Dr. Steven A. Beim, M.D. of the Eye Associates of Brazos Valley has treated thousands of glaucoma patients painlessly and successfully in this area since 1995. He has the experience and the