Glaucoma is a group of related diseases that damage the optic nerve, resulting in vision loss and possible blindness. Glaucoma, a leading cause of blindness and visual impairment in the United States, can affect patients of all ages. Many people affected with glaucoma do not experience any symptoms and may not be aware that they have the disease until they have lost a significant amount of vision. With early detection and treatment, however, eyes can be protected against the serious loss of vision or blindness. Catching glaucoma at an early, treatable stage is one important reason to have thorough eye examinations regularly.
Risk Factors for Glaucoma
There are several factors that increase the risk of developing glaucoma, including:
- Being over 60
- Being of particular descent, such as African-American or Asian
- Having a family history of glaucoma
- Having elevated intraocular pressure
- Having poor vision or other eye disorders or injuries
- Having certain medical conditions, like diabetes
- Taking certain medications, such as corticosteroids for prolonged periods
Patients with risk factors for the disorder should be especially vigilant about having regular eye examinations.
Causes of Glaucoma
Certain diseases or conditions can contribute to the development of glaucoma. These include:
- Increased pressure within the eye
- Severe eye infection
- Injury to the eye
- Blocked blood vessels
- Inflammatory conditions of the eye
Glaucoma is considered primary if its origin is unknown and secondary if it results from another medical condition.
Types of Glaucoma
There are several types of glaucoma. The two major types are primary open-angle glaucoma, in which fluid drains too slowly from the drainage channels (trabecula) of the eye, and angle-closure (narrow-angle) glaucoma, which occurs when the trabecula become blocked. Approximately 95 percent of glaucoma patients suffer from primary open-angle glaucoma. Other types of glaucoma, which occur much more rarely, include:
- Low Tension Glaucoma
- Congenital Glaucoma
- Secondary Glaucoma
- Pigmentary Glaucoma
- Pseudoexfoliation Glaucoma
Symptoms of Glaucoma
It is important to remember that patients with early stage glaucoma are most often asymptomatic. When symptoms occur, they vary depending on the type of glaucoma and can occur in one eye or both eyes. The symptoms of open-angle glaucoma include:
- Dim or blurred vision
- Gradual loss of peripheral vision
- Tunnel vision (at advanced stages)
The symptoms of angle-closure glaucoma encompass systemic, as well as eye symptoms, including:
- Severe eye pain
- Nausea and vomiting
- Sudden visual disturbance
- Blurred vision
- Halos around lights
- Red eyes
- Headache
Either type of glaucoma may be a primary or secondary disorder.
Diagnosis of Glaucoma
The diagnosis of glaucoma is made after a comprehensive medical examination of the eye and a review of the patient's medical history. Tests are conducted to confirm the diagnosis. Testing may include some of the following:
- Tonometry
- Dilated eye examination
- Visual field test (perimetry)
- Retinal evaluation
- Pachymetry
- Gonioscopy
- Visual acuity test
Once glaucoma has been diagnosed, treatment should begin as soon as possible to help minimize the risk of permanent vision loss.
Treatment of Glaucoma
There is no cure for glaucoma, so treatment focuses on relieving symptoms and preventing further damage. Some of the treatment methods for glaucoma are as follows:
Medication
Eye drops or oral medication may be used to either reduce fluid production in the front of the eye or to help drain excess fluid. Side effects of the medication may result in redness, stinging, irritation or blurred vision. Regular use of the medication is needed to keep the eye pressure under control.
Laser Surgery
Trabeculoplasty, iridotomy or cyclophotocoagulation are laser procedures that aim to increase the outflow of fluid from the eye or eliminate fluid blockages.
Other Surgery
A trabeculectomy may be used to create a new channel to drain fluid from the eye and reduce the pressure that causes glaucoma. Surgery is performed only after medication and laser procedures have been unsuccessful.
While patients with early stage glaucoma may not experience any symptoms, prompt treatment is required to preserve their vision.
New Laser Glaucoma Treatment at Apex Vision
What is DSLT Laser Treatment for Glaucoma & Ocular Hypertension?
Glaucoma and ocular hypertension are conditions that can lead to progressive vision loss if left untreated. One of the most effective non-invasive treatments available today is laser trabeculoplasty, which helps to lower intraocular pressure (IOP). A new advancement in this field is Digital Selective Laser Trabeculoplasty (DSLT), a novel, automated laser treatment that builds upon the success of Selective Laser Trabeculoplasty (SLT).
Why Use DSLT?
- Non-invasive & Contact-Free: Reduces the risk of complications associated with contact laser procedures.
- Consistent & Precise Treatment: AI-driven technology ensures accurate laser delivery for optimal results.
- Enhanced Patient Experience: Shorter procedure time with no direct eye contact.
- Effective IOP Reduction: Similar efficacy to SLT but with added convenience and safety. Most studies show an eye pressure reduction of 4 points.
What is DSLT?
DSLT is a newer, automated laser treatment for glaucoma, offering a faster and more efficient alternative to traditional SLT.
- The laser delivers energy directly to the trabecular meshwork (the eye's natural drainage channel), improving fluid outflow and reducing eye pressure.
