Glaucoma

Known as the “silent thief of sight,” glaucoma is one of the most common causes of blindness in the world. The eye condition develops gradually over time, often with no noticeable symptoms.

What is Glaucoma?

Glaucoma is a group of diseases that damage the eye’s optic nerve. Most types of glaucoma are associated with elevated intraocular pressure (IOP). When the optic nerve is damaged, it can no longer send signals to the brain for the vision process to occur. If not treated, glaucoma can result in serious loss of vision or even irreversible blindness. The good news is glaucoma can be treated. High eye pressure can be lowered with medication, laser surgery, or small incision surgeries.

Here at Eye Physician Associates S.C., we are proud to provide patients with state-of-the-art glaucoma treatments in Milwaukee, WI. It is our mission to improve your vision and ensure your eyesight lasts for years to come.

Types of Glaucoma

Open Angle Glaucoma is the most common type of glaucoma. It is usually inherited or develops gradually with age. Most people do not notice early symptoms because glaucoma attacks the side (peripheral) vision before it affects central vision. It’s possible to have open angle glaucoma for years and not notice a change in vision quality, hence the nickname, “silent thief of sight.”

Angle Closure Glaucoma is a dangerous type of glaucoma that occurs suddenly when fluid cannot drain out of the eye properly. The buildup of fluid causes a rapid increase in eye pressure. Symptoms include severe pain and nausea, blurry vision, and redness in the eye. Angle closure glaucoma is a medical emergency and must be treated immediately to avoid severe vision loss. Prompt laser treatment and medications can usually clear the fluid blockage and lower the eye pressure.

Low or Normal Tension Glaucoma occurs when people with normal eye pressures experience damage to the optic nerve and side vision loss. This type of glaucoma often goes undetected because it is not associated with increased eye pressure levels. Early detection and treatment are critical with this type of glaucoma.

Congenital Glaucoma is a condition in which children are born with a defect in the angle of the eye that interferes with fluid drainage.

Secondary Glaucomas can occur as a result of other diseases or treatments, such as:

• Diabetes that is poorly controlled
• Repeated retinal injections
• Steroid treatments
• Inflammation or autoimmune disease
• Cataracts that have been left untreated for too long

Can Glaucoma be Prevented?

Unfortunately, most types of glaucoma cannot be prevented. However, early detection and treatment can usually control the disease before severe vision loss occurs. Since glaucoma affects side vision first, you may not notice a change in your eyesight. For this reason, anyone over the age of 40 should have an annual comprehensive eye exam. Your eye care specialist will check your vision, eye pressure and the condition of your optic nerve.

Treatments for Glaucoma

Glaucoma cannot be cured, but its damaging effects can be limited. Most types of glaucoma are treated by lowering the pressure inside the eye.

Doctors use three different methods to accomplish this:

Medications

Medications in the form of eye drops or pills are the most common form of early glaucoma treatment. There are a wide variety of drugs that lower eye pressure effectively. Some reduce the amount of fluid the eye produces, and others help drain fluid from the eye.

Some patients experience side effects from glaucoma medications, such as eye redness or stinging. It’s important to discuss this with your eye doctor so you can find a glaucoma treatment that you’re comfortable with. There are many glaucoma medications to choose from. It is important to note that the treatment of glaucoma is only effective when patients use their medications on a regular basis, as prescribed.

Laser Treatments

Selective Laser Trabeculoplasty (SLT)

Selective Laser Trabeculoplasty (SLT) can be used to treat patients with open-angle glaucoma.  SLT has traditionally been used as an alternative to eye drops when the drops are inadequately lowering the eye pressure or are causing uncomfortable side effects.  Recently, clinical studies are showing that SLT laser may be more effective than eye drops as the initial treatment for open angle glaucoma.

SLT is a painless procedure conveniently performed in your doctor’s.  Numbing drops are applied to the eye, then your doctor will use a special lens to apply a beam of light to your eye’s drainage system. The laser treatment improves the eye’s internal circulation and effectively lowers the eye pressure.  The lower pressures usually last from 1- 5 years.  Many patients can reduce or eliminate their eye drops.  Since the laser does not cause any damage or scarring to the eye, the treatment can be repeated in the future if needed.

Micropulse Laser Cyclophotocoagulation (MP3 CPC)

MP3 CPC is for patients with any type of glaucoma when eye drops or other surgeries are not effective at reducing the eye pressure or are causing uncomfortable side effects. MP3 CPC can also be used if other surgeries have failed. MP3 CPC is performed in the operating room with the assistance of a local injection and sedation. The laser is applied through the wall of the eye to shrink the tissues that are producing too much fluid inside the eye. The reduction in fluid greatly reduces the intraocular pressure as well as the need for eye drops. The treatment can be repeated if the effect wears off in the future.

Surgical Treatments

Micro-Invasive Glaucoma Surgery (MIGS)

In the last ten years, a variety of new surgical treatments have been developed that fall under a general category of glaucoma treatment called Minimally Invasive Glaucoma Surgery (MIGS).  These surgeries are outpatient procedures that are typically performed in eye surgery centers. MIGS can be very effective in reducing IOP and have a lower risk of complications than traditional surgery.

iStent® Microtrabecular Bypass Device

The iStent® is a small, injectable device used to reduce IOP and help glaucoma patients eliminate or reduce their use of prescription eye drops. The iStent is approved by the FDA for treatment of mild to moderate open angle glaucoma in conjunction with cataract surgery.  Recently, a newer model of the iStent, the iStent Infinite, has been approved for use in cases of severe glaucoma that have failed  other treatments.

A tiny, titanium implant, the iStent® improves the drainage of aqueous fluid from the eye to help manage eye pressure. The iStent functions by creating permanent bypasses from the front chamber of the eye through the trabecular meshwork, where fluid blockage occurs, into Schlemm’s canal where the fluid is drained out of the eye.

Hydrus MicroStent