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What is Glaucoma?
Glaucoma is an eye disease in which the main nerve (the optic nerve) connecting each eye to the brain undergoes progressive deterioration in a characteristic way. Deterioration of the optic nerve leads to slow, progressive loss of peripheral (side) and central vision. Glaucoma is a leading cause of blindness for people over 60 years old. But blindness from glaucoma can often be prevented with early treatment.
Types of Glaucoma
Primary Open Angle Glaucoma
This is the most common type of glaucoma. It happens gradually, where the eye does not drain fluid as well as it should (like a clogged drain). As a result, eye pressure builds and starts to damage the optic nerve. This type of glaucoma is painless and causes no vision changes at first.
Some people can have optic nerves that are sensitive to normal eye pressure. This means their risk of getting glaucoma is higher than normal. Regular eye exams are important to find early signs of damage to their optic nerve.
Signs/Symptoms
- Since glaucoma is a slow, painless process, most patients do not know they have the disease until advanced vision loss has occurred. Once vision is lost from glaucoma, it cannot be restored.
- A diagnosis of glaucoma may be based on the appearance of the optic nerve, testing of the peripheral field of vision, and/or computerized imaging of optic nerve fibers.
Treatment
The only known treatment for glaucoma is lowering internal eye pressure with either medication or, in more advanced cases, surgery. Lowering of eye pressure decreases the risk of further loss of vision due to glaucoma but does not restore vision that has already been lost.
Narrow Angle Glaucoma
This type happens when someone’s iris is very close to the drainage angle in their eye. The iris can end up blocking the drainage angle. You can think of it like a piece of paper sliding over a sink drain. When the drainage angle gets completely blocked, eye pressure rises very quickly. This is called an acute attack. It is a true eye emergency, and you should call your ophthalmologist right away or you might go blind.
Sudden-onset narrow angle glaucoma
Signs/Symptoms
- Severe eye pain
- Headache
- Eye redness
- Blurred vision with halos
- Nausea/vomiting
Chronic narrow angle glaucoma
A slow loss of peripheral and central vision often goes unnoticed until advanced vision loss has occurred. Angle-closure glaucoma can cause blindness if not treated right away.
Treatment
Laser peripheral iridotomy (LPI) is a procedure in which a tiny microscopic opening is made in the iris so internal eye pressure is lowered.
Secondary Glaucoma
A group of eye disorders are common causes of secondary glaucoma including pigment dispersion (pigment in the iris flakes off and blocks eye drainage), pseudoexfoliation (flaking of the outer layer of the lens in the eye), eye injury, neovascularization (abnormal blood vessel formation), eye inflammation and prior eye surgery.
Signs/Symptoms
The signs and symptoms of secondary glaucoma differ based on the specific underlying disorder. In some types of secondary glaucoma such as neovascular glaucoma, vision loss and pain may occur suddenly. In other types of secondary glaucoma such as pseudoexfoliative and pigmentary glaucomas, vision loss may occur in a slow, painless manner.
Treatment
The treatment of secondary glaucoma varies based on the exact cause but usually includes medications, laser surgery or standard surgery.
State-Of-The-Art Diagnostic Services
Glaucoma-related vision loss most often begins with the decline of peripheral vision. People suffering from the condition often do not notice the effects of their glaucoma damage until they have lost a significant portion of their sight. Glaucoma may be detected early through routine eye exams. Glaucoma specialists examine both the structure and function of the optic nerve to assess its state of health.
- Visual Field Testing: Standard Automated Perimetry and Short-Wavelength Automated Perimetry
- Ultrasound Biomicroscopy
- Optical Coherence Tomography
- Fluorescein Angiography
- Optical Coherence Tomography Angiography
- Corneal Pachymetry
- Anterior Segment Optical Coherence Tomography
- Stereoscopic Optic Disc Photography
At SCEI we use cutting-edge diagnostic tools, including:
Personalized Treatment Plan
The world-renowned glaucoma experts at the Southern California Eye Institute are dedicated to preventing vision loss through high-quality patient care and cutting-edge research efforts. Our experts trained at some of the leading eye institutes in the world, including The Johns Hopkins Wilmer Eye Institute and the Wills Eye Hospital. They are board certified and fellowship training and have a combined experience of over 30 years in the management of glaucoma patients.
When you come to see us, we develop a personalized treatment plan. This may include non-invasive treatments such as medication and lasers, minimally invasive glaucoma surgery (MIGS), or an incisional surgical procedure.
