Glaucoma

Glaucoma is a degenerative disease of the optic nerve leading to progressive loss of peripheral vision. Glaucoma is a group of eye diseases that damage the optic nerve. Optic nerve carries visual information from the eye to the brain.

There are three types of glaucoma.

  • Open-angle glaucoma usually affects both eyes at the same time. Patient vision gradually gets worse so slowly that they might not notice it.
  • Closed-angle glaucoma usually affects one eye at a time. Closed-angle glaucoma can happen suddenly and be a medical emergency.
  • Congenital glaucoma is a rare form of glaucoma that some infants have at birth. Some children and young adults can also get a type of the disease.

Measurement of IOP, angle study, corneal pachymetry, OCT optic nerve analysis and Visual field analysis (perimetry) are essential tools for managing glaucoma. Eye pressure is modulated with eye drops, laser or incisional surgery.

There are two types of laser treatment options depending on the type of glaucoma:

(1) SLT (selective laser trabeculoplasty) and
(2) LPI (laser peripheral iridotomy).

SLT uses low energy light to enhance the natural mechanism of fluid drainage from the eye to help treat open-angle glaucoma.
Early detection and treatment of glaucoma are important for controlling the condition and preventing visual loss leading to blindness.
Treatment options include medicines and surgery, including laser. It is important to know that treatment for glaucoma will most likely continue for the rest of life of the patient. Patient will need regular eye exams by an eye doctor.

Treatment for Open Angle Glaucoma usually starts with eyedrops. If medicines don’t work, patient may need laser treatment or surgery.
The first treatment for Closed Angle Glaucoma is usually a procedure called laser iridotomy. Patient may also need medicine (usually eyedrops) to help you stay at target eye pressure.

Congenital glaucoma almost always requires surgery to lower eye pressure.

MICROINVASIVE GLAUCOMA SURGERY (MIGS)

Standard glaucoma surgeries, such as trabeculectomy and Ex-Press shunts, are major surgical procedures. Although these are often very effective at decreasing eye pressure ,they have several potential complications. The MIGS group of operations have been developed in recent years to reduce complications of most standard glaucoma surgeries.

AHMED GLAUCOMA VALVES

These devices can successfully control intraocular pressure (IOP) in the eyes caused by a previous failed trabeculectomy and in eyes with inadequate conjunctiva due to scarring from prior injuries or surgery. The devices have also shown success in treating complicated types of glaucoma, including uveitic glaucoma, pediatric and developmental glaucoma, and neovascular glaucoma.

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