Armory Eyecare

Glaucoma

Glaucoma Treatments Image

What is Glaucoma?

Glaucoma is a disease that results in damage to your eye’s optic nerve. This usually happens due to a fluid buildup in the front part of your eye. This fluid buildup creates an increased pressure in the eye, and this pressure damages the optic nerve. The optic nerve carries visual information from the eye to the brain, and as it is damaged, vision is lost.

Glaucoma usually develops gradually, often without any other symptoms, making vision loss often significant when glaucoma is first detected. Glaucoma is the leading cause of blindness in people over 60 years of age. Blindness from glaucoma can often be prevented with early diagnosis and treatment.

Who is at risk?

People who have a higher than normal risk of developing glaucoma include:

  • Over age 40
  • Have family who suffer from glaucoma
  • Are of African or Hispanic heritage
  • Have high eye pressure
  • Farsighted or nearsighted
  • Have suffered an eye injury
  • Have Corneas that are thin in the center
  • Have thinning of the optic nerve
  • Have migraines, poor blood circulation or other health problems affecting the whole body

How is it diagnosed?

The only sure way to diagnose glaucoma is with an eye exam. A glaucoma screening that only checks eye pressure is not always enough to detect glaucoma. A complete eye exam can detect early stages of glaucoma, which is essential to prevent further optic nerve damage, as damage already done is not reversible. 

During a glaucoma exam, your ophthalmologist will:

  • Measure eye pressure
  • Inspect your eyes drainage angle
  • Examine your optic nerve for damage
  • Test your peripheral vision
  • Take a measurement of your optic nerve
  • Measure the thickness of your cornea

How is Glaucoma Treated?

Damage done to the optic nerve due to Glaucoma is irreversible, however, surgery and medicine can help to stop further damage. Your ophthalmologist may recommend one or more of the following treatments:

Medication

Glaucoma can be controlled with eye drop medicine. These eyedrops can lower eye pressure and prevent more damage to the optic nerve.

Injection Durysta

Chronic use of eye drops to treat glaucoma can worsen Dry eye that many patients suffer from in their older years. Drops can also cause low grade inflammation of the surface of the eye. Injection Durysta into the front chamber of the eye, is a replacement for many of the eye drops used to treat glaucoma. Since the drops are eliminated or reduced, the signs and symptoms of Dry eye and general health of the eye are improved. Dr. Dua performs these injections in the office as a quick procedure on the slit lamp. Patients do not experience any pain or discomfort and resume all activities uninterrupted.

Laser Surgery

Different types of laser surgery can help aqueous drain from the eye. These are usually performed in the ophthalmologist’s office or the surgery center on an outpatient basis.

Operating room surgery

Some surgery for glaucoma is performed in an operating room. This procedure will create a new drainage for the aqueous humor to leave the eye and relieve the eye’s pressure.

These include minor procedures called MIGS, performed with or without cataract surgery for mild to moderate glaucoma.

  • OMNI® Surgial System: The OMNI® Surgical System is a safe and minimally invasive surgical procedure that
    helps reduce intraocular pressure (within the eye) in adult, primary openangle
    glaucoma patients by opening up and restoring flow through the eye’s natural drainage
    pathway. This procedure can be performed at the same time as cataract surgery or on
    its own as a standalone glaucoma procedure. The procedure is implantfree, allowing the eye’s natural drainage system to safely
    restore pressure.
  • Hydrus® Microstent: A minimally invasive FDA-approved implantable device for the treatment of open angle glaucoma. The Hydrus® is a Micro-Invasive Glaucoma Surgery (MIGS) approved to be done in conjunction with cataract surgery. Since it is done at the same time as cataract surgery, no additional incisions are necessary.
  • iStent: An elegant way to help reduce intraocular pressure for patients with open angle glaucoma. It is the world’s tiniest medical device – it is 20,000 times smaller than the intraocular lens (IOL) that you will receive as part of your cataract surgery. It works by increasing your eye’s ability to drain fluid, thereby safely lowers your eye pressure towards a level that will prevent damage to the optic nerve.
  • Endoscopic CycloPhotocoagulation (ECP) Laser: Performed on an outpatient basis, in this procedure, the ciliary body of the eye, which creates fluid, is treated with a laser. This reduces fluid production that in turn, reduces intra-ocular pressure.
  • Goniotomy: A surgical procedure in which the doctor uses a lens called a goniolens to see the structures of the front part of the eye (anterior chamber). An opening is made in the trabecular meshwork, the group of tiny canals located in the drainage angle, where fluid leaves the eye. The new opening provides a way for fluid to flow out of the eye.
  • XEN® Gel Stent: A small, tubular implant about the length of an eyelash. When placed just under the surface of the eye, the stent acts as a drainage device that channels fluid from the anterior chamber of the eye into an area called the subconjunctiva. As fluid leaves the eye, intraocular eye pressure is reduced. Lowering eye pressure levels can protect against optic nerve damage and permanent vision loss.

OR

More extensive surgery like trabeculectomy or Ahmed valve placement for advanced glaucoma.

Since Dr. Dua is Fellowship trained in Glaucoma, she performs all the above procedures.