Gainesville Eye Associates

What is glaucoma?
Glaucoma is an eye disease where the pressure inside the eye becomes too high resulting in progressive damage to the main nerve of the eye (the optic nerve). This progressive damage initially causes a gradual loss of side vision that is not noticeable until it is very advanced. Untreated glaucoma will eventually cause blindness. Most forms of glaucoma produce no noticeable symptoms until major, irreversible nerve damage has already occurred. This is the real danger of the disease. However, if diagnosed early, glaucoma is treatable. Therefore, being examined for glaucoma on a regular basis is very important. In addition, if it is determined that you are at high risk for glaucoma or you already have the condition, careful examination, testing, and follow-up care are needed to preserve your sight. The take home message is that vision loss CAN be prevented from glaucoma if caught early. Early detection is the key.

Glaucoma can essentially be thought of as a plumbing problem. The eye has a faucet that is continually making fluid (aqueous humor), and the eye has a drain. Glaucoma is when the drain does not work well enough to keep up with the faucet, and the pressure inside the eye builds up.

Although glaucoma can occur at any age, the risk of developing the disease increases as we age, being most common after 35 - 40 years of age. It is estimated that glaucoma will affect 1 of every 50 adults. Anyone can get glaucoma, but people at higher risk include:

Those who are significantly near-sighted (high myopia)
Those with a family history of glaucoma
Those who have had a significant trauma to an eye (even decades earlier)
Those who have had major eye surgery
Those of African descent

However, it is important to emphasize that even low risk patients over the age of 35 should have their eyes examined by their family doctor of optometry for glaucoma at least every two years. Also, testing for glaucoma involves much more than a "pressure check" at a health fair. Many early glaucoma patients have intra-ocular pressures that vary significantly from day to day or even from one hour to the next. It has been estimated that as many as one third of all early glaucoma patients will present to an eye doctor with a "normal" eye pressure. Therefore testing for glaucoma based on intraocular pressure measurements alone will result in a significant number of patients with progressive glaucoma being missed. Bottom line: A "pressure test" is not enough.

How is glaucoma diagnosed?
A thorough eye examination that includes intraocular pressure readings, careful assessment of a patient's side vision (visual field) and optic nerves is essential to diagnose glaucoma early when it is most treatable. At Gainesville Eye Associates, we believe it is important for our patients to have access to leading edge technology and expertise to properly manage their glaucoma. Examples of this technology are the GDx Nerve Fiber Analyzer, the Argon Laser to perform glaucoma laser procedures, the OCT optic nerve analyzer, and the incorporation of pachymetry corneal thickness analysis. These devices give us the most complete amount of information to make diagnostic and treatment protocols of our patients.

How is glaucoma treated?
Glaucoma is usually treated by lowering the pressure in the eye to a level that hopefully stops progressive damage to the nerve. The first line of treatment for glaucoma is usually topical eye drop medications. Fortunately many glaucoma drops have been developed over last few years with several more on the horizon. Glaucoma medications typically work by either reducing the amount of fluid produced inside the eye or by helping intraocular fluid drain out more efficiently. Some medications may actually do both. It is not uncommon to be on two or more medications at one time to treat glaucoma.

Once a patient is on two or more medications and they still need their intraocular pressures lowered more, it is likely they will need laser or other glaucoma surgery to further reduce the pressure in the eye if it is needed. If topical medications and laser treatments fail to lower intraocular pressure effectively, glaucoma surgery is an option. Our doctor performs the latest techniques in glaucoma surgery, offering patients the best likelihood for success in long term eye pressure reduction.

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