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Eye Consultants of Colorado

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Glaucoma Testing & Management

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Glaucoma is a Serious Eye Disease that Requires Early Detection and Prompt Treatment

Glaucoma is often called the “silent thief of sight” because of the way it develops and progresses. It is typically initially asymptomatic, and has often caused vision loss by the time it is noticed. The only way to properly detect and treat developing glaucoma is with regular eye exams.

Developing initially without symptoms, glaucoma is frustrating because it generally causes permanent vision loss before it is detected.

There are several causes of glaucoma, though the most prevalent is when your eye produces more fluid than is drained away. This raises your eye pressure, which over time can damage your optic nerve. Glaucoma can also be caused by other conditions and eye diseases, such as diabetic eye disease or prolonged use of steroid therapy.

The most common treatment for glaucoma are medicated eye drops that lower your eye pressure. In order for treatment to be effective, it is important to follow the regimen as prescribed by our doctors.

Important Information about Glaucoma Testing

Types of glaucoma

 Glaucoma has many forms, though open-angle glaucoma is the most common variant of it. Below are some, but not all, of the forms glaucoma presents in:

  • Open-angle glaucoma – This type reduces your peripheral vision, usually without other symptoms. This is the most common type of glaucoma.
  • Acute angle-closure glaucoma – Also called “narrow-angle glaucoma” or “closed angle glaucoma”, this type of glaucoma produces sudden symptoms (eye pain, headaches, vision loss, nausea, vomiting). These symptoms represent a medical emergency- see us immediately if you are experiencing them.
  • Normal-tension glaucoma – Also called “low-tension” or “low-pressure” glaucoma. This type of glaucoma occurs despite normal eye pressure. Its cause is not currently known.
  • Pigmentary glaucoma – This is a rare form of glaucoma. It is caused when the drainage angle in your eye becomes clogged by pigment that has detached from the iris. Your body generally induces an inflammatory response, blocking the drainage system.
  • Congenital glaucoma – 80% of congenital glaucoma cases are diagnosed by age one. Present since birth, congenital glaucoma is the result of some type of defect within the eye drainage system.

Testing for glaucoma

A comprehensive eye exam checks for glaucoma using a few different tests:

  • Visual acuity test – Measures how well you see at various distances.
  • Visual field test – Measures your peripheral vision.
  • Dilated exam – Eye drops are used to dilate your pupils. Once open, we will check your retina and optic nerve for signs of damage.
  • Tonometry – Tests eye pressure. Numbing drops are used prior to this test, as the tonometer makes contact with your eye.
  • Optical coherence tomography (OCT) – Measures the optic nerve and checks for signs of damage.

Treating glaucoma

 The most common treatment for glaucoma is medicated eye drops, which lower your eye pressure by reducing the amount of fluid created and increasing the amount of fluid drained by your eye.

Surgical treatments include:

  • Laser trabeculoplasty – Used to treat open-angle glaucoma. It has two variants: argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT). Both types of surgery lower eye pressure by prompting the drainage system to work better.
  • Laser iridotomy – A small hole (roughly the size of a pinhead) is created in the iris using a laser. This lets aqueous fluid drain through the drainage angle.
  • Peripheral iridectomy – Used to treat cases of closed-angle glaucoma where traditional medications or a laser iridotomy did not work. This procedure involves removing a small piece of the iris, enabling the aqueous fluid to drain via the drainage canal. This surgery is rarely performed due to the high degree of success from traditional and laser treatments.
  • Trabeculectomy – A small flap is created in the sclera. A filtration reservoir (called a bleb) is created under the conjunctiva. This bleb is usually covered by your eyelid.

    The bleb allows your aqueous humor to drain, where it is absorbed into blood vessels around the eye.
  • Aqueous shunt surgery – A drainage device, called an aqueous shunt, is placed in the conjunctiva via a small incision. This enables fluid to drain from the eye, where it is then absorbed by surrounding blood vessels. It cannot be seen in most circumstances.

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