Screening & Treatment Options for Glaucoma

More than 2.2 million, or 1.9 percent of Americans age 40 and over have glaucoma. The risk of developing glaucoma increases significantly with age. Unfortunately, approximately half of all patients with glaucoma do not know they have it and will likely suffer unnecessary vision loss. Since glaucoma in its most common form seldom causes symptoms until the disease has progressed substantially, patients are generally unaware that they have glaucoma until it is diagnosed in the course of a comprehensive eye and vision examination.

Risk Factors: People with a strong family history of the disease, those of African, Asian, and Hispanic descent, people over 65, diabetics, and people who are severely nearsighted should be examined at an earlier adult age. Other risk factors are eye trauma and chronic steroid use.

Screening Recommendation: For people with a family history of glaucoma, a baseline exam should be done and, if no glaucoma is detected, it should be repeated every couple of years. People without risk factors should have an eye exam every couple of years. After age 65, people should have eye exams once a year. 

Type of Screening: The typical screening for glaucoma by just measuring intraocular pressure is largely ineffective. Even with normal eye pressure, a patient may have glaucoma. There is no substitute for a complete dilated eye exam. If glaucoma is suspected at that exam, then a complete glaucoma workup is instituted. 

Treatment Options:

• FDA-approved medications are intended to reduce elevated intraocular pressure and prevent damage to the optic nerve. Current glaucoma eye drop therapy includes: prostaglandin analogs, beta blockers, alpha agonists, and carbonic anhydrase inhibitors.
• Laser treatment for open-angle glaucoma. 
• When medicines and laser surgeries do not lower eye pressure adequately, a trabeculectomy is performed to create a drainage hole in the sclera (white part of the eye). The hole allows fluid to flow out of the eye and helps lower eye pressure and reduces damage to the optic nerve.
• Minimally invasive glaucoma surgeries, or MIGS procedures, are newer glaucoma treatments that can be used to treat milder stages of the disease. Some of the more common types involve the placement of a drainage tube or device inside the eye (i.e., iStent and CyPass devices). Other types involve the use of internal lasers such as Trabectome and Endocyclophotocoagulation (ECP).
• Transscleral diode cyclophotocoagulation (external laser) can treat severe end stage glaucoma.
• For patients having severe glaucoma with better visual potential, we now offer MicroPulse diode laser (external laser) with a G6 probe.

Glaucoma is the leading cause of blindness in adults and the sooner it is detected and treated, the better the prognosis for minimizing damage to the optic nerve and retaining sight.

If you are at risk, schedule a visit today with the
Starling Eye Center: (860) 826-4460.