Glaucoma

Glaucoma is often called the “sneak thief of sight” as there are no early symptoms. If left untreated, glaucoma can lead to severe loss of vision, and even blindness. As one of the leading causes of visual impairment and blindness in the US, glaucoma affects patients of all ages. Although glaucoma cannot be cured, it can be controlled.

There are two types of glaucoma: open- and closed-angle. Open-angle glaucoma is the more common type and occurs when the clear fluid (aqueous), from which the eye receives its nourishment, drains too slowly through a small drainage system in the corners of the eye called the trabecular meshwork. This places pressure on the delicate optic nerve, which is responsible for sending visual signals to the brain. A damaged optic nerve causes impaired or lost vision. Closed-angle glaucoma (or angle-closure) occurs when there’s a sudden buildup of pressure in the eye due to the angle between the iris and cornea being too narrow for aqueous to drain. Both forms of glaucoma are treatable at Niswander Eye Center.

Glaucoma Treatment

Niswander Eye Center recommends one of three methods to treat your glaucoma: medicine, laser surgery or filtration surgery. The goal of all three treatments is to relieve pressure within the eye. As there is no cure for glaucoma, these medical and surgical treatments are administered to relieve symptoms and prevent further damage to your eyes.

The recommended treatment is based on the severity of your glaucoma. If medication or eye drops do not relieve your symptoms, you may need laser treatment or a surgical procedure. This is determined on an individual basis and the team at Niswander Eye Center is prepared to discuss your options with you in greater detail during your exam.

Glaucoma Prevention

There is no guaranteed method of preventing glaucoma. The best way to protect your eyes from glaucoma, and other degenerative eye diseases, is to have your eyes examined regularly. Niswander Eye Center recommends patients have a comprehensive eye exam at least once every year. The following examinations are used to detect glaucoma early:

  • Tonometry: A simple and painless measurement of the pressure in the eye.
  • Ophthalmoscopy: An examination of the back of the eye to observe the health of the optic nerve.
  • Visual Field Test: A check for the development of abnormal blind spots.
  • Optical Computerized Tomography: Allows precise study of tiny nerve fibers in the back of the eye.

Anyone can develop glaucoma, however some patients are at a higher risk than others. These higher-risk patients should schedule an eye exam more frequently to ensure healthy eyes:

  • Over the age of 40
  • Diabetics
  • African-Americans or Hispanic-Americans
  • Family history of glaucoma
  • Poor vision, especially patients who are very nearsighted

Glaucoma Laser Treatments 

If eye drops or other medicines are not viable options, surgical laser treatment to relieve symptoms of glaucoma may be your best treatment method. The type of laser surgery for your eyes will depend on the form and severity of glaucoma you experience.

There are several types of laser surgical procedures to treat glaucoma. They include laser trabeculoplasty (ALT), laser peripheral iridotomy (LPI) and endocyclophotocoagulation (ECP). ALT is used to treat open-angle glaucoma by applying laser energy at damaged drainage channels (trabecular meshwork).

LPI is used to treat closed-angle glaucoma. The laser creates a small opening in the iris, allowing aqueous to freely flow again. In ECP, laser energy is directed inside the eye using fiber optics and a miniature video camera.

These types of outpatient, laser treatments are extremely successful and usually only take 10-15 minutes. They are not painful, but some patients may experience minor discomfort after the procedure. The long-term benefits include prolonged symptom relief and preservation of vision. Be sure to speak with your doctor during your next scheduled exam at Niswander Eye Center to understand your best options.

Tips for Overcoming Eye Drop Challenges 

Glaucoma is a leading cause of irreversible blindness in the United States. When glaucoma is treated in its early stages, vision loss can be prevented. Yet, studies show that more than half of glaucoma patients do not adhere to their prescribed treatment plans due to factors including difficulty in applying eye drops, lack of medication education and forgetfulness.

The American Academy of Ophthalmology recommends to patients six tips to help them overcome medication challenges:

1. Be honest with your ophthalmologist about your medication difficulties Missed a dose? It may not seem to matter much, but research shows that skipping doses can cause your glaucoma to become more severe. Be candid with your ophthalmologist about any problems you face in taking your medicine regularly, and ask about the best way to make up for a missed dose.

2. Ask for help from health professionals and loved ones It can be difficult to keep track of which meds to take and when. Talk with your ophthalmologist or pharmacist about your medications, their impact and possible side effects. Also, use the buddy system and tell your friends, family and caregivers about your condition and treatments. Consider taking a loved one or caregiver with you to your ophthalmology appointments, so they can help you follow your treatment plan when you’re at home. They may also be able to help you apply your eye drops.

3. Use memory aids The most common reason for not taking eye drops is forgetfulness. Try simple memory aids like linking your eye drop schedule to other things you do routinely. For example, put your eye drop bottle next to your toothbrush or your pill box if you take other medications. Try using physical reminders such as marking off a calendar when you use your drops, or moving your eye drop bottle from one place to another after you’ve applied your drops. Also, take advantage of today’s technology and set an alarm on your phone, or look for free smartphone apps and other tools.

4. Perfect the “pocket” Research has shown that nearly 30 percent of people taking glaucoma medication are not properly applying their eye drops. This should involve gently pulling and pinching the lower lid to make a pocket to catch your drops. Once the drops are in, close your eyes (do not blink) and apply pressure to the point where the lids meet the nose for two to three minutes. Learn more with the video at bit.ly/1xrHOCo.

5. Know your Medicare part D coverage Some people find they run out of their glaucoma eye drops early – especially when they are still learning how to apply the drops properly. For those whose glaucoma eye drops are covered through Medicare part D, early refills are possible once 70 percent of the predicted time of use has gone by. That means that a one month supply can be refilled after 21 days at both retail and mail-in pharmacies.

6. Don’t use pot as a glaucoma treatment Don’t fall for rumors that medical marijuana can replace glaucoma medications. Prescription medicated drops are much more effective at treating the condition and have fewer risks. Marijuana can also affect memory, which could make it more difficult to remember your treatments.

Learn more about glaucoma at geteyesmart.org.