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Eye Physicians and Surgeons, P.A.
1207 North Scott St.
Wilmington, DE 19806
Ph / (302) 652-3353
Fax / (302) 656-9979
Glaucoma and Glaucoma Treatment for Patients in Wilmington, Delaware – Eye Physicians and Surgeons, P.A.
The leading cause of blindness, glaucoma often sneaks up on those who suffer with it. Most types of glaucoma do not exhibit symptoms, though your vision will slowly begin to narrow. Symptoms are often dependent on the type of glaucoma you have and are so gradual that people often do not realize that they have it. For this reason, aggressive glaucoma treatment is often pursued to stave off permanent damage and vision loss.
Though glaucoma can affect anyone, the following factors increase the risk for glaucoma:
- Race—African Americans have a higher risk for glaucoma.
- Age, specifically those over the age of 60
- Family history
- High intraocular pressure (IOP)
- History of conditions such as diabetes, hypothyroidism, leukemia, and ocular hypertension
- Prior injuries to the eye
- Prior steroid use
It is important to schedule yearly eye exams that not only check your vision, but also include diagnostic tests to check the health of your eye. Two such tests—tonometry and ophthalmoscopy—can help detect glaucoma in its early stages. While the former measures your IOP, the latter allows our Wilmington-area glaucoma specialist, Dr. Scott Fudemberg, to examine the retina and optic nerve. Prompt detection allows for more effective glaucoma treatment. Contact Eye Physicians and Surgeons, P.A. schedule an appointment with Dr. Fudemberg.
What is Glaucoma?
Glaucoma is an incurable degenerative eye disease in which the intraocular pressure (IOP) of the eye increases so much that it causes damage to the optic nerve, leading to blindness if left untreated. The eye produces fluid within it that circulates throughout the structures of the eye. When a blockage occurs, the fluid cannot drain, increasing the IOP in the eye. This pressure causes the eye to push against the optic nerve, causing damage to the nerve. The optic nerve is located at the back of the eye and transmits signals from the retina to the brain. When it is damaged, vision loss occurs.
Types of Glaucoma
There are several types of glaucoma, each with a different cause and symptoms associated with it. Universal symptoms include cloudy vision, headaches, sensitivity to light, and decreased vision.
- Open-Angle Glaucoma, the most common form of the condition, is the result of a blockage in the trabecular meshwork of the eye. The blockage keeps the natural flow of fluid in the eye from draining, causing pressure to build. Though there are often no symptoms initially, over time you may lose your peripheral vision. Early treatment is necessary in order to save the rest of your sight.
- Closed-Angle Glaucoma, a rare form of the condition, is the result of a defect in the structure of eye in which the canal between the iris and cornea becomes blocked. Though fluid is produced normally within the eye, it cannot drain, causing pressure to build. Medications that cause the pupil to dilate—antihistamines and some antidepressants—in turn may cause this blockage. Symptoms of closed-angle glaucoma include blurry vision, eye pain, nausea, and headache.
- Normal-Tension Glaucoma is the one form of the condition that is not connected to an increase in IOP. In fact, the exact cause is a mystery. While some believe it is connected to a family history of the condition, others connect it to the death of nerve cells, a reduction in blood flow, an autoimmune disease, or low blood pressure. Early detection is the best way to diagnose and treat this form of glaucoma.
- Secondary Glaucoma occurs as a result of a previous injury or disease of the eye and can be considered open-angle or closed-angle. This type of glaucoma is also associated with prior steroid use.
- Congenital Glaucoma occurs at birth and is caused by genetic defects in the drainage structure of the eye or another eye condition. Since it occurs in children and infants, symptoms can be difficult to detect. Some symptoms include cloudy corneas or spasms of the eyelid.
Glaucoma Treatment
There are a wide variety of options available to treat glaucoma. Those with glaucoma are often prescribed oral and/or topical medications. The following types of topical medications are often prescribed:
- Epinephrine
- Beta-blockers
- Carbonic-anhydrase inhibitors
- Alpha-adrenergic agonists
- Prostaglandin analogs
- Miotics
Epinephrines, miotics and prostaglandin analogs help increase the outflow of fluid from the eye. Beta-blockers, carbonic-anhydrase inhibitors, and alpha-adrenergic agonists all work to reduce the amount of fluid in the eye. Carbonic-anydrase inhibitors also come in an oral form, which our ophthalmologists may prescribe.
Glaucoma Laser Surgery
When medication fails to effectively treat glaucoma, surgical options are explored. Glaucoma laser surgery is often a safe an effective treatment for glaucoma. While it may not free you from your topical glaucoma medication, it can relieve a significant amount of pressure from the inside of the eye. There are three types of laser surgery:
- Trabeculoplasty is an effective procedure to lower IOP in patients with open-angle glaucoma. This in-office procedure uses laser pulses to burn tissue in the trabecular meshwork of the eye—near the cornea—to encourage the flow of fluid in the eye. This lowers IOP by an average of 60 -70 percent in clinical studies. Argon Laser Trabeculoplasty (ALT) focuses on the meshwork as a whole while Selective Laser Trabeculoplasty (SLT) targets cells containing natural pigment.
- Iridotomy, an effective procedure for those with closed-angle glaucoma, uses a laser to create a tiny hole in the iris. This allows the canal between the iris and cornea to open and for fluid to flow freely.
- Cyclophotocoagulation slows the production of fluid by using a laser to burn the ciliary tissue. This lowers IOP, which relieves the symptoms of glaucoma.
Conventional Surgery
When the other options—medication and laser surgery—have failed to reduce IOP, conventional glaucoma surgery may be an option. Conventional surgery includes trabeculectomy and filtering surgery. A trabeculectomy involves the creation of a drainage bypass in the trabecular meshwork. Filtering surgery is an updated version of a trabeculectomy, where the fluid flows into a reservoir just beneath the conjunctiva—the outer layer of the eye. Both procedures successfully lower IOP.
Schedule an Appointment to Learn if You are at Risk for Glaucoma
Contact our office in Wilmington to schedule an appointment for a comprehensive glaucoma exam. An early diagnosis can lead to more effective glaucoma treatment. Don't let glaucoma steal your sight, make an appointment today.