Glaucoma is a general term for many conditions that cause progressive damage to the optic nerve resulting in loss of vision. Usually, the eye pressure is elevated, causing direct or indirect optic nerve damage. The pressure is high because the fluid, or aqueous, produced by the eye is blocked from getting to the drain, or trabecular meshwork, or the drain itself is clogged.
If the circulation to the optic nerve is poor, then even “normal” pressures may compromise blood flow, causing loss of vision. If a patient shows evidence of optic nerve injury on examination and/or shows an elevated intraocular pressure, then perimetry, or a visual field examination, is performed. Perimetry involves utilizing a computer program to measure hundreds of spots in your side (peripheral) vision within 4 minutes. If a visual field loss is detected, one of the following treatments will be recommended:
- Topical medications (drops)
- Laser surgery
- Systemic medications (tablets or capsules)
- Viscocanalostomy or trabeculectomy
Our goal is to halt progression of the disease with the least amount of medical or surgical intervention, allowing the patient to maintain useful vision throughout his or her lifetime.
Argon/YAG Laser Glaucoma Surgery
If drops fail to control your glaucoma or if you are considering potential alternatives to using drops, there are surgical options to reduce your intraocular pressure. Surgery can facilitate the outflow of fluid (aqueous) or reduce its production.
If you are at risk for severe and sudden visual loss due to a potential blockage of fluid enroute to the natural drainage ducts of your eye, Argon and YAG lasers can be used to create a “by-pass” opening to ensure that this blockage does not occur. This procedure is known as Laser Peripheral Iridotomy, or LPI.
If you are without risk of a sudden blockage, but have elevated pressures due to problems within the drainage ducts proper, you can be treated with the YAG laser. This procedure is known as Selective Laser Trabeculoplasty, or SLT. SLT can safely reduce your dependence on glaucoma drops and helps control the pressure long term by naturally enhancing the function of the outflow drains in your eyes.
For patients requiring a decreased production of fluid, endocyclophotocoagulation, or ECP, is an option. A tiny diode laser can directly treat the ciliary processes (fluid producing tissue), which reduces fluid production and lowers the pressure.