole is made through the iris causing an alternate path allowing the flow of aqueous humor to the front of the eye and through the trabecular meshwork.