Glaucoma Management Options

Glaucoma is a disease where the pressure inside the eye rises to a level where it damages the optic nerve in the back of the eye.  If glaucoma is not treated, patients will have progressive loss of their peripheral vision until all vision is lost.

WHAT MAKES GLAUCOMA SO DANGEROUS?

Glaucoma is very easy to treat.  What makes it so dangerous, is that it has no symptoms and therefore, patients do not realize that they need to be treated. Patients will not feel the increased pressure in their eye and the peripheral vision loss occurs so slowly that, again, patients don’t notice it. This point cannot be stressed enough.  It is almost impossible for someone to know they have glaucoma without being tested for it.  Pressures 50% above normal are asymptomatic.  Even the most observant patients will not notice peripheral vision loss until it too late.

WHAT MAKES TREATMENT SO DIFFICULT?

Treatment for glaucoma is very simple.  Using eye drops every day will adequately treat over 95% of glaucoma patients.  The problem is many patients cannot or will not use their drops as prescribed.  (Studies have shown that less than 50% of patients will actually use their drops as prescribed.) In addition, drops can be very, very expensive.  That is why laser is such a good alternative to drops.  The laser treatment takes less than a minute, hurts less than a mosquito bite, removes the worry about using drops every day and, in the long term, is less expensive than drops.

A MORE DETAILED DESCRIPTION OF GLAUCOMA

A closeup diagram of the front of the eye showing the effects of glaucoma.Inside the eye are two “cavities. The larger cavity, in the back of the eye, is filled with a jelly called the vitreous.  The smaller cavity, in the front of the eye, is called the anterior chamber and is filled with a fluid called the “aqueous”. The aqueous is constantly being produced by a structure called the “ciliary body”.  The aqueous flows through the pupil to the “angle” in the corner of the eye, and then is drained from the eye through a structure called the “trabecular meshwork”.  From the trabecular meshwork it travels to the veins in the eye. (The aqueous does not drain to the outside of the eye.)  

The balance between the production of the aqueous, and its exit from the eye, is what gives the eye its pressure.  Too much fluid production, or not enough fluid drainage will increase the pressure inside the eye causing “open angle glaucoma”.  If the fluid produced in the ciliary body cannot get through the pupil to the trabecular meshwork, again, the pressure will increase causing “narrow angle glaucoma”.

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