Glaucoma

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Glaucoma is a disease that damages the eye’s optic nerve. It is the optic nerve that sends signals from your retina to your brain, where these signals are interpreted as the images you see.

Vision loss from glaucoma results from deterioration of the optic nerve, often associated with high eye pressure, leading to irreversible loss of the field of vision.

Over 3 million Americans suffer from glaucoma, and it is also the leading cause of preventable blindness. Regular eye exams are key in diagnosing glaucoma, because patients often do not experience any symptoms until irreversible vision loss has already occurred.

Unlike many other eye diseases, most types of glaucoma are chronic disorders that can be controlled but not cured. As with diabetes, high blood pressure, asthma, or arthritis, glaucoma can require some lifestyle modifications. This includes compliance with medical regimens and regular eye exams to achieve successful treatment.

GLAUCOMA INTRODUCTION

Who Is at Risk for Glaucoma?

People at risk for glaucoma include:

What Are the Symptoms of Glaucoma?

Unfortunately, glaucoma rarely has symptoms that can warn you that something is wrong. Glaucoma is often called “the silent thief of sight” since it usually doesn’t hurt and can steal the vision very slowly. Most people notice vision loss from glaucoma only after significant damage has already taken place. Gradual loss of vision can occur over a period of weeks, months, or years before you even realize that you are losing your vision. The good news is, advanced diagnostic equipment can help detect glaucoma before you experience symptoms and the problem can be addressed very early. For many, glaucoma can be managed without surgery, and with proper treatment, most patients can expect to see well their entire life. New Eyes doctors are very experienced in treating glaucoma and are committed to saving your vision.

What Causes Glaucoma?

Glaucoma is often caused by increased pressure in the eye; however, this is not always the case. Some patients experience normal pressures and still develop the disease. It is imperative that patients be checked for glaucoma on a routine basis to ensure early detection. Click on the illustration below to view the development of glaucoma.

GLAUCOMA OVERVIEW

What Are the Different Types of Glaucoma?

Glaucoma is characterized by three types: open-angle, narrow-angle, and low-tension. Open-angle glaucoma occurs when there are problems with the eye’s drainage system – this is the type seen most commonly. The aqueous fluid has access to the drainage system, but does not flow properly through it. Narrow-angle glaucoma is typically more severe and occurs when access to the drainage system is blocked, resulting in rapid eye pressure buildup because the fluid has nowhere to drain. There have also been instances of low-tension glaucoma, in which there is no excess eye pressure, but the optic nerve is still damaged

How Is Glaucoma Detected and Diagnosed?

Our eye doctors can diagnose glaucoma with a comfortable screening here at our practice. We can measure eye pressure, test your side vision, and evaluate the health of your optic nerve to see if the internal symptoms of glaucoma are present.

GLAUCOMA TESTING

How Is Glaucoma Treated?

At New Eyes Las Vegas, we are committed to early detection and successful management of glaucoma. Experienced ophthalmologist Jason C. Smart, MD provides our patients with some of the latest minimally-invasive surgical treatment options available. Dr. Smart completed an ophthalmology residency with direct training from some of the pioneers in the field of micro-invasive glaucoma surgery.

There is no cure for glaucoma, but the right treatment approach can reduce intraocular pressure to prevent damage to the optic nerve and mitigate vision loss. At New Eyes, we take a comprehensive approach to glaucoma and offer a range of treatment options. Possible treatments include medicated eye drops, laser treatments, and Minimally-Invasive Glaucoma Surgery (MIGS).

GLAUCOMA: TREATMENT OVERVIEW

It’s important to note that vision loss due to damage of the optic nerve typically cannot be restored. This is why regular checkups and early detection are crucial. With that in mind, there are several options to treat glaucoma and protect vision from deteriorating. Treatments for glaucoma include:

Eye Drops for Glaucoma

Prescription eye drops are typically the first treatment option recommended to patients. There are several different types of eye drops that can help control eye pressure to prevent the progression of glaucoma. Your doctor at New Eyes can help customize your eye drop regimen to best fit your needs.

