Glaucoma is a group of eye diseases that progressively damage the optic nerve. If it is not detected and managed early enough, this disease can lead to irreversible vision loss and potential blindness. Unfortunately, most forms of glaucoma develop with no pain or symptoms, making comprehensive eye exams an essential tool for protecting your eyes from this disease.
It is not entirely clear what causes glaucoma, but there are many theories. One theory is that increased IOP puts pressure on the optic nerve, while another suggests an inadequate blood supply to the optic nerve is to blame. However, each type of glaucoma is associated with its own potential causes.
Some factors can increase your chances of developing glaucoma as well:
Corticosteroid use. Long-term corticosteroid use (including cortisone, hydrocortisone, and prednisone) may put some people at risk of developing secondary glaucoma.
Open-angle glaucoma is the most common form of glaucoma. It results in slow and painless progressive damage to the optic nerve. Many people with this type of glaucoma may not realize they have it until they start noticing problems with their vision. At this point, however, damage is already extensive.
Primary open-angle glaucoma is generally believed to be caused by problems with the eye’s drainage system, causing fluid to build up and elevate IOP. However, it is also thought that open-angle glaucoma is related to poor blood flow to the optic nerve.
Angle-closure/narrow-angle glaucoma is less common than open-angle. It can develop slowly (chronic) or come on suddenly (acute) and occurs more frequently in Asian ethnicities. Acute angle-closure glaucoma is considered a medical emergency and requires immediate attention.
Angle-closure/narrow-angle occurs when the eye’s drainage angle between the cornea and the iris becomes blocked or closes. Many who develop angle-closure glaucoma have narrow drainage angles, which continue to narrow as they age. This narrowing blocks the drainage system, causing fluid to build up and increase IOP. Angle-closure/narrow angle glaucoma is less common than open-angle. It can develop slowly (chronic) or come on suddenly (acute).
Angle-closure glaucoma occurs when the eye’s drainage angle between the cornea and the iris becomes blocked or closes. Many who develop angle-closure glaucoma have narrow drainage angles, which continue to narrow as they age. This narrowing blocks the drainage system, causing fluid to build up and increase IOP.
Normal-tension or low-tension glaucoma occurs even when IOP remains within the normal range. This type of glaucoma still causes optic nerve damage, although the exact reason is unknown. Those who develop normal-tension glaucoma may have a naturally sensitive optic nerve or reduced blood supply to the area caused by a hardening of the arteries.
There is no cure for glaucoma, but early detection and consistent treatment can protect your vision. The stage and type of eye disease determine what treatment will work best for you. Our eye care team at Advanced Eye Physician will provide you with a personalized treatment plan during your eye exam.
We offer several ophthalmological treatments for our patients with glaucoma.
Laser surgery has become an important tool for managing the effects of glaucoma. There are various procedures available. At Advanced Eye Physician, we can perform SLT and LPI.
Selective laser trabeculoplasty (SLT) is used to treat primary open-angle glaucoma.
It’s referred to as ‘selective’ because this laser has minimal heat energy absorption. Sometimes referred to as a ‘cold laser’ because it is only taken up by selected pigmented tissue in the eye. Because of this, the procedure produces less scar tissue with minimal pain.
SLT uses a low-energy laser to selectively treat specific cells in the eye’s trabecular meshwork. Because it leaves many cells intact, SLT can safely be done repeatedly.
This laser surgery is a good option for patients who had little success with medicated eye drops.
Laser peripheral iridotomy (LPI) is a laser procedure that prevents narrow drainage angles and angle-closure glaucoma.
LPI makes a small hole in the iris to increase the fluid channel and help the fluid drain.
At Advanced Eye Physician, we offer a variety of minimally invasive glaucoma surgery (MIGS). Based on each patient’s unique characteristics and target treatment range of intraocular pressure, the physician will select the appropriate MIGS procedure in discussion with the patient. Surgeries we offer include but not limited to i-stent, Hydrus stent, Kahook Dual Blade Goniotomy, OMNI trabeculoplasty, Xen gel implant, and micropulse cyclophotocoagulation.
The MIGS group of operations were developed in recent years to reduce some of the complications associated with traditional glaucoma surgeries. They are performed using microscopic-sized equipment and tiny incisions to reduce the chance of serious complications.
MIGS operations consist of 4 different categories:
Microtrabeculectomies involve microscopic tubes that are inserted into the eye to drain fluid within the eye to the outer membrane of the eye. 2 new devices involved with this procedure have been shown to be extremely effective in lowering ocular pressure with improved safety over traditional trabeculectomy.
Trabecular surgery is a minimally invasive glaucoma surgery (MIGS) procedure that uses a tiny incision into the trabecular meshwork without damaging any other tissues in the eye’s drainage system.
Using a high-powered microscope, the trabecular meshwork is bypassed with a tiny, snorkel-like device called the iStent. This procedure is most effective in early to moderate stages of glaucoma.
Suprachoroidal shunts involve using tiny tubes with very small internal openings to connect the front of the eye to the suprachoroidal space between the retina and the wall of the eye to drain fluid. This procedure has been shown to be effective in lowering pressure in moderate to severe cases of glaucoma.
Laser cyclophotocoagulation is typically reserved for advanced cases of glaucoma that could not be controlled with trabeculectomy or tube shunts. The procedure reduces the fluid-forming capacity of the eye by targeting the delicate tissue that makes the fluid. 2 new additions to the laser procedure makes it a useful procedure even before glaucoma progresses into the advanced stage, called endocyclophotocoagulation and micropulse cyclophotocoagulation.
Glaucoma shunt surgery involves implanting a flexible tube shunt into the eye. It is designed to divert fluid that drains into the eye to an external reservoir.
This procedure is effective for patients who had little success with previous glaucoma surgeries and glaucoma associated with uveitis or inflammation, neovascular glaucoma associated with diabetes, traumatic glaucoma, and others.
A trabeculectomy is a surgical procedure to lower intraocular pressure inside your eye. It involves creating a new channel, or “bleb,” for fluid to drain from the eye, which helps lower internal eye pressure and reduce the chances of future progressive vision loss.
A glaucoma diagnosis can be scary and life-changing, but we are here to help you every step of the way. Please book your appointment to learn more about how you can successfully live with glaucoma.
Find our Manhattan office in the heart of Chinatown, near Little Italy, on the corner of Grand Street and Elizabeth Street.
Find our Queens office near Downtown Flushing, Queens, on Kissena Boulevard.
Find our Manhattan office in the heart of Chinatown, near Little Italy, on the corner of Grand Street and Elizabeth Street.
Find our Queens office near Downtown Flushing, Queens, on Kissena Boulevard.
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