Glaucoma is a medical condition where the optic nerve in the back of the eye becomes damaged usually from elevated eye pressures. The optic nerve acts as a cable transmitting images from the eyeball to the brain. Glaucoma is the second leading cause of blindness worldwide behind cataracts.
Glaucoma detection involves getting your eyes examined on a regular basis. During a comprehensive eye examination, eye pressures and optic nerves are checked. If eye pressures are abnormally high or the optic nerves have a suspicious appearance suggestive for glaucoma, further testing is performed. These include checking central corneal thickness (the thickness of the windshield of the eye), visual fields (to check for side vision loss), optic nerve imaging (to detect loss/thinning of optic nerve tissue/structures), optic nerve photographs (for future comparison), and gonioscopy (looking at the internal drainage angle to determine if access to it is narrow). If there are abnormalities on the visual field, optic nerve imaging, or both, these usually indicate optic nerve damage and glaucoma.
Medications for glaucoma treatment are usually aimed at lowering the eye pressures by decreasing the aqueous fluid made by the eye, increasing the drainage/outflow of aqueous, or both.
Lasers are performed if there are narrow drainage angles present (laser peripheral iridotomy), to stimulate an increase in the outflow of aqueous fluid from the eye (laser trabeculoplasty), or to decrease aqueous fluid production in an eye with poor visual potential (cyclophotocoagulation).
Incisional glaucoma surgeries include i-Stent, trabeculectomies with antifibrotics, and glaucoma drainage devices/tube shunts.
Not uncommonly, it does take a combination of glaucoma surgeries and glaucoma eye drops to maintain control of a patient’s glaucoma. The key to adequate treatment is timely follow-up and compliance with treatment regimen of glaucoma medications. Regular follow-up is necessary to make adjustments to optimize glaucoma treatment. Prevention is key.
By seeing an ophthalmologist annually for general eye health, individuals who are at higher risk of developing glaucoma are identified and appropriately tested to determine if the condition is present or not hopefully at an early stage.
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