- The treatment is typically completed in a few seconds.
- The process is automated, with eye-tracking technology ensuring accurate targeting and delivery of laser pulses.
DSLT vs. Glaucoma Drops
Eyedrops are still a good first line treatment for glaucoma but DSLT may be more convenient.
- Compliance: It is sometimes hard to remember to use your glaucoma eyedrops consistently.
- Allergies: You can develop an allergy to your glaucoma drops causing redness of the eyes and skin.
- Comfort: Glaucoma eyedrops can cause dryness and irritation of the eyes.
- Cost: The monthly cost of glaucoma medications can add up over the years.
Will Glaucoma Eyedrops Still be Needed After DSLT?
Although the DSLT can lower the eye pressure enough for some patients to not need glaucoma medications, some patients may still need to use drops but the DSLT may limit the number of drops they need. Regular eye exams and testing are important to make sure your glaucoma is being treated appropriately.
DSLT represents the future of laser-based glaucoma treatment, providing a safer, more efficient alternative for patients and clinicians alike. If you have been diagnosed with glaucoma or ocular hypertension, speak with your ophthalmologist to determine whether DSLT is the right treatment for you.
Frequently Asked Questions (FAQ) – Glaucoma
1. What is glaucoma?
Glaucoma is a group of eye diseases that cause damage to the optic nerve, often due to high intraocular pressure (pressure inside the eye). The optic nerve is responsible for transmitting visual information from the eye to the brain, and damage to it can result in permanent vision loss.
2. What are the types of glaucoma?
The most common types of glaucoma are:
- Primary Open-Angle Glaucoma (POAG): The most common type, where the drainage angle of the eye becomes less efficient over time, leading to increased eye pressure and optic nerve damage.
- Angle-Closure Glaucoma: A less common, but more acute form where the drainage angle is suddenly blocked, causing a rapid rise in eye pressure and painful symptoms.
- Normal-Tension Glaucoma: Optic nerve damage occurs despite normal eye pressure.
- Congenital Glaucoma: A rare form that occurs in infants or young children due to developmental abnormalities in the eye.
- Secondary Glaucoma: Glaucoma that develops as a result of another condition, such as an injury, eye disease, or medication.
3. What are the symptoms of glaucoma?
In the early stages of glaucoma, there are usually no symptoms, and vision loss happens gradually. This is why it’s often called the “silent thief of sight.” However, some forms, like acute angle-closure glaucoma, may present with:
- Severe eye pain
- Headache
- Nausea and vomiting
- Sudden vision changes or loss of peripheral vision
- Redness in the eye
- Seeing halos around lights
4. What causes glaucoma?
Glaucoma is typically caused by an increase in intraocular pressure (IOP), which can damage the optic nerve. The increase in pressure often occurs due to the accumulation of aqueous humor (fluid) inside the eye. Various factors contribute to this, including:
- Poor drainage of the fluid due to blocked or narrowed drainage angles.
- Overproduction of aqueous humor.
- Genetic factors (family history of glaucoma).
- Age, with those over 60 being more at risk.
- Other health conditions like high blood pressure, diabetes, and myopia (nearsightedness).
- Eye injuries or prolonged use of corticosteroid medications.
5. How is glaucoma diagnosed?
Glaucoma is diagnosed through a comprehensive eye exam, which may include:
- Tonometry: Measures the intraocular pressure.
- Ophthalmoscopy: Allows the eye care professional to examine the optic nerve for signs of damage.
- Perimetry (visual field test): Checks for loss of peripheral vision, which is one of the first signs of glaucoma.
- Gonioscopy: Examines the drainage angle to determine if it is open or closed.
- Pachymetry: Measures the thickness of the cornea, as thicker corneas can affect intraocular pressure readings.
6. What are the risk factors for glaucoma?
Risk factors for developing glaucoma include:
- A family history of glaucoma.
- Age over 60 (especially for open-angle glaucoma).
- High intraocular pressure.
- Being of African, Hispanic, or Asian descent (for certain types of glaucoma).
- Existing eye conditions, such as eye injury or retinal problems.
- Medical conditions like diabetes, high blood pressure, or migraines.
- Long-term use of corticosteroid medications.
7. Can glaucoma be prevented?
There is no guaranteed way to prevent glaucoma, but early detection and regular eye exams are essential. For individuals at higher risk, such as those with a family history of glaucoma or those over 60, regular eye exams can catch the condition early before significant vision loss occurs.
8. How is glaucoma treated?
Treatment for glaucoma typically aims to lower intraocular pressure to prevent further damage to the optic nerve. Treatment options include:
- Medications (eye drops): The most common treatment, which helps reduce eye pressure by improving fluid drainage or decreasing its production.
- Oral medications: In some cases, oral medications may be prescribed alongside eye drops.
- Laser therapy: For certain types of glaucoma, laser procedures can improve drainage in the eye or reduce fluid production. Examples include selective laser trabeculoplasty (SLT) or laser iridotomy.
- Surgery: In advanced cases, surgical procedures may be needed to create a new drainage channel in the eye or to insert a drainage implant to reduce pressure.
