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Glaucoma

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Glaucoma is fairly common in adults over age 35.  Glaucoma can produce damage to the optic nerve causing blind spots in areas of vision to develop. People seldom notice these blind areas in the side vision until considerable optic nerve damage has occurred. If the entire nerve is destroyed, blindness results. Fortunately, this rarely occurs if Glaucoma is diagnosed and treated before major damage has taken place.

Symptoms

There are two main types of glaucoma- open angle and closed angle.

In open angle glaucoma the drain of the eye is open yet too much fluid accumulates in the eye. This is the most common type of glaucoma. There are no warning signs or obvious symptoms in the early stages. Chronic Open Angle Glaucoma develops slowly over a period of time and the patient is often unaware they are losing vision. The best way to diagnose this form of glaucoma is by regular eye exams.

In closed angle glaucoma the drain of the eye is obstructed. In Closed Angle glaucoma, parts of the eyes may completely or partially obstruct the drainage system of the eye. Unless this condition is relieved promptly, blindness can result in a day or two.

Angle-Closure Glaucoma Symptoms include:

  • Severe ocular pain and redness
  • Decreased vision
  • Colored halos around lights
  • Headache
  • Nausea
  • Vomiting

Because raised eye pressure can damage the optic nerve and lead to vision loss, an Closed - Angle Glaucoma attack must be treated immediately.

Diagnostic Testing

There are several diagnostic tests which your doctor will complete during your visit. After these have been completed and Glaucoma has been diagnosed, your doctor may:

  • Monitor the progression of the disease with special photographs of the optic nerve.
  • Check for progressive enlargement of the optic cup, which indicates continuing damage from the elevated eye pressure.
  • Note blood vessel changes in the optic cup, another sign of Glaucoma progression.
  • Advise you how often your eyes will need to be checked.

Occasionally, a person may have a “borderline” eye pressure, which means that, although the pressure is elevated, there is no evidence of glaucoma damage. If you are a Glaucoma suspect with a borderline pressure, your doctor may not prescribe medication immediately. Instead, your pressure will require monitoring by your doctor so that if changes do occur, treatment can be started.

Open-Angle Glaucoma Treatment

Glaucoma tends to run in families, and if either of your parents or any of your grandparents had it, you have a higher than average chance of developing the disease.

Glaucoma is usually controlled with eye drops given 1 -  2 times a day given in various combinations. These medications act to decrease eye pressure. To be effective, these medications must be taken regularly and continuously.

As a rule, damage caused by glaucoma cannot be reversed. Eye drops, laser and surgery are used to prevent further damage from occurring, and to preserve existing vision.

Closed-Angle Glaucoma Treatment

Laser iridotomy is a surgical procedure used to treat  Closed Angle  Glaucoma and those at risk for Angle-Closure Glaucoma.
What is a Laser Iridotomy?

During laser iridotomy, a small hole is made in the iris to create a new way for the fluid to drain from your eye. The new hole restores the balance between fluid entering and leaving your eye, lowering eye pressure. The surgery is performed by an opthalmologist on an outpatient basis.

Preventing Glaucoma-Related Blindness

Patients with any type of Glaucoma need periodic examinations. Glaucoma sometimes gets worse (or better) without the patient being aware of it, and as a result, treatment may need to be changed after a while.

The key to preventing optic nerve damage or blindness from Glaucoma is early diagnosis and treatment. If you are over age 35, you should have your eyes checked for Glaucoma every 1-3 years. Consult your Ophthalmologist whenever there is any decrease in vision or recurrent pain. Regular medical eye examinations from your eye care professional are the best defense against Glaucoma.

What to Expect During Your Glaucoma Evaluation

Please allow at least two-hours for the initial Glaucoma exam. Your visit will include testing specific to your problems and concerns, and a complete and thorough eye exam with dilation. Dilating drops may be placed in your eyes. As the drops begin to work, you will have trouble seeing things up close and may experience light sensitivity. These effects will wear off in a few hours.

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