Glaucoma
Glaucoma is a condition in which the optic nerve, responsible for carrying images from the eye to the brain, is damaged. Normally, most of the people with glaucoma are not aware of the gradual loss of sight until very late in the disease when vision is seriously affected. The result is a slow and gradual loss of vision, which can potentially lead to blindness.The primary factor in the development of glaucoma in most people is the increased pressure inside the eye. The eye constantly produces aqueous, the clear fluid that fills the front part of the eye or the space between the cornea and iris. Proper drainage and the equal balance between the production, flow and drainage of this fluid determines the eye’s pressure. If your eye’s drainage system is working properly, then fluid can drain out and prevent a buildup and the right pressure will be produced for a healthy eye.
It is also important to understand that some people may develop glaucoma but never have a high eye pressure. Glaucoma can be caused by many other factors other than increased eye pressure.
In a glaucomatous eye, this fluid does not drain properly resulting in an increase in the pressure inside the eye. This increased pressure destroys the optic nerve and decrease your vision gradually. If left untreated, it may lead to blindness by destroying the optic nerve. The nerve damage that occurs with glaucoma cannot be repaired. With early diagnosis and treatment, useful vision may be preserved.
What are the symptoms of glaucoma?
At first there are no symptoms. Damage occurs in a steady fashion that many patients are unaware of the disease. As glaucoma remains untreated , the patient may experience a dimness of the vision, or they miss objects to the side of their eye. Without treatment, people with glaucoma may find that it seem as though they are looking through a tunnel, they loss the side vision. Over time, the remaining central vision may decrease until there is no vision left.
Am I at risk to develop glaucoma?
Certain risk factors increase a person’s risk to develop glaucoma:
- People with relatives with glaucoma
- Age over 50
- African American descent
- Diabetes
- Eye injury
- High myopia
What are the tests needed to evaluate if I have Glaucoma?
Several tests are needed to help assess your risk for glaucoma. These are the some of the tests that will be done to you to determine if you have glaucoma:
Measurement of the eye pressure: This is a simple and painless procedure. The doctor will use a special device that measures the eye’s pressure.
Visualization of the optic nerve: To check the optic nerve, the eye doctor uses an instrument to examine the inside of the eye. This can reveal slight changes that may indicate beginning glaucoma.
Visual Field Testing: This is a special test to evaluate your peripheral vision which can be lost due to damage in the optic nerve.
Optic Nerve Imaging: This test evaluates the health of the optic nerve. Muscat Eye Laser Center has the state of the art Optic Nerve Computer Imaging System- Heidelberg Retinal Tomography of HRT.
What is the treatment of glaucoma?
Treatment can involve surgery, lasers or medication, depending on the severity. Most patients with glaucoma require only medication to control the eye pressure. The surgical management of glaucoma is offered to patients if drug therapies have not been satisfactory or is inappropriate. There are two types of surgical treatment: those using a laser (Laser Iridotomy and Selective Laser Trabeculoplasty) and surgical techniques.
Muscat Eye Laser Center offer several glaucoma procedures to treat our patients.
Trabeculectomy Surgery
The trabeculectomy is a common surgical treatment for Glaucoma, high pressure in the eye.
This surgery reduces pressure in an eye with glaucoma, making a new drain in the eye. In this procedure, the surgeon creates a microscopic passageway in the sclera, from the inside to the outside of the eye, which helps fluid drain better from the eye to reduce the eye pressure. Then the fluid is absorbed by the body.
SLT
Also known as Selective Laser Trabeculoplasty, SLT is a simple, yet highly effective laser procedure that reduces the intraocular pressure associated with glaucoma.
The laser increases drainage by selectively treating certain cell tissue of the trabecular meshwork. The meshwork is at the entrance of the drainage canals. For this reason, it is believed that SLT, unlike other types of laser surgery, may be safely repeated many times. With this procedure, the surrounding non-pigmented cells – as well as the rest of the eye structure – are untouched and undamaged.
SLT is an outpatient procedure.
Iridectomy Surgery
This surgical procedure is used as an effective treatment in primary acute angle-closure glaucoma.
By making a small hole in the iris to allow the aqueous humour to fall back from the fluid channel and helping the fluid drain.
The narrow-angle glaucoma occurs when the angle between the iris and the cornea in the eye is too small, causing the iris to block fluid drainage and making the inner eye pressure increase.
Laser Iridotomy
The laser peripheral iridotomy procedure is completed in the office. It typically lasts 10-15 minutes. Prior to the procedure a glaucoma medication is given to prevent any post-laser IOP elevation. In addition, pilocarpine is given to make the pupil smaller so that the hole can be placed peripherally. After the procedure, you may experience blurry vision and stinging sensation. But as a whole it is painless and simple.
YAG IRIDECTOMY
Our ophthalmologist uses a laser to remove a full-thickness section of the iris. The patient sits in special chair with his or her chin resting on a frame or support to prevent the head from moving. The ophthalmologist numbs the eye with anesthetic eye drops. After the anesthetic has taken effect, the doctor shines the laser beam into the affected eye. The entire procedure takes about 10-30 minutes.
