Glaucoma
Symptoms
Glaucoma is the leading cause of irreversible vision loss and blindness in the United States. It can affect patients of all ages but becomes much more common with advancing age. Glaucoma is known as the “Thief or Sight” because there are few to no symptoms such as pain or noticeable vision loss early in the disease. In addition, at least half of people with glaucoma are unaware they have it. Peripheral, or side, vision is usually affected first, and patients rarely notice they have lost vision until significant, irreversible damage has already occurred.
Glaucoma refers to a group of disorders that result in optic nerve damage. The optic nerve is the only connection between the eye and the brain and is essential for normal vision. Increased eye pressure is the largest risk factor for developing glaucoma, but many other factors such as family history, abnormal blood vessel function, injury, eye inflammation and infection can put you at risk. The two main types of glaucoma are open-angle and angle-closure. Open-angle is much more common and usually involves microscopic damage to the eye’s drainage system. This causes slow, chronic but completely painless vision loss. In contrast, angle-closure glaucoma can cause intermittent eye pain, blurred vision and headaches. A glaucoma attack refers to an angle-closure with a sudden and extreme rise in eye pressure. This is an emergent situation and can cause severe eye pain, headaches, nausea, vision loss and halos around lights. If not treated promptly, a glaucoma attack can quickly lead to profound vision loss.
Diagnosis
Given the lack of symptoms for most people with glaucoma, signs of glaucoma are usually only picked up during routine eye exams. A comprehensive eye examination done by a trained eye professional is then needed to fully diagnose the disease. The examination includes checking eye pressure, determining if the drains within the eye are open, and dilation to examine the optic nerve. A number of tests are also used if glaucoma is suspected or diagnosed, including visual field tests (side-vision tests), pictures of the optic nerve and functional tests of the optic nerve.
Treatment
Glaucoma treatment currently centers on reduction of intraocular eye pressure. Many large clinical studies have proven that a reduction in eye pressure can slow down or stop progression of glaucoma damage and vision loss. Treatment usually starts with daily eye drops or a laser procedure. Additional eye drops, laser treatments or surgical procedures can be used if the pressure remains too high. Ohio Eye Associates is equipped to offer all options for glaucoma care.
Laser Surgery
We offer several types of laser procedures that are used in the treatment of glaucoma.
Direct Selective Laser Trabeculoplasty (dSLT): A cutting edge update to a well established procedure, Direct SLT is a low risk, non invasive, non contact laser treatment that is painless and can effectively lower eye pressure in many glaucoma patients. Direct SLT offers many advantages over traditional SLT; it is more comfortable for the patient, faster and more precise while offering the same results. dSLT can be used as an alternative to eye drops as a first line treatment for glaucoma, or in conjunction with eye drops to control eye pressure.
Laser Peripheral Iridotomy (LPI): Used to treat narrow or closed angle forms of glaucoma. This non-invasive procedure drastically reduces the risk of a glaucoma attack, may effectively lower eye pressure and preserve vision in at risk patients.
Micro-pulse Laser: This laser can be used for all stages of glaucoma. It is a gentle O.R based laser procedure that can help lower eye pressure in a non-damaging way. It can be used as an alternative to incisional surgery and to reduce the number of eye drops needed for many patients.
G-Probe Laser: This type of treatment is typically reserved for advanced cases of glaucoma. It is also an O.R based laser procedure. We provide this specialty option locally, eliminating the need for travel, which is often challenging for patients with advanced glaucoma.
MIGS
Minimally Invasive Glaucoma Surgeries (MIGS) are a collection of surgical options for glaucoma care that are much safer than traditional glaucoma surgeries. The recovery from these surgeries is also much easier, more comfortable and faster than traditional surgeries. In general, these surgeries involve opening or rejuvenating the natural drains in the eye, restoring flow and reducing eye pressure. The surgeries are often combined with cataract surgery. The safety profile of MIGS allows us to intervene surgically at earlier stages of disease, providing many more effective options for glaucoma management and reduction in eye drop use. Dr. Skarie is the only fellowship trained glaucoma specialist in the area and is trained in several MIGS procedures.
Traditional Glaucoma Surgery
While MIGS offer excellent surgical options for the majority of glaucoma patients, those with advanced glaucoma or glaucoma associated with other severe eye disease may require a traditional glaucoma surgery. These surgeries involve bypassing the natural drains to create a new drainage system that can drastically lower eye pressure. Dr. Skarie has the training and expertise to perform these surgeries locally, avoiding the need for travel. Frequent follow-up care is needed following this type of surgery, making this local specialty care especially convenient.