• Adler Eye Institute

Glaucoma Evaluation & Treatment

Glaucoma is a group of eye conditions that causes damage to the optic nerve, which is necessary for good vision. Vision loss due to Glaucoma cannot be recovered. It is important to have regular eye appointments that includes a reading of your intraocular pressure. This is especially true if you are over 50. The signs and symptoms of glaucoma depend on the type of Glaucoma you have and the stage of Glaucoma.

Open Angle Glaucoma: The most common form of Glaucoma. The change is so gradual that you wouldn’t notice until the condition is at an advanced stage. The drainage area formed by the iris and cornea remains open, but the trabecular meshwork remains partially blocked. This causes pressure in the eye to gradually increase causing damage to the optic nerve. Some symptoms are:

  • Patchy blind spots in your side (peripheral) or central vision.
  • Tunnel vision in the later stages of the condition.

Acute Angle Closure Glaucoma: This condition is less common. Angle Closure Glaucoma happens when the iris bulges forward to narrow or block the drainage angle formed by the iris and cornea. As a result, fluid can’t circulate through the eye and pressure increases. Some people have narrow drainage angles, putting them at increased risk of Angle closure glaucoma. Angle closure glaucoma is a medical emergency. If you experience sudden blurred vision ALONG with any of the following symptoms call an ophthalmologist or go to the emergency room as soon as possible.

  • Severe headache
  • Eye Pain
  • Nausea and vomiting
  • Mid dilated pupil

Normal tension glaucoma: In normal tension glaucoma your optic nerve becomes damaged even though your eye pressure is within the normal range.

No one knows the exact reason for this. You may have a sensitive optic nerve or less blood is being supplied to your optic nerve. This limited blood flow could be caused by atherosclerosis- the buildup of fatty deposits in the arteries- or other conditions that impair circulation.

Glaucoma in children: It’s possible for infants and children to have glaucoma. It may be present form birth or develop during the first few years of life. The optic nerve damage may be caused by drainage problems or underlying medical issues.

Pigmentary glaucoma: In Pigmentary glaucoma pigment granules from your iris build up in the drainage channels slowing or blocking fluid exiting your eye. Activities such as jogging, sometimes stir up the pigment granules, depositing them on the trabecular meshwork and causing intermittent pressure elevations.

Because chronic forms of glaucoma can cause permanent vision loss before any signs or symptoms are apparent, be aware of the following risk factors:

  • Having high intraocular pressure readings
  • Being over age 60
  • Being Black or Hispanic
  • Having a family history of the condition
  • Having certain medical conditions, such as, diabetes, high blood pressure, sickle cell anemia, and heart disease.
  • Having certain eye conditions
  • Having had eye surgery or certain types of eye surgery.
  • Early estrogen deficiency, which can occur after removal of both ovaries (bilateral oophorectomy)
  • Taking steroid eye drops for a long time

How is Glaucoma treated?

Glaucoma treatment usually begins with eye drops.

Prescription eye drop medications include:

  • Prostaglandins
  • Beta Blockers
  • Alpha-androgenic agonists
  • Carbonic anhydrase inhibitors
  • Miotic or cholinergic agents
  • Surgery and other therapies

Other treatment options include laser therapy or surgical procedures. There are always risks with any procedure and Dr. Adler will advise you of the risks/benefits and if surgical intervention is necessary for your glaucoma.

*The latest procedure Dr. Adler is using is called I-Stent.

If you have glaucoma and are preparing for cataract surgery, I-Stent may be an option for you! Most patients can maintain normal eye pressure without medications after the I-Stent tiny implant is done during cataract surgery. The procedure is covered by Medicare and most private insurance companies. You may be a candidate and a consultation with Dr. Adler is necessary. For more information about I-Stent log onto www.glaukos.com/istent-procedure/istent-procedure.