Watch fellowship trained glaucoma specialist Dr. Kurt Schwiesow, MD, discuss the specifics of glaucoma. This disease is considered sight's silent thief, and is the second leading cause of blindness worldwide. Dr. Schwiesow explains the need for early testing and treatment because once sight is lost, it can't be returned.
“What is glaucoma?”
Glaucoma is a disease of the optic nerve and is the second leading cause of blindness worldwide. Like a balloon, your eye needs a reasonable amount of pressure to maintain its shape, but too much pressure can damage the optic nerve and cause a loss of peripheral vision.
Glaucoma is typically not painful and does not cause symptomatic loss of vision until it reaches an advanced state. Glaucoma is readily treatable, but screening and early diagnosis are vitally important.
“My father had glaucoma. Does that put me at risk?”
If you have a first degree relative (mother, father, brother, sister, child) with glaucoma you are at increased risk and should have a screening exam. Because glaucoma does not cause symptoms until late in the disease process, only about half of people with glaucoma in the U.S. have been diagnosed. Other risk factors include history of steroid use (even asthma and sinus medications), eye injury, African American ancestry, diabetes and nearsightedness. Because glaucoma can strike at any age, regular eye exams are highly recommended.
“How is glaucoma detected?”
If your doctor feels that you have early signs of glaucoma, further screening tests may be required. Visual field testing is typically performed to detect subtle changes in your peripheral vision. These tests take approximately five minutes per eye and can be a useful tool for detecting glaucoma.
Because visual field testing can fail to detect early damage, our doctors also use the Zeiss Optical Coherence Tomographer (OCT). This device performs a scan of the optic nerve to evaluate the layer of tissue in the eye affected by glaucoma. Often this test can detect structural changes to the optic nerve before they affect the field of vision, allowing for earlier glaucoma detection and treatment.
“What is angle closure glaucoma?”
The “angle” refers to the drain of the eye that can close off and cause a rapid and severe rise in eye pressure. Although this can be treated, the effects of an attack of angle closure glaucoma can be lasting. Farsighted patients and patients with cataracts are at greatest risk for this form of glaucoma. Laser peripheral iridotomy is recommended for at-risk patients to prevent attacks of this type of glaucoma before they occur.
“I have been diagnosed with glaucoma. Are there any changes to my lifestyle that I should make?”
The only proven treatment for glaucoma consists of reducing pressure in the eye with drops, laser treatments or surgery. Although not proven to have an impact on glaucoma, adopting a healthy diet and exercise regimen along with smoking cessation will improve your overall health and may have an impact on your long-term treatment.
“How is glaucoma treated?”
Treatment for glaucoma is directed to reduce eye pressure, which slows or stops the damage caused to the optic nerve. There are three primary ways eye pressure is reduced:
For the majority of patients, one or more eyedrops are effective at reducing eye pressure. While eyedrops typically have few or minimal side effects, some can be problematic in the setting of certain medical conditions or when used with other medications. It is important to use your eyedrops as prescribed.
When eyedrops prove ineffective or are difficult to take because of side effects or cost, laser treatment is an excellent option. Laser trabeculoplasty consists of a three minute treatment that is performed in the clinic. From the patient’s perspective, it is similar to having an examination and requires no restrictions afterward. During the treatment, a laser is used to shrink tissues that affect the drain of the eye, opening microscopic channels for eye fluid to flow out.
For a minority of patients, surgery to create a new drain for the eye may become necessary.
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