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Glaucoma Treatment

Medical & Surgical Treatment of Glaucoma

What is Glaucoma?

Glaucoma is a disease of the optic nerve, the part of the eye that carries the images we see to the brain. The optic nerve is made up of many nerve fibers., like an electric cable containing numerous wires. When damage to the optic nerve fibers occurs, blind spots develop. These blind spots usually go undetected until the optic nerve is significantly damaged. If the entire nerve is destroyed, blindness results. Early detection and treatment by your eye doctor are the keys to preventing optic nerve damage and blindness from glaucoma.

How is Glaucoma Detected?

Regular eye examinations are the best way to detect glaucoma. A glaucoma screening that checks only the pressure of the eye is not sufficient to determine if you have glaucoma. The only sure way to detect glaucoma is to have a complete eye examination. During your glaucoma evaluation, our doctors will measure your intraocular pressure (tonometry), inspect the drainage angle of your eye (gonioscopy), evaluate whether or not there is any optic nerve damage (ophthalmoscopy), and test the peripheral vision of each eye (visual field testing or perimetry).

How is Glaucoma Treated?

As a rule, damage caused by glaucoma cannot be reversed. Eyedrops, laser surgery, and surgery in the operating room are used to prevent further damage. In some cases, oral medications may also be prescribed. Because glaucoma can progress without your knowledge, adjustments to your treatment may be necessary from time to time.

Medications

Glaucoma is usually controlled with daily eyedrops. These medications lower eye pressure, either by decreasing the amount of aqueous fluid produced within the eye or by improving the flow through the drainage angle. Never change or stop taking your medications without consulting your eye doctor.

Laser Surgery

Laser surgery treatments may be recommended for different types of glaucoma. In open-angle glaucoma, the drain itself is treated. The laser is used to modify the drain (trabeculoplasty) to help control eye pressure. In closed-angle glaucoma, the laser creates a hole in the iris (irodotomy) to improve the flow of aqueous fluid to the drain.

Surgery in the Operating Room
iStent

Minimally Invasive Glaucoma Surgery (MIGS) is the newest surgical option for glaucoma. Dr. Dickes places the Trabulecular Micobypass stent (i stent) at the time of cataract surgery. It is a 1 mm stent placed in the your drainage system to improve the outflow and thus lower your intraocular pressures (IOP).

Traditional glaucoma surgery, in which a new drainage outflow system is created, is still available and necessary for some patients with more advanced glaucoma.

Karen Dickes, DO
Gregory Kouri, OD
Brady Betten