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Glaucoma

Glaucoma ranks as the second leading cause of blindness worldwide, making early detection and treatment critical for preserving vision. At Longwood Eye & LASIK, our experienced ophthalmologists understand the serious nature of this condition and provide comprehensive care to help patients maintain their sight.  We combine advanced diagnostic technology with proven treatment methods to catch glaucoma in its earliest stages and prevent irreversible vision loss.

What is Glaucoma?

Glaucoma encompasses a group of progressive eye diseases that gradually damage the optic nerve, the vital connection between your eye and brain. This damage typically occurs when pressure inside the eye becomes elevated, though glaucoma can develop even with normal eye pressure. Your eyes continuously produce a fluid called aqueous humor, which normally flows through the eye and exits through specialized drainage channels. This balanced system maintains healthy pressure levels within the eye. 

When these drainage pathways become blocked or function improperly, fluid accumulates and pressure rises, potentially damaging the delicate nerve fibers that transmit visual signals to your brain. The insidious nature of glaucoma lies in its gradual progression.  Most patients experience no noticeable symptoms until significant nerve damage has already occurred, which is why glaucoma is often called “the silent thief of sight.” Once vision loss begins, it cannot be reversed, making early detection through regular eye examinations essential.

Who is at Risk for Glaucoma?

While glaucoma can affect anyone, certain factors significantly increase your likelihood of developing this condition. Age plays a significant role, with risk increasing substantially after the age of 40. 

Your genetic background also matters, as those with a family history of glaucoma or individuals of African, Hispanic, and Asian descent face higher rates of glaucoma compared to other populations.

Additional risk factors include:

  • Severe nearsightedness or farsightedness
  • Previous eye injuries or surgeries
  • Long-term use of corticosteroid medications
  • Diabetes, high blood pressure, and migraine headaches
  • High eye pressure
  • Thin corneas
  • Thinning of the optic nerve

If any of these factors apply to you, maintaining regular eye examinations becomes even more important for protecting your vision. Early detection allows for treatment before substantial damage occurs.

These attacks can occur when the eye’s drainage network becomes completely blocked, resulting in skyrocketing eye pressure and severe symptoms that require immediate medical attention. These symptoms include intense eye or forehead pain, nausea and vomiting, sudden blurred vision, eye redness, and seeing halos or rainbow patterns around lights.

If you experience any symptoms of acute angle-closure glaucoma, seek emergency medical care immediately. This form of glaucoma can cause rapid, permanent vision loss if not treated promptly.

How is Glaucoma Diagnosed?

At Longwood Eye & LASIK, we use comprehensive diagnostic testing to detect glaucoma and monitor its progression. Our evaluation includes several specialized tests that provide detailed information about your eye health:

The Humphrey Visual Field analyzer creates a computerized map of your peripheral vision. This test can detect visual field defects before they become noticeable to you, making it essential for early diagnosis of glaucoma and ongoing monitoring.

Optical coherence tomography (OCT) provides high-resolution, cross-sectional images of your retinal nerve fiber layer. This technology utilizes light waves to create detailed images of retinal structures, enabling the detection and measurement of subtle changes that may indicate glaucoma damage.

Eye pressure measurement remains a cornerstone of glaucoma evaluation. During tonometry, we use numbing drops to ensure your comfort, then gently measure the pressure inside your eye using specialized instruments.

A thorough examination of your optic nerve requires dilating your pupils with eye drops. This allows us to evaluate the color, size, shape, and blood vessel patterns of your optic nerve, helping determine if glaucoma damage has occurred.

How is Glaucoma Treated?

Effective glaucoma treatment focuses on lowering eye pressure to prevent further damage to the optic nerve. At Longwood Eye & LASIK, we offer a comprehensive range of treatment options, from medications to advanced surgical procedures:

Medication

Prescription eye drops often provide the first line of treatment for glaucoma patients. These medications work through different mechanisms; some improve fluid drainage from the eye, while others reduce the amount of fluid your eye produces. Common medications include prostaglandin analogs, beta-blockers, alpha agonists, and carbonic anhydrase inhibitors.

Laser Procedures

Laser procedures offer a minimally invasive way to lower eye pressure and can reduce your reliance on glaucoma medication:

Selective laser trabeculoplasty (SLT) targets specific pigmented cells within the eye’s drainage system using low-energy laser pulses. This treatment improves fluid outflow and reduces pressure without damaging surrounding tissues. 

SLT can be repeated if necessary and may reduce your dependence on daily eye drops.

Laser peripheral iridotomy (LPI) addresses narrow-angle and angle-closure glaucoma by creating a small opening in the iris. This procedure enhances fluid circulation and prevents potentially dangerous pressure spikes that could lead to rapid vision loss.

MicroPulse laser trabeculoplasty (MLT) delivers laser energy in brief pulses, allowing tissue to cool between treatments. This gentle approach reduces the risk of thermal damage while effectively lowering eye pressure. The procedure can be repeated as needed and is comfortable for most patients.

Glaucoma Surgery

At Longwood Eye & LASIK, we offer glaucoma surgeries that incorporate the latest technology and advancements in the field, including:

Minimally invasive glaucoma surgery (MIGS) encompasses several advanced procedures that reduce recovery time compared to traditional surgery while effectively lowering eye pressure.

The Hydrus Microstent system provides surgeons with immediate visual confirmation of successful placement while reducing pressure and medication dependence.

Two tiny titanium stents create permanent openings in the drainage system, enabling improved fluid flow and reduced pressure.

This breakthrough FDA-approved device continuously releases medication directly where needed through an incision smaller than that required for cataract surgery. The treatment provides sustained pressure reduction for months.

Using a specialized lens for visualization, surgeons create openings in the drainage channels to enhance fluid outflow, which is particularly effective in treating congenital glaucoma cases.

The Xen Gel Stent is a soft, flexible tube that creates new drainage pathways with minimal tissue disruption. The stent softens and becomes flexible after implantation, reducing inflammatory reactions.

Durysta is a dissolvable implant that replaces daily eye drops for select patients. Containing bimatoprost medication, Durysta provides sustained pressure reduction for 4-6 months after a single in-office treatment. The implant dissolves naturally and can only be used as a one-time treatment option.

Cyclophotocoagulation is a laser procedure that treats advanced glaucoma by targeting the ciliary body, which produces eye fluid. The treatment reduces fluid production and lowers pressure in cases where other methods have proven insufficient.

This established surgical procedure creates a new drainage channel from inside the eye to beneath the conjunctiva. While more invasive than MIGS procedures, trabeculectomy remains an effective treatment option for advanced glaucoma cases. 

Tube shunt surgery involves implanting a small drainage device to redirect eye fluid and lower pressure. These procedures work well in eyes with previous scarring or after cataract surgery.

Glaucoma Doctors