Glaucoma

What Is Glaucoma?

Glaucoma is an eye disease that gradually damages the optic nerve. If left untreated, it can lead to vision loss and blindness. In the United States, glaucoma is the leading cause of irreversible vision loss.

In most cases, the drainage system becomes clogged, so the aqueous humor cannot drain. When this happens, pressure (intraocular pressure) builds up inside the eye. High pressure can damage the optic nerve, which then leads to vision loss.

The optic disc is where the optic nerve connects to the eye. As pressure increases, nerve fibers in the optic nerve begin to die. When this happens, the disc begins to hollow out and become cupped.

Early detection and treatment often help to prevent serious vision loss.

Who is at Risk for Glaucoma?

Anyone is at risk, but there are factors that increase the risk for glaucoma:

  • Age (especially those over 60 years of age)
  • Myopia (nearsightedness)
  • Long-term use of steroids
  • Thin corneas
  • African American, Asian or Hispanic descent
  • Family history of glaucoma

The best way to avoid the negative consequences of this disease is to undergo regular glaucoma examinations. Our practice has locations throughout the state, from Flagstaff to Tucson, where you can talk to an experienced optometrist or ophthalmologist and learn more about glaucoma treatment options.

 

New Advancements for Glaucoma Patients

Glaucoma is a disease defined as optic nerve damage. The primary cause of this nerve damage is elevated pressure inside the eye (intraocular pressure). Damage to the optic nerve can lead to progressive sight loss throughout a patient’s life. Over the past several decades in the United States, the use of surgery as a stand-alone procedure for treating glaucoma has declined steadily. This is because the medications (eyedrops) available to treat the disease have improved dramatically, while standard glaucoma surgeries are still considered to be high-risk for sight-threatening complications.

The risks associated with some glaucoma surgeries, such as aqueous shunts or trabeculectomies, are often unacceptably high when compared to the risks associated with medical treatment.

MIGS, or Micro-Invasive Glaucoma Surgery, is a great treatment option for glaucoma patients who are considering cataract surgery. One such micro stent, roughly the size of an eyelash, can be placed into the eye’s drainage system during cataract surgery. It acts as a kind of scaffolding that helps to open and enlarge the drainage system, lowering intraocular pressure. This innovative device is similar in form and fashion to the stents used for heart conditions such as coronary artery disease.

Because the device is inserted simultaneously with cataract surgery, patients who need or want cataract surgery can have a combined cataract and glaucoma procedure. The cataract portion is performed to improve vision, and the micro stent placement is performed to help control glaucoma. Insertion of the micro stent generally adds only a few minutes to the surgery and is done when the cataract portion is completed. The microstent adds little overall risk to the procedure. Insertion of the microstent, however, can help greatly with controlling eye pressure and thus controlling a patient’s glaucoma.

Most patients with both cataracts and glaucoma are considered good candidates for this combined procedure. The microstent allows patients to reduce the number of medications they use to manage their disease. It also provides the opportunity to improve eye pressure without being subjected to an ever-increasing number of topical medications (eyedrops), each of which can have side effects for the eyes and other organs, such as the heart and lungs.

We are fortunate at Barnet Dulaney Perkins Eye Center to have Dr. Neil Atodaria, a board-certified, fellowship-trained glaucoma expert who specializes in managing cataracts in patients with glaucoma. He has been performing glaucoma surgery for nearly a decade in Arizona. He is proficient in other glaucoma surgeries as well and is on the cutting edge of improving existing procedures.

Dr. Atodaria and the other physicians and staff members at Barnet Dulaney Perkins Eye Center will be happy to provide information to any patient interested in this surgical option. Other combined procedures are available for those not interested in the microstent. For example, Dr. Atodaria can perform a laser procedure known as endocyclophotocoagulation (ECP) at the time of cataract surgery. This procedure has been paired successfully with cataract surgery for nearly two decades and is very effective.

Glaucoma Medications and Surgery

Glaucoma is a term used to describe a group of eye conditions in which the optic nerve is damaged due to an increase in pressure within the eye. Left untreated, glaucoma often causes blindness. The best way to avoid the negative consequences of this disease is to undergo regular glaucoma examinations. Our practice, based in Phoenix, Arizona, has locations throughout the state where you can talk to an experienced optometrist or ophthalmologist and learn more about glaucoma treatment options.

Types of Glaucoma

Though all glaucoma is caused by increased pressure in the eye, different types of the condition can yield different symptoms and levels of severity. Below are descriptions of two of the most common types of glaucoma.

Primary Open-Angle Glaucoma

The most common type of glaucoma affecting our Phoenix, Arizona, patients is called chronic glaucoma, or primary open-angle glaucoma (POAG). In a normally operating eye, fluid called aqueous humor continually flows through the eye, eventually exiting through tissue known as the trabecular meshwork. In an eye affected by chronic glaucoma, this meshwork becomes blocked or clogged and fluid is unable to flow out of the eye. Intraocular pressure increases, pushing against the optic nerve and causing peripheral vision loss.

Angle-Closure Glaucoma

Angle-closure glaucoma, or narrow-angle glaucoma, occurs suddenly and presents symptoms such as headaches, eye pain, haloes around lights, and nausea. This type of disease occurs when fluid in the eye is suddenly kept from draining properly due to blockage or over-dilated pupils. Though symptoms may disappear, seek medical treatment as soon as possible. Each renewed attack destroys more of your sight. Fortunately, there is a treatment, or laser therapy called LPI to completely eliminate the risk of this ever developing.

Causes of Glaucoma

The most prevalent cause of glaucoma is age. It is estimated that one percent of Americans between the ages of 60 and 80 suffer from primary open-angle glaucoma; this number jumps to three percent in people over the age of 80. Ethnic background also plays a large role in glaucoma development. African-Americans have a high risk of developing glaucoma, as do people of Irish, Scandinavian, or Russian heritage.

Medical conditions such as extreme nearsightedness and diabetes have a hand in glaucoma risk. Our Phoenix, Arizona, doctors will also ask you about your medications during your examination, as certain inhaled or oral steroids may increase the chances of developing glaucoma.

Treatment for Glaucoma

If you are diagnosed with glaucoma at one of the Arizona locations of Barnet Dulaney Perkins Eye Center, we will attempt to control the disease with medications that either decrease the amount of fluid produced by the eye or increase the amount of fluid that drains from the eye. If these medications do not adequately treat your glaucoma, your doctor may suggest surgery to increase the drainage flow.

Get Help Today

If you are at risk for Glaucoma or symptoms of Glaucoma are making you uncomfortable and interfering with your daily life, call us. Our doctors across Arizona have the expertise and tools to give you the relief you need.

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