Glaucoma

Symptoms

Glaucoma is the leading cause of irreversible vision loss and blindness in the United States. It can affect patients of all ages but becomes much more common with advancing age. Glaucoma is known as the “Thief or Sight” because there are few to no symptoms such as pain or noticeable vision loss early in the disease. In addition, at least half of people with glaucoma are unaware they have it. Peripheral, or side, vision is usually affected first and patients rarely notice they have lost vision until significant, irreversible damage has already occurred.
Glaucoma actually refers to a group of disorders that result in optic nerve damage. The optic nerve is the only connection between the eye and the brain and is essential for normal vision. Increased eye pressure is the largest risk factor for developing glaucoma, but many other factors such as family history, abnormal blood vessel function, injury, eye inflammation and infection can put you at risk.
The two main types of glaucoma are open-angle and angle-closure. Open-angle is much more common and usually involves microscopic damage to the eye’s drainage system. This causes slow, chronic but completely painless vision loss. In contrast, angle-closure glaucoma can cause intermittent eye pain, blurred vision and headaches. A glaucoma attack refers to an angle-closure with a sudden and extreme rise in eye pressure. This is an emergent situation and can cause severe eye pain, headaches, nausea, vision loss and halos around lights. If not treated promptly, a glaucoma attack can quickly lead to profound vision loss.

Diagnosis

Given the lack of symptoms for most people with glaucoma, signs of glaucoma are usually only picked up during routine eye exams. A comprehensive eye examination done by a trained eye professional is then needed to fully diagnose the disease. The examination includes checking eye pressure, determining if the drains within the eye are open, and dilation to examine the optic nerve. A number of tests are also used if glaucoma is suspected or diagnosed, including visual field tests (side-vision tests), pictures of the optic nerve and functional tests of the optic nerve.

Treatment

Glaucoma treatment currently centers on reduction of intraocular eye pressure. Many large clinical studies have proven that a reduction in eye pressure can slow down or stop progression of glaucoma damage and vision loss. Treatment usually starts with daily eye drops or a laser procedure. Additional eye drops, laser treatments or surgical procedures can be used if the pressure remain too high. Ohio Eye Associates is equipped to offer all options for glaucoma care.

Laser Surgery

We offer several types of laser procedures that are used in the treatment of glaucoma.
SLT: For open-angle glaucoma, Selective Laser Trabeculoplasty (SLT) can be used as an alternative to eye drops as a first line therapy, or in conjunction with eye drops to control eye pressure. This low risk, quick and painless procedure keeps many people off of eye drops while still providing excellent glaucoma control.
LPI: For angle-closure or those at risk for this type of glaucoma, a laser peripheral iridotomy (LPI) is used for treatment. This non-invasive procedure drastically reduces the risk of a glaucoma attack in at risk patients and may effectively lower eye pressure and save vision in patients with angle-closure.
Micro-pulse Laser: This gentle OR based laser procedure helps lower eye pressure in a non-damaging way and can be used at any stage of glaucoma. It can be used as an alternative to incisional surgery and reduce the number of eye drops needed for many patients.
G-Probe Laser: Also an OR based laser procedure, this treatment is usually reserved for patients with advanced glaucoma. We are able to provide this specialty option locally, eliminating the need for travel, which is often challenging for patients with advanced glaucoma.

MIGS

Minimally Invasive Glaucoma Surgeries (MIGS) are a collection of new surgical options for glaucoma care that are much safer than traditional glaucoma surgeries. The recovery from these surgeries is also much easier, more comfortable and faster than traditional surgeries. In general, these surgeries involve opening or rejuvenating the natural drains in the eye, restoring flow and reducing eye pressure. The surgeries are often combined with cataract surgery. The safety profile of MIGS allows us to intervene surgically at earlier stages of disease, providing many more effective options for glaucoma management and reduction in eye drop use. Dr. Skarie is the only fellowship trained glaucoma specialist in the area and is trained in several MIGS procedures.

Traditional Glaucoma Surgery

While MIGS offer excellent surgical options for the majority of glaucoma patients, those with advanced glaucoma or glaucoma associated with other severe eye disease may require a traditional glaucoma surgery. These surgeries involve bypassing the natural drains to create a new drainage system that can drastically lower eye pressure. Dr. Skarie has the training and expertise to perform these surgeries locally, avoiding the need for travel. Frequent follow-up care is needed following this type of surgery, making this local specialty care especially convenient.