What is Glaucoma?

Glaucoma is a disease of the eyes that, if untreated, can lead to permanent loss of vision.  In fact, it is the second leading cause of blindness worldwide.  Glaucoma is, unfortunately, relatively common as well affecting an expected 3 million Americans.  The disease occurs as a result of damage to an area in the eye called the optic nerve, which can be thought of as the cable that transmits the vision from the eye to the brain, where all of the vision is processed.  Many, but definitely not all, patients with glaucoma have elevated pressure inside the eye and we believe this is what contributes to the damage in their eyes.  Some patients, however, can have a condition called Normal Pressure Glaucoma in which they develop damage even at relatively normal pressure levels, likely due to a slight difference in the anatomy of their eye that allows damage at even relatively normal pressure.  For all patients with glaucoma, even ones with Normal Pressure Glaucoma, research has shown the most effective treatment to be lowering the pressure within the eye.  This can be done with either eye drops, laser treatments, or glaucoma surgery.  These treatment options are discussed further below. 

Eye-Related Risk Factors

Non Eye-Related Risk Factors

Importance of Regular Eye Exams

It is estimated that as many as 50% of the patients who are currently losing their vision from glaucoma don’t even know that they have this condition.  This is because most patients with glaucoma have no eye pain, eye redness, or other obvious symptoms.  And, the vision changes that happen from glaucoma usually affect the outside portion of the vision first which allows glaucoma patients to still be able to read and see things clearly straight ahead of them until the late stages of glaucoma.  The scary and frustrating thing about glaucoma is that once the damage has happened there is nothing that can be done to bring that vision back; it is lost forever.  All our treatments for glaucoma are designed to prevent additional/future vision loss.  This is why it is so important to catch glaucoma at an early stage before advanced vision loss.  And the only way to do that is through regular eye exams with a qualified eye professional, such as the ones here at Surevision Eye Centers.

Initial Treatment Options

For years, the mainstay of treatment of early glaucoma has always been medical management with pressure lowering eye drops.  There are now a number of different medications for this use, some of which are generic and some which are only available in more expensive brand name versions.  Most patients who begin drops are typically started on either generic Latanoprost or Timolol.  Both medications have been used for years, have good safety profiles, and are effective for most patients.  If we are unable to control the eye pressure with one drop we can prescribe two or more drops for patients in order to get their eye pressure in a safe range for them.  Conveniently, some of these medications also come in combination formulations in which two different medications can be mixed into one bottle.  Your doctor will work with you to find the safest, most effective, most convenient, and best tolerated regimen for you. 

In short, there is no one perfect option for glaucoma treatment for all patients, but rather many great options for patients that can be individualized to each patient’s specific case and needs.  The eye care professionals at Surevision Eye Centers are here to screen your eyes for glaucoma, catch it at it’s earliest stages, and treat it effectively with an individualized approach for every patient.  If you have a family history of glaucoma or any of the other risk factors above, please do yourself a favor and schedule a screening with one of our doctors right away.

Drops are not the only option for early glaucoma, however.  A laser procedure called Selective Laser Trabeculoplasty (or SLT for short) can be done by a trained Ophthalmologist to lower the eye pressure.  Numerous large research studies have shown initial treatment with either the SLT laser or eye drops to be equally effective at preventing worsening of glaucoma and subsequent vision loss.  The laser procedure can be done in our office and takes just a few minutes to complete.  When I am performing the laser most patients are aware that I am doing something, but do not have any pain or discomfort.  The purpose of the laser is to provide a small amount of energy to the drainage system of the eye to help “unclog the drain”.  The end result is more efficient outflow of the fluid in the front part of the eye and thus lower eye pressure.  The laser doesn’t cut, burn, or make any permanent change to the structures in your eye.  Because of this, it is extremely safe and can be repeated in the future, if needed.  The full pressure lowering effect is typically seen several weeks after the laser treatment, results in a significant lowering of pressure in approximately 80% of patients, and lasts for years for most patients.  The procedure is typically covered well by insurance and is almost always cheaper in the long run for patients than the monthly out-of-pocket cost of eye drops.  Additionally, some patients have sensitive eyes that turn red or have other side effects with the long-term use of glaucoma drops or they have poor compliance with remembering to take the drops regularly due to dementia or some other cause.  The SLT laser is a good option for both of these types of patients.   For more advanced glaucoma, there are other surgical options that are beyond the scope of this discussion, but fortunately are available. 

In short, there is no one perfect option for glaucoma treatment for all patients, but rather many great options for patients that can be individualized to each patient’s specific case and needs.  The eye care professionals at Surevision Eye Centers are here to screen your eyes for glaucoma, catch it at it’s earliest stages, and treat it effectively with an individualized approach for every patient.  If you have a family history of glaucoma or any of the other risk factors above, please do yourself a favor and schedule a screening with one of our doctors right away.