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Glaucoma Management

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CoupleGlaucoma is the second leading cause of blindness. Sometimes called the silent thief of sight, glaucoma can damage your vision so gradually you don't notice any loss of vision until the disease is at an advanced stage. Glaucoma is an eye condition that develops when too much fluid pressure builds up inside of the eye. This increase in pressure, called intraocular pressure, can damage the optic nerve, which transmits images to the brain. If damage to the optic nerve from high eye pressure continues, glaucoma will cause loss of vision. Without treatment, glaucoma can cause total permanent blindness within a few years.

Because most people with glaucoma have no early symptoms or pain from this increased pressure, it is important to have regular routine eye exams so that glaucoma can be diagnosed and treated before long-term visual loss occurs.

There are two main types of glaucoma:

  1. Open-angle glaucoma - This is the most common type of glaucoma. The structures of the eye appear normal, but fluid in the eye does not flow properly through the drain of the eye, called the trabecular meshwork.
  2. Angle-closure glaucoma - This type of glaucoma is less common, but can cause a sudden buildup of pressure in the eye. Drainage may be poor because the angle between the iris and the cornea (where a drainage channel for the eye is located) is too narrow. Or, the pupil opens too wide, narrowing the angle and blocking the flow of the fluid through that channel.

Please consult with an ophthalmologists at Hayden Vision - American Eye Institute regarding glaucoma treatment options. Your ophthalmologist will be able to diagnose the type of glaucoma and the actual severity of the Intraocular Pressure (IOP). Treatment options will drastically vary from patient to patient.

Glaucoma Medications

Glaucoma is typically treated with eye drops that decrease eye pressure either by slowing the amount of fluid produced within the eye or by improving the flow through the drainage angle. Glaucoma medications may produce side effects, so be sure to talk to your doctor if you experience any unusual symptoms.

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GlaucomaGlaucoma Surgery

Trabeculectomy

Trabeculectomy is a surgical procedure performed by an ophthalmologist used to lower eye pressure. By trying to lower the eye pressure, damage can be halted from further pressure increases, but that damage already done is not reversible.

The trabeculectomy procedure involves the surgeon creating a tiny passage way from the inside to the outside of your eye. This helps fluid drain better from the areas it is presently not draining. Trabeculectomy can lower the pressure in your eye and help prevent more damage to the optic nerve. Trabeculectomy is more commonly used after other treatment options have not been successful or are simply not stopping the increasing IOP (Intraocular Pressure). Your eye surgeon may consider trabeculectomy if:

  • Medicines do not work as planned
  • Laser surgery to lower the eye pressure has not worked

SLT – Selective Laser Trabeculoplasty

Selective Laser Trabeculoplasty (SLT) is quickly becoming a widely accepted treatment option in glaucoma treatment. SLT offers a new glimpse of hope for glaucoma patients. By engaging in this laser technology, the ophthalmologists can now lower pressure that can possibly help a patient avoid a more invasive surgery. The surgery might even reduce the dependence on medications or drops.

Selective Laser Trabeculoplasty (SLT) is an advanced laser system that improves the flow of fluid in the eye, lowering Intraocular pressure (IOP) for patients who have glaucoma. SLT uses short pulses of low energy laser light to target melanin-containing cells in a network of tiny channels, called the trabecular meshwork. The objective of the surgery is to help fluids drain out of the eye, reducing intra-ocular pressure that can cause damage to the optic nerve and loss of vision.

iStent

Dr. Gregory Hayden of Hayden Vision - American Eye Institute is pleased to utilize the iStent® Trabecular Micro-Bypass Stent as a treatment option to reduce eye pressure for patients with both cataracts and glaucoma. The iStent is FDA-approved for use in conjunction with cataract surgery to reduce eye pressure in adult patients with mild-to-moderate open-angle glaucoma currently being treated with glaucoma medicine.

iStent works like the stents used to prevent heart attacks and strokes. When blood vessels get clogged, a stent creates access to the vessel flow. While a highly innovative technology, how iStent works is elegantly simple:

  • If you have glaucoma, over time the eye’s natural drainage system becomes clogged.
  • iStent creates a permanent opening through the blockage to improve the eye’s natural outflow.
  • Restoring this mechanism lowers and controls pressure within the eye.

iStent: managing glaucoma while treating your cataracts

iStent is implanted during your cataract surgery procedure. Once implanted, iStent will begin working to safely and effectively manage pressure. What’s more, patients who receive iStent may experience a reduction in glaucoma medications; but this will be at the discretion of your physician. This is important because once diagnosed, most patients will spend the rest of their lives putting one, two or even three different kinds of drops in every day. Unfortunately, all of these drops will not only be inconvenient, but potentially very expensive.

iStent: the world’s smallest medical implant delivers big results in mild-to-moderate open-angle glaucoma.

While mild-to-moderate open-angle glaucoma is very common, many people are unaware of their condition, especially in the early stages, when their vision may be unaffected. In many people, open-angle glaucoma is characterized by an increase in the intraocular pressure (IOP) of your eye. This pressure is caused by the buildup of fluid within the eye. Too much fluid raises pressure, which can cause the gradual loss of vision. And while glaucoma moves slowly, its damage is irreparable.

iStent

The world’s tiniest medical device—iStent—is 20,000 times smaller than the intraocular lenses (IOL) used in your cataract surgery. But the size of iStent is only part of its story. By increasing the eye’s ability to drain fluid, this technology is designed to reduce the pressure in your eye.

In a U.S. clinical study, 68% of glaucoma patients who received iStent remained medication free at 12 months while sustaining a target IOP of = 21 mm Hg vs. only 50% of patients who underwent cataract surgery alone.