Glaucoma

Treatment Options


Medications

A number of medications are currently available to treat glaucoma. Most of these medications are in the form of eye drops.  Dr. DeMers or Dr. McKnight may prescribe one, or a combination of medications to control your eye pressure.  Over time, we may change these medications to reduce side-effects, or provide a more effective treatment. Monitoring your eye pressure several times a year is how we determine how well the medications are working.  Typically medications are the first treatment introduced to reduce elevated eye pressure, prevent damage to the optic nerve, and preserve vision.  Glaucoma is, unfortunately, a chronic disease that rarely resolves after it develops.  Ongoing treatment is required by most patients for life.


Surgery by an Ophthalmologist

When eye drops fail to control glaucoma, laser surgery or intraocular surgery are the next steps in treatment.  Surgical interventions are designed to increase the flow of fluid out of the eye when medications are unable to lower the eye pressure an adequate amount. The type of surgery your doctor recommends will depend on the type and severity of your glaucoma, and the general health of your eye. Surgery may help lower pressure when medication is not sufficient, however, it cannot reverse vision loss.

 WHAT IS GLAUCOMA?

Glaucoma is a group of eye diseases that gradually steal sight without warning.  In the early stages of the disease, there may be no symptoms.  Early vision loss occurs in the peripheral vision, and often goes unnoticed until more severe vision loss develops.  Experts estimate that half of the people affected by glaucoma may not know they have it.

Vision loss is caused by damage to the optic nerve.   The nerve acts like an electric cable with over a million wires.  It is responsible for carrying images from the eye to the brain.

There is no cure for glaucoma—yet. However, medication or surgery may slow or prevent further vision loss.  Appropriate treatment varies depending upon the type of glaucoma, response to medications, other existing health conditions, and a number of other factors. Early detection is vital to stopping the progression of the disease.

It was once thought that high pressure within the eye, also known as intraocular pressure or IOP, was the main cause of optic nerve damage in glaucoma.  Although IOP is clearly a risk factor, we now know that glaucoma may be present with “normal” levels of eye pressure.  A comprehensive eye exam screens the patient for multiple risk factors in glaucoma.  In addition to measuring eye pressures, the visual field (peripheral vision), ocular drainage, and optic nerves are carefully examined for signs of glaucoma disease as well.​

Diagnostic Tests We Perform


Tonometry
The tonometry test measures the fluid pressure inside of the eye.

Optic nerve photos
Optic nerve photos are used to monitor and compare changes in the optic nerve over time. 

Perimetry
The perimetry test is also called a visual field test. During this test, you will be asked to look straight ahead, and then indicate when a moving light appears in your peripheral vision. This helps draw a “map” of your vision, and shows the doctor whether vision loss is developing from glaucoma.

Gonioscopy
Gonioscopy is a painless eye test that checks the drainage system of the fluid filled chamber in the eye.  This test helps determine the difference between "open" and "narrow" angle glaucoma types. 

Pachymetry
A pachymetry test measures the thickness of your cornea. With this measurement, Dr. DeMers and Dr. McKnight can better interpret the significance of your eye pressure reading, and develop a treatment plan that is right for your condition.

Optic Nerve Scanning Laser Ophthalmoscopy
The OCT instrument utilizes a technique called optical coherence tomography to project harmless laser beams through the deeper layers of the optic nerve.  The OCT instrument is capable of detecting loss of optic nerve tissue at the level of microns, and gives us the capability to diagnose the early stages of glaucoma before vision loss has developed.  This instrument has revolutionized eye care, and is the gold standard in evaluating and managing glaucoma.