Glaucoma is a problem where the pressure in the eye erodes the optic nerve. The optic nerve is the telephone cable that connects the eye to the brain and tells you what you see. As the optic nerve gets thinner and thinner, you start to lose your side vision then eventually all your vision, if not caught and treated early enough. 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, Dr. Perozek can protect your eyes 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 50
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
Having thin optic nerves
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.
All patients should be especially vigilant about having regular eye exams with SEE RIGHT NOW with TIMOTHY PEROZEK,MD in order to be screened for this disease which can definitely cause blindness and yet if treated early enough, Dr. Perozek can save your sight from devastating loss. Once you lose vision from Glaucoma, it cannot be improved or fixed. However, with regular exams, we can treat you before it becomes a problem.
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. Most patients don’t know they have it until it is too late. 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
The symptoms of angle-closure glaucoma encompass systemic, as well as eye symptoms, including:
- Severe eye pain
- Sudden visual disturbance
- Halos around lights
- Nausea and vomiting
- Blurred vision
- Red eyes
The diagnosis of glaucoma is made after a complete eye exam and a review of the patient’s medical history. Tests are conducted to confirm the diagnosis. Testing may include some of the following:
- Dilated eye examination
- Visual field test (perimetry)
- Retinal evaluation
- Visual acuity test
- OCT/HRT optic nerve head thickness measurements
Once glaucoma has been diagnosed, treatment should begin as soon as possible to help minimize the risk of permanent vision loss. Many times, your ophthalmologist will see that your nerve is thin and will assign you a diagnosis of Glaucoma Suspect which means you have risk factors for glaucoma and have nerves that look suspicious. In that case, we will get photos of your optic nerve to have as a record to compare, and HRT test to measure how thick your nerve is, and a visual field test to see how your optic nerve functions. We will do these test spread out over the year with pressure checks at each visit and then repeat them throughout the next couple years to look for any progression as we try to determine if you have glaucoma or if you were just assembled at the plant like this.
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:
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 (SLT)
Trabeculoplasty, iridotomy or cyclophotocoagulation are laser procedures that aim to increase the outflow of fluid from the eye or eliminate fluid blockages. Dr. Perozek can do this in the office as an SLT laser which can lower your pressure so that you do not have to use drops every day. The SLT laser can make it such that you don’t have to buy expensive medications or remember to use them and you won’t have to deal with side effects from the drops. Most insurances cover the SLT laser and even with your copay, it ends up being cheaper than drops over the long term. Selective Laser Trabeculoplasty (SLT) is a widely accepted treatment option in glaucoma treatment. SLT definitely offers a new glimpse of hope for glaucoma patients. By engaging in this NEW laser technology Dr. Perozek can now further lower pressure that can possibly help a patient avoid a more invasive surgery or avoid drops all together! The simple laser process typically involves only numbing of the eye with topical eye drops. A contact lens is applied which will help the surgeon focus the laser on the proper region when applying the laser spots on the trabecular meshwork. What does the procedure do? SLT actually lowers (IOP) intraocular pressure by cleaning out the pressure drain (the trabecular meshwork) by small pulsing low-energy laser light to target cells in the trabecular meshwork of the eye, allowing more pressure to leave the eye. After the laser, your eye will be a little light sensitive and achy for a couple days. We do one eye and the other eye a week later. It is done in the office and you can drive yourself to and from the appointment.
There are much more invasive glaucoma surgical options to treat glaucoma. It is our goal at SEE RIGHT NOW with TIMOTHY PEROZEK, MD to diagnose and treat you early enough such that you do not need these surgeries.