A leading cause of blindness, glaucoma often sneaks up on those afflicted with the disease. Most types of glaucoma do not exhibit symptoms until significant vision has been permanently lost, making regular screening and early diagnosis important. Aggressive treatment cn prevent, but not reverse, 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. Prompt detection allows for more effective glaucoma treatment. Our eye doctors regularly perform comprehensive examinations to rule out undetected diseases. While all of our eye doctors treat common glaucoma, Dr. Scott Fudemberg of Eye Physicians and Surgeons and Wills Eye Hospital specializes in complex, difficult to treat glaucoma and is one of only several referral specialists treating glaucoma in Wilmington, Delaware. 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 damage to the optic 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, permanent vision loss occurs.
Types of Glaucoma
There are several types of glaucoma, each with different cause and symptoms.
- 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 reduces the natural drainage of fluid from the eye, causing pressure to build. Though there are ofteGlaucoma, 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 n no symptoms initially, over time you may lose your peripheral vision. Early treatment is necessary in order to preserve sight.
- Closed-Angle Glaucoma often causes an acute sudden blockage, where fluid cannot drain, causing pressure to build rapidly. 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 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.
There are a wide variety of options available to treat glaucoma. Those with glaucoma are often prescribed oral and/or topical medications. Newer medications in recent years are much more effect, and can usually preserve vision and avoid the need for more invasive treatment.
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. 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 treat tissue in the trabecular meshwork of the eye—near the cornea—to encourage the outflow of fluid from 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, and is thought to be safer. Eye Physicians has offered the newer SLT laser for several years
- 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 treat the ciliary tissue which produces aqueous fluid. This lowers IOP, which relieves the symptoms of glaucoma in those with serious diesease. Dr. Scott Fudemberg is one of few in Wilmington Delaware to offer the full range of treatments.
When the other options—medication and laser surgery—have failed to reduce IOP, conventional glaucoma surgery may be an option. Conventional surgery includes trabeculectomy filtering surgery and tube shunt surgery. A trabeculectomy involves the creation of a drainage bypass in the trabecular meshwork. Tube shunt surgery is a more effective, but more extensive surgery, where the fluid flows into a reservoir just beneath the conjunctiva—the outer layer of the eye. Both procedures successfully lower IOP. Dr. Scott Fudemberg specializes in difficult to manage glaucoma patients, receiving referrals from other eye doctors throughout the region.
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.