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Glaucoma

What is Glaucoma?

Glaucoma is an eye condition that develops when too much fluid pressure builds up inside of the eye. It tends to be inherited and may not show up until later in life.  The increased pressure, called intraocular pressure, can damage the optic nerve, which transmits images to the brain. If damage to the optic nerve from high eye pressure continues, glaucoma will cause loss of vision. Without treatment, glaucoma can cause total permanent blindness within a few years.

Because most people with glaucoma have no early symptoms or pain from this increased pressure, it is important to see your ophthalmologist regularly so that glaucoma can be diagnosed and treated before long-term visual loss occurs.

If you are over the age of 40 and if you have a family history of glaucoma, you should have a complete eye exam with an ophthalmologist every one to two years. If you have health problems such as diabetes or a family history of glaucoma or are at risk for other eye diseases, you may need to visit your eye doctor more frequently. 

South Palm Eye Associates offers the most Advanced Technologies in Both.

 

Offering Advanced Technologies in Glaucoma Diagnosis

Ocular Coherence Tomography (OCT)

OCT technology makes it possible to diagnose glaucoma earlier than with standard optic nerve photography and clinical examination. This computerized technology provides a computerized three-dimensional map of the optic nerve and retinal nerve fiber layer to diagnose early-stage optic nerve changes and thinning of the optic nerve rim.  This technology also makes it easier to detect a change or progression in the optic nerve earlier than by clinical exam or standard photography (OCT).

Sita Visual Field Testing and Progression Analysis

The Sita Humphrey Visual Field Analyzer is the latest prototype of visual field technology to detect early loss of peripheral vision associated with glaucoma. Both the Sita Standard and Sita Fast modalities are available, to allow more accurate detection of the earliest changes in peripheral (side) vision that can occur with glaucoma. The newest statistical progression analysis allows us to detect peripheral vision loss earlier and more accurately, so that glaucoma treatment can be increased or enhanced if needed

Digital Stereoscopic Optic Nerve Photography

We have the most advanced digital camera currently available to obtain stereoscopic photographs of the optic nerve. These photographs can be viewed immediately on our digital computer screen and are still considered the gold standard in optic nerve evaluation. They document the appearance of the optic nerves and make it possible to observe any subtle changes in the nerves that can occur at the start of or with progression of glaucoma. This digital technology also allows us to immediately compare the appearance of the optic nerve to previous photographs to make sure the optic nerve is stable and its condition has not worsened.

Corneal Pachymetry

This ultrasound device quickly and accurately measures the thickness of the cornea. Research has shown that eye pressure measurements are related to corneal thickness. If the cornea is very thin, the true intraocular pressure is higher than what is actually measured, and a very thick cornea indicates that the true eye pressure is lower than what is actually measured. Corneal pachymetry is therefore extremely important in accurately determining eye pressure.

Gonioscopy

This special four-mirror instrument is placed on the anesthetized eye to determine if the angles are open, narrow, or closed. This instrument makes it possible to accurately diagnose which type of glaucoma (open-angle or angle-closure) the patient has. Gonioscopy can also detect critically narrow angles that require a laser peripheral iridotomy to prevent angle closure glaucoma from occurring.

 

Advanced Technologies to Effectively Treat Glaucoma

The goal of glaucoma therapy is to protect the optic nerve and prevent loss of peripheral vision by lowering eye pressure. To individualize treatment, we carefully consider each patient’s lifestyle and needs and then evaluate the risk/benefit ratio of each treatment regimen.

While eye drop medications that lower eye pressure are the mainstay of therapy, several safe and effective laser treatments provide excellent alternatives or additional treatments.

Selective Laser Trabeculoplasty (SLT)

The newest Glaucoma Therapy SLT takes only a few minutes to perform in the office. Eye drops are used to prepare the eye for treatment. The doctor controls the laser through a special microscope similar to the one used for an eye examination.

To allow the laser to have maximal effect while remaining gentle, each eye receives two SLT treatments, with only one half of the eye treated at a time. SLT targets specific cells within the eye that contain melanin (a natural pigment).  It improves outflow of the fluid in the eye and lowers eye pressure by using laser light to stimulate the body’s natural healing response.

The laser’s special wavelength and energy targets only the melanin-containing cells of the eye.  SLT is not associated with systemic side effects and is easier (and less expensive) for the patient than eye medications.  It is a covered benefit of Medicare and many other insurance plans; this minimizes your out-of-pocket expense.

Laser Peripheral Iridotomy 

The eye’s internal drainage canals are located inside the angle between the iris and cornea. If the drain canal becomes very narrow or closes, the entrance to the drain can close, causing an acute very high eye pressure, which can cause severe pain or loss of vision. Performing a peripheral iridotomy to widen the angle can prevent both an acute attack of angle closure glaucoma and chronic angle closure glaucoma.

This safe and effective laser procedure is performed in the office. To widen the angle where the drainage canals are located, the doctor creates a small microscopic opening in the peripheral iris, which provides an alternate pathway for fluid to flow out of the eye.