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Glaucoma – Diagnosis and Treatment in our Las Vegas Offices

Diagnosing and treating glaucoma to help patients avoid severe symptoms including blindness.

Glaucoma refers to a number of eye diseases that involve optic nerve damage resulting from excessive intraocular pressure. Over time, glaucoma can lead to increasing and permanent loss of vision. Many patients first experience imperceptible blind spots in the periphery of their vision, later developing tunnel vision followed by blindness.

Diagnosing Glaucoma

Glaucoma results from reduced removal or increased production of aqueous humor, a clear fluid, inside of the eye. After the resulting high pressure damages the optic nerve, blind spots start to appear. Ophthalmologists divide glaucoma into open-angle and closed-angle types. Open-angle, or chronic, glaucoma develops more slowly and may not be noticed by patients until the disease has caused major damage. Glaucoma may also occur temporarily after retinal procedures and can happen alongside some types of retinal disorders.

Who Is Likely to Get Glaucoma?

Glaucoma is most often diagnosed in men and women over 40 years old. Those with high blood pressure, ocular hypertension or diabetes have a greater risk of developing glaucoma. Vision problems, such as nearsightedness, and migraines are also associated with heightened glaucoma risk. Finally, African Americans and those who have family members with glaucoma are more likely to suffer from this disorder.

Symptoms of Glaucoma

In the initial stages of glaucoma, symptoms are not usually noticeable. This means that patients who may be at risk of this disorder should be checked by an ophthalmologist regularly through a comprehensive eye exam. The eye doctor can detect glaucoma by analyzing a patient’s visual field, optic nerves and intraocular pressure. When closed-angle glaucoma occurs, patients may suffer from visual disturbances, such as halos surrounding lights, headache accompanied by nausea and pain behind or inside of the eye. However, many patients experience no symptoms before being diagnosed.

Treatment Options for Glaucoma

Eye Drops

Generally speaking, eye drops are the first treatment elected, because they are non-invasive and simple to administer. They generally come in five different varieties, and depending on your specific health profile, one or more of these may be a suitable option for you. Prostaglandin analogs, beta blockers, alpha agonists, carbonic anhydrase inhibitors, or combination medications that will offer the benefits of more than any one of these may be prescribed to curtail symptoms of glaucoma.

Laser Treatments

There are several laser treatment options available for patients suffering from glaucoma, including:
Selective Laser Trabeculoplasty: Eye doctors utilize a laser to begin a biological change in drainage tissue of the eye, facilitating better drainage and reducing intraocular pressure. Post-operative side effects are almost non-existent and healing is usually managed with an oral NSAID or eye drops to reduce inflammation or pressure from swelling. This treatment is generally recommended if eye drops are not a viable option or have proven insufficient, and most often administered to those with open-angle glaucoma in which the frontal drainage system of the eye is open.

YAG Capsulotomy (Yttrium Aluminum Garnet): YAG Capsulotomy is often helpful in the case of membrane clouding following a cataract removal. Three out of four individuals who have cataract surgery will eventually require this simple treatment. A laser is directed at the membrane or capsule, which remains after lens removal, creating a clear space in the center of the capsule and improving vision. This is an incredibly simple procedure that we perform in a single, outpatient appointment. The risk of retinal swelling is minimal, and most patients who have the procedure experience few, if any ill effects or pain. The most commonly noted side effect was a brightness of colors and a slight red haze after being out in direct sunlight soon after the surgery. This is the body’s natural response to renewed clarity of vision after a long period of blurred or clouded sight.

Laser Peripheral Iridotomy: This procedure is typically recommended for patients with narrow-angle glaucoma or acute angle closure glaucoma. In the case of the former, it is considered a preventative measure to ensure that the patient does not develop the latter. LPI opens the narrow angle, which is the part of the eye associated with fluid drainage. If the patient already suffers from acute angle closure glaucoma, the laser is used to make a tiny opening in the peripheral iris, which allows fluid to drain more normally and reduces intraocular pressure (IOP).

Recovery from Glaucoma

Optic nerve damage cannot be recovered, but with early detection of glaucoma, blindness can often be prevented through surgery and medical intervention. An eye doctor often prescribes eye drops to reduce intraocular pressure as a first line of treatment, followed by laser therapy if necessary. Unfortunately, even laser therapy does not offer permanent improvements. Many patients also benefit from supplementing with certain nutrients, such as lutein and vitamin C.