GLAUCOMA DROPS VIDEO

Laser Glaucoma Treatment with SLT (Selective Laser Trabeculoplasty)

Literature suggests that laser surgery with selective laser trabeculoplasty (SLT) may be superior to eye drop therapy. SLT uses a gentle light that does not cut, burn, or destroy tissue. It gently stimulates the drain to work better and can help improve drainage from the eye. This technique often reduces the dependence on drops and, in some patients, may even stop the need for ongoing glaucoma medication. For some patients, it takes two treatments for there to be pressure reduction. The duration of effect from this procedure varies, but can be repeated, and in about 1/3 of patients it lasts five years or longer.

GLAUCOMA: S.L.T. SURGERY VIDEO

Minimally-Invasive or Micro-Invasive Glaucoma Surgery (MIGS)

If glaucoma continues to progress, surgery may be required in an attempt to relieve eye pressure and reduce potential damage to the optic nerve. The category of surgeries called MIGS are minimally-invasive to optimize results with improved patient comfort and safety. There are several types of MIGS offered at New Eyes:

The iTrack ABiC™ procedure utilizes a tiny micro-catheter to enlarge the drainage canal of the eye without cutting through the outer wall of the eye. Not to be mistaken with traditional canaloplasty, this minimally-invasive approach leaves no hardware or other glaucoma devices behind.

In the GATT procedure, the drainage system is unroofed in a minimally-invasive fashion, allowing greater access to the drain of the eye.

The iStent® is part of a dual procedure to treat glaucoma and cataracts. Following cataract surgery, a tiny stent – the smallest medical device approved by the FDA – is placed in the eye to enhance drainage.

ABiC MINIMALLY INVASIVE GLAUCOMA SURGERY

MIGS: HOW MICRO-STENTS WORK VIDEO

Benefits of MIGS*

The innovative options available for minimally invasive glaucoma surgery offer many benefits, including:

*Individual Results May Vary

Traditional Glaucoma Surgery

If initial treatment is not successful in controlling eye pressure, or if glaucoma is advanced, then a traditional surgical approach may be needed. Examples of traditional surgical options include:

This surgical procedure, also referred to as glaucoma filtration surgery, involves creating a new channel allowing fluid to drain into a blister-like fluid collection (bleb) on the outside of the eye. The goal is to reduce pressure in the eye to prevent further damage to the optic nerve.

In this surgery, a flexible tube is placed in the eye, leading to a drain reservoir attached to the outside of the eye.

TRABECULECTOMY: OVERVIEW VIDEO

Regular eye exams with a qualified professional are often the only way to detect glaucoma. Please contact us to schedule an appointment. If you have glaucoma, Dr. Smart can evaluate your progression, discuss treatment options with you, and create a personalized plan to prevent further damage and vision loss.

How Much Does Glaucoma Treatment Cost?

The cost of glaucoma treatment at our practice often varies considerably among patients based on the specific type of glaucoma treatment performed and insurance coverage. A less invasive treatment for earlier stages of glaucoma, such as the SLT laser, may cost less than drops and other surgical treatments. With this in mind, please remember that treatment for glaucoma is considered a medical necessity by health insurance providers. Once your glaucoma treatment plan is created during the initial consultation, a friendly member of our team here at New Eyes will calculate an estimate of the total cost and answer any questions you may have. Our practice accepts a variety of health insurance plans and we will be happy to assist you with identifying any coverage that may be available for your treatment. We also accept numerous convenient payment methods, and we work with CareCredit®, a reputable healthcare financing company that offers an expansive selection of payment plans for qualified applicants who would like to pay for their glaucoma treatment over time. Rest assured, our team at New Eyes believes that glaucoma treatment should be available to all individuals who need it, and we will do our best to assist you with finding a way to pay for treatment that works within your budget.

Additional Frequently Asked Questions (FAQ) About Glaucoma

Below are answers to some of the most commonly asked questions about glaucoma. The doctors at New Eyes would be happy to personally and thoroughly answer any inquiries you may have. Contact us today if you’d like to meet with one of our experts.

Everything Patients Need to Know About Glaucoma

How do I know which glaucoma treatment I should undergo?

