Glaucoma Treatment
Glaucoma is one of the most common causes of preventable blindness in the world. Most people who tragically lose their vision from glaucoma were either never diagnosed or were diagnosed once their glaucoma was very advanced.
What is Glaucoma?
Glaucoma is damage to the optic nerve in the back of your eye. This nerve carries signals from the retina to your brain where it is interpreted as vision. Glaucoma is typically associated with high eye pressure but not always. Many patents are familiar with the “air puff” test. This is actually not a very accurate way of measuring eye pressure so it is not used in most Ophthalmologists’ offices. The way we typically measure eye pressure is with a device called a Goldmann applanation tonometer. This is the little blue light attached to the slit lamp that the doctor or technician puts very close to your eye. There are other ways to measure eye pressure as well such as a Tonopen, which gently taps the front of your eye as it takes measurements.
Does high eye pressure cause glaucoma?
If your eye pressure is “normal” you don’t have to worry about glaucoma, right? Well, not exactly. The eye pressure is only one part of the picture when we test for glaucoma. Other factors we look at are the of the optic nerve itself, peripheral or side vision loss, progression or changes over time and other coexisting eye conditions.
How do we test for glaucoma?
The shape of the optic nerve is called the “cup-to-disk ratio”. Essentially, we look at the overall size of the nerve and compare it to how large the central “cup” or scooped out area is. This can be deceiving because many people are naturally born with large “cups” and never end up developing glaucoma. The way we track potential development of glaucoma is with repeated eye exams every 6 to 12 months and closely monitoring the optic nerve. We can use photographs to track changes over time but nowadays, the most common test for monitoring the optic nerve is called an OCT. The OCT is a very accurate device that takes detailed scans of your optic nerve, or other parts of the eye, and looks for potential damage. These scans measure the optic nerve and surrounding nerve fiber layer down to the micron. For comparison, one human hair is about 70 microns thick. Ophthalmologists can observe very small changes over time using this technology and catch glaucoma in its early stages. Typically, when we are able to catch glaucoma very early and start treatment, it becomes much less likely the patient will be severely impacted by the disease.
Visual field exams are another test used very commonly to monitor or screen for glaucoma. Patients often refer to this test as the “clicky button test”. A visual field study maps out the peripheral, or side vision of each eye. This is because glaucoma damage is typically seen in the periphery first which is why many patients are not aware of any problems early on. Visual field tests have become faster over the years but they still take a few to 10 minutes to complete for each eye. The information from a visual field test is very useful however, as it lets us know not just how your optic nerve looks but how it is actually functioning.
How is glaucoma treated?
Thankfully, we have many good options to treat glaucoma. The typical first-line treatments are eye drops that lower your eye pressure. If a patient has difficulty using drops or simply cannot remember to take them every day, we can use an in office laser procedure called a Selective Laser Trabeculoplasty or SLT. The SLT has been shown to be as effective as drops and some recent research is showing it may actually be better to start with SLT instead of drops.
There are different surgical treatments for glaucoma if drops and laser treatment cannot stabilize the patient’s eye pressure. In recent years there have been many developments for treating glaucoma with “MIGS” or Minimally Invasive Glaucoma Surgery. Most frequently, these “MIGS” procedures are done at the same time as cataract surgery. This can be a very good option for some patients as they only need to undergo one single surgery for both their cataracts as well as their glaucoma.
The good news is we have many tools in our toolbox to help our patients with glaucoma and prevent them from losing their vision.
Make an appointment today!
If you've been diagnosed with glaucoma or have a family history of glaucoma, you should have regular check ups to avoid permanent vision loss. Schedule an appointment with Dr. Zelenak! We proudly serve patients in Wixom, Novi, Northville, Livonia and the surrounding Metro Detroit areas.
What is Glaucoma?
Glaucoma is damage to the optic nerve in the back of your eye. This nerve carries signals from the retina to your brain where it is interpreted as vision. Glaucoma is typically associated with high eye pressure but not always. Many patents are familiar with the “air puff” test. This is actually not a very accurate way of measuring eye pressure so it is not used in most Ophthalmologists’ offices. The way we typically measure eye pressure is with a device called a Goldmann applanation tonometer. This is the little blue light attached to the slit lamp that the doctor or technician puts very close to your eye. There are other ways to measure eye pressure as well such as a Tonopen, which gently taps the front of your eye as it takes measurements.
Does high eye pressure cause glaucoma?
If your eye pressure is “normal” you don’t have to worry about glaucoma, right? Well, not exactly. The eye pressure is only one part of the picture when we test for glaucoma. Other factors we look at are the of the optic nerve itself, peripheral or side vision loss, progression or changes over time and other coexisting eye conditions.
How do we test for glaucoma?
The shape of the optic nerve is called the “cup-to-disk ratio”. Essentially, we look at the overall size of the nerve and compare it to how large the central “cup” or scooped out area is. This can be deceiving because many people are naturally born with large “cups” and never end up developing glaucoma. The way we track potential development of glaucoma is with repeated eye exams every 6 to 12 months and closely monitoring the optic nerve. We can use photographs to track changes over time but nowadays, the most common test for monitoring the optic nerve is called an OCT. The OCT is a very accurate device that takes detailed scans of your optic nerve, or other parts of the eye, and looks for potential damage. These scans measure the optic nerve and surrounding nerve fiber layer down to the micron. For comparison, one human hair is about 70 microns thick. Ophthalmologists can observe very small changes over time using this technology and catch glaucoma in its early stages. Typically, when we are able to catch glaucoma very early and start treatment, it becomes much less likely the patient will be severely impacted by the disease.
Visual field exams are another test used very commonly to monitor or screen for glaucoma. Patients often refer to this test as the “clicky button test”. A visual field study maps out the peripheral, or side vision of each eye. This is because glaucoma damage is typically seen in the periphery first which is why many patients are not aware of any problems early on. Visual field tests have become faster over the years but they still take a few to 10 minutes to complete for each eye. The information from a visual field test is very useful however, as it lets us know not just how your optic nerve looks but how it is actually functioning.
How is glaucoma treated?
Thankfully, we have many good options to treat glaucoma. The typical first-line treatments are eye drops that lower your eye pressure. If a patient has difficulty using drops or simply cannot remember to take them every day, we can use an in office laser procedure called a Selective Laser Trabeculoplasty or SLT. The SLT has been shown to be as effective as drops and some recent research is showing it may actually be better to start with SLT instead of drops.
There are different surgical treatments for glaucoma if drops and laser treatment cannot stabilize the patient’s eye pressure. In recent years there have been many developments for treating glaucoma with “MIGS” or Minimally Invasive Glaucoma Surgery. Most frequently, these “MIGS” procedures are done at the same time as cataract surgery. This can be a very good option for some patients as they only need to undergo one single surgery for both their cataracts as well as their glaucoma.
The good news is we have many tools in our toolbox to help our patients with glaucoma and prevent them from losing their vision.
Make an appointment today!
If you've been diagnosed with glaucoma or have a family history of glaucoma, you should have regular check ups to avoid permanent vision loss. Schedule an appointment with Dr. Zelenak! We proudly serve patients in Wixom, Novi, Northville, Livonia and the surrounding Metro Detroit areas.
