Glaucoma Treatment

Glaucoma Treatment

What Is Glaucoma?

Glaucoma is a disease that causes permanent damage to the optic nerve. It is often caused by a progressive buildup of pressure inside the eye. Over time, this elevated pressure causes optic nerve fibers to become damaged. The optic nerve is responsible for sending visual signals to the brain, and damage to the nerve results in irreversible vision loss. This usually starts with a loss of peripheral vision and can lead to complete vision loss if not controlled. Glaucoma is one of the leading causes of irreversible blindness in the United States and affects 2.7 million Americans. Because there are often no symptoms until glaucoma is more severe, glaucoma is often called the “silent thief of sight”. Early detection is critical to prevent loss of vision and to preserve quality of life.

diagram of glaucoma

What are the risk factors for glaucoma?

Risk factors for glaucoma include:

  • Age – people over 60 are at a higher risk, and the risk increases slightly each year
  • Race – African Americans are significantly more likely to develop glaucoma. People of Asian descent are at higher risk for angle-closure glaucoma, and people of Japanese descent are at higher risk for low-tension glaucoma.
  • Family history – having a parent or sibling with glaucoma increases your risk
  • Eye injury – severe trauma can damage the structures in the eye and can cause increased eye pressure
  • Medical conditions – diabetes and high blood pressure may increase your risk for glaucoma
  • Steroid use – steroids like prednisone and cortisone, when used for prolonged periods, may increase your eye pressure and lead to glaucoma
  • High myopia (nearsightedness) – some studies suggest that people with high myopic prescriptions may be at higher risk for glaucoma (even if this was corrected with refractive surgery like LASIK)

How is glaucoma diagnosed?

Glaucoma can be diagnosed by your eye doctor at Diagnostic Eye Center through a combination of different tests. Your eye pressure will be measured with a blue light (no puff of air here!) and your eyes will be dilated to view the optic nerves. This is part of a standard comprehensive eye exam. If there is suspicion for glaucoma, your doctor will recommend more extensive testing, including a visual field test to map your peripheral vision and imaging of your optic nerves.

Elderly man applying eye drops to manage glaucoma symptoms

Is there a cure for glaucoma?

While there is no cure for glaucoma, treatment is aimed at lowering the pressure inside the eye to prevent further vision loss. We can do this most commonly with eye drops, but sometimes surgery is recommended. These can be simple laser procedures or more complex surgeries, depending on the severity. We also offer minimally invasive glaucoma surgery (MIGS), which is discussed below.

It’s important to remember that once vision loss occurs, we cannot get it back. Our treatment is aimed at preventing further vision loss, so early detection is key. In its early stages, glaucoma is often asymptomatic. This means that you do not notice any pain or blurred vision at all. This is why yearly eye exams are important for everyone, even if your glasses are working well or you have no vision complaints.

What can I do to prevent glaucoma?

Other than making sure you have a comprehensive dilated eye exam at least once a year, new research suggests that exercise, especially vigorous exercise, may help reduce your risk for glaucoma. It is also important to control any systemic health conditions, like high blood pressure of diabetes. Talk with your doctor about your risk factors for glaucoma and what you can do to lower your risk.

What Is Minimally Invasive Glaucoma Surgery?

Micro-invasive glaucoma surgery (MIGS), describes a new genre of procedures and devices to treat glaucoma. It’s called “microinvasive” or “minimally invasive” because the tools required are microscopic in size and the incision is tiny. These procedures are predicated by extreme safety, quick recovery, and are minimally traumatic to the anatomy and physiology of the eye.

Usually performed in conjunction with cataract surgery, they are performed through a very small incision. Before MIGS, treatment options for glaucoma were limited to eye drops, lasers, and traditional glaucoma surgeries. Our Houston Glaucoma Surgeons utilize the MIGS technologies below. Dr. Sanders and Dr. Salem will perform a thorough eye exam and determine which procedure is best for you.

iStent Inject

The iStent inject is the world’s smallest medical device implanted in the human body.  It creates two bypasses between the front part of the eye and its natural drainage pathway, the trabecular meshwork, to increase the flow of fluid.  It can be inserted at the time of cataract surgery to improve the eye’s natural outflow to safely lower intraocular pressure.  The iStent inject is used to treat patients with mild to moderate glaucoma and may help to reduce the need for topical glaucoma medications.  Once implanted, the iStent inject is not seen or felt by the patient.

Kahook Dual Blade (KDB) Goniotomy

The Kahook Dual Blade (KDB) is an elegant, single-use, ophthalmic blade designed to excise a strip of tissue from the trabecular meshwork of the eye.  The trabecular meshwork is part of the eye’s natural drainage system, so by removing part of this tissue, which may be diseased, fluid can flow more freely through the eye.  As with any other glaucoma treatment, the goal is to reduce the pressure inside the eye.  The KDB can be used in a stand-alone goniotomy procedure, or in combination with cataract surgery in patients with mild to moderate glaucoma.