Glaucoma Explained (Treatment for Glaucoma) – Greenbelt, MD

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About Glaucoma

Glaucoma is a group of diseases that can damage the eye's optic nerve and result in vision loss and blindness. It is almost invariably the result of fluid buildup that increases pressure within the eye and on the optic nerve — the cable that takes information from the eye to the brain for interpretation. In a healthy eye, the fluid that nourishes the eye tissue is able to flow back and forth through a special tissue between the iris and the cornea. However, sometimes this flow is blocked or severely slowed, which causes the fluid to build up and increase internal eye pressure. This pressure then presses on the optic nerve.

Most glaucoma patients are 60 years of age or older; however, it can affect younger people as well. It is quite common with around two million Americans estimated to have the disease. Of these two million, many are undiagnosed; initially, glaucoma has no symptoms. It is frequently referred to as the “silent thief" and can go unnoticed until it is too late. Should glaucoma remain untreated, peripheral vision (side vision) is the first to go. Over time, a progressive constriction occurs, leaving merely a central island of vision.

At Solomon Eye Physicians and Surgeons, we strongly encourage all men and women over the age of 40 to have regularly scheduled comprehensive eye exams. At our Greenbelt and Bowie, MD offices, we have state-of-the-art diagnostic technologies that can help glaucoma patients get ahead of the condition and treat it in its earliest stages.

Symptoms

Very often, there are no symptoms of glaucoma until it is in the later stages. Further, there are different kinds of glaucoma, and each kind may have one or more symptoms that could be mild or severe. Some of these symptoms include:

  • Severe headache
  • Eye soreness or pain
  • Tunnel vision
  • Blurry vision
  • Peripheral or central blind spots
  • Rainbows and/or halos around lights
  • Nausea and vomiting
  • Eye redness

Causes

Glaucoma is nearly always caused by eye pressure that damages the optic nerve, though the damage can occur in other ways. Anyone can be afflicted with glaucoma, but there are certain risk factors that can increase the likelihood of developing the condition:

  • Increasing age
  • Having a thin cornea
  • Having a family history of glaucoma
  • Being African American, Hispanic, or Asian
  • Having diabetes, high blood pressure, and heart disease
  • Taking corticosteroid eye drops for a long period

Treatment Options

Before determining your best treatment options, Solomon Eye Physicians and Surgeons will perform a thorough eye exam to evaluate the type and stage of your glaucoma. This exam would include the following tests: 

  • Visual acuity – measures the quality of vision at different distances
  • Visual field – measures the degree of peripheral vision
  • Dilated eye exam – evaluates the optic nerve and adjacent tissue by widening the pupil with dilation eye drops
  • Tonometry – determines an accurate approximation of the pressure inside the eye
  • Pachymetry – measures the thickness of the cornea, which has been determined to be an independent risk factor of the development of glaucoma

Whether through the use of medication, minimally invasive laser treatment, or surgery, the basis of glaucoma care lies in the reduction of intraocular pressure.

Eye drops are the most common early treatment for glaucoma. Some medicines decrease the production of fluid or increase the rate of drainage within the eye. Eye drops, like every medication, have potential side effects. Therefore, it is important to inform us of any adverse reaction after beginning treatment. 

For patients whose glaucoma is in the later stages, treatments such as MIGS (minimally invasive glaucoma surgery), SLT therapy, Peripheral Iridotomy, and traditional glaucoma surgery may be required.

The SLT therapy and Peripheral Iridotomy are two safe and effective in-office procedures available for glaucoma treatment. 

SLT Laser – Selective light therapy (SLT) is a treatment used for primary and open-angle glaucoma. This treatment stimulates natural healing within the eye's built-in drainage system (the trabecular meshwork) using a nonthermal nanosecond laser.

SLT is quite quick and painless. A special mirrored contact lens is inserted over your eye for the procedure, and then you'll sit in front of the laser, which looks a lot like the machine you sit at for your regular eye exam. As you look into the machine, your ophthalmologist will precisely aim the laser to target only the pigmented cells within the drainage meshwork surrounding the iris. As these cells heal in the next several weeks, circulation is improved, which promotes better drainage and reduces eye pressure. After your procedure, the contact lens is removed, and you may be given special eye drops.

YAG Laser Peripheral Iridotomy –  The Peripheral Iridotomy has been a commonly used treatment for narrow- and acute-angle glaucoma since 1984. This procedure works by utilizing a laser to create a tiny hole at the periphery of the iris. This tiny hole widens the "angle" between the iris and the cornea and helps to reduce pressure. It is often used as a preventative measure but can also be curative in some circumstances.

The YAG laser iridotomy procedure is very much like the SLT above except that the laser is used to create only one tiny pinprick hole as opposed to targeting cells around the whole iris. Most patients report feeling no pain or discomfort, although some feel a prick or hear a small "pop" as the laser is fired.

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Relieve Your Glaucoma 

Glaucoma is a very common condition that the board-certified ophthalmologists at Solomon Eye Physicians and Surgeons see and treat quite often. While receiving a diagnosis of glaucoma can be upsetting, it's important to remember that the symptoms are manageable if detected and treated early enough. We urge anyone who has possible symptoms, a family history, or an existing diagnosis of glaucoma to plan a visit to our Greenbelt or Bowie, MD office at your earliest convenience. 

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*Individual results are not guaranteed and may vary from person to person. Images may contain models.