The method of treatment for glaucoma depends on the disease’s severity in each patient. Eye drops can often help lower pressure in the eye by decreasing the amount of fluid produced or improving the flow of drainage. Glaucoma characterized by a larger amount of pressure buildup can often be treated with SLT to open the eye’s drainage system. This can also be done using a minimally-invasive glaucoma procedure. An experienced New Eyes doctor can examine your unique case and determine the best treatment to preserve your vision.

When should I check if I have glaucoma?

Most glaucoma patients begin to notice symptoms starting at age 40. If you are in this age range, it is wise to undergo a glaucoma screening every 3-5 years. However, if your parents or siblings have been diagnosed with glaucoma, a screening may be necessary sooner and more often. Glaucoma can be hereditary, so early detection is the best chance at slowing the progression of the disease. Because you cannot recover the vision lost to glaucoma, generally, the earlier you are diagnosed, the less vision loss you will face. Also, keep in mind that it’s generally recommended to have a routine eye examination at least once per year.

What happens if I don’t treat my glaucoma?

Glaucoma is a progressive disease; unfortunately, left untreated, it can result in total vision loss and is known as the second leading cause of blindness in the world. However, glaucoma can often be treated and managed without much change to one’s life. With regular checkups and professional treatment from New Eyes doctors, you can go a long way toward retaining your sight for the rest of your life.

What is pre-glaucoma?

“Pre-glaucoma” and “glaucoma suspect” are terms typically used to describe a condition in which the patient is experiencing ocular hypertension, but they can also sometimes be used to refer to individuals with a strong family history of the disease. In most cases of pre-glaucoma or glaucoma suspect, ocular pressure is elevated, but vision and/or disc damage has not been identified. Additionally, these terms may refer to patients who may or may not show signs of early normal-tension glaucoma but have a standard field of vision and a large cup/disc ratio.

What foods should I eat (or avoid) if I have glaucoma?

Some research indicates that foods containing a high concentration of antioxidants are helpful for maintaining eye health, as well as keeping intraocular pressure low. Some nutrient-rich foods to incorporate into your diet include: dark leafy greens (e.g., spinach, kale, and collard greens), acai berries, cranberries, pomegranate, tomatoes (for lycopene), and fish with plenty of omega-3 fatty acids.

Consider avoiding foods that contain high levels of trans fatty acids, such as fried foods, as well as foods high in saturated fat, like lard, shortening, butter, and fatty cuts of beef, pork, or lamb. These foods may potentially cause damage to the optic nerve or lead to further progression of the disease. Glaucoma patients should also reduce their caffeine intake—one study found that drinking five or more cups of caffeinated coffee increased the risk of damage to the nerve.

How long does it take to go blind if glaucoma isn’t treated?

If left untreated, there is a high risk for glaucoma to cause blindness within several years. Early detection and consistent treatment can help slow the progression of the disease, often enabling patients to maintain good eyesight over many years.

Can I prevent glaucoma naturally?

The best way to prevent the effects of glaucoma is to have regular eye exams, since early detection and treatment can significantly reduce any damage to your eyesight. Other ways to reduce your risk of developing glaucoma include a nutritious diet and a healthy, active lifestyle. Additionally, trauma to the eyes can also result in glaucoma. It is important to wear protective eyewear during high risk activities, such as sports or home improvement activities that may involve flying debris.

How long does glaucoma treatment last?

The potential length of the effects from glaucoma treatment will depend on several factors, including the particular type of glaucoma treatment that has been performed, the severity of the condition at the time of the procedure, and anatomical characteristics that are unique to each individual patient’s response. The duration of effect from procedures is variable. In the case of the SLT laser, the effects typically wear off with time to the point that, after five years, the procedure has been shown to be effective in about 1/3 of patients. Procedures such as SLT can be repeated when they wear off, and for some it may take two treatments for the procedure to take effect. Our doctor will explain all of your options to you and make a treatment recommendation based on your individual needs. The most important thing to remember is that glaucoma is a treatable condition for many individuals, and its progression can be significantly slowed in order to minimize its effects on one’s livelihood.

Please contact New Eyes for more information on glaucoma, or to schedule an appointment for diagnosis and/or treatment for the condition. Please remember that glaucoma is a progressive condition and early detection and treatment is crucial for the health of your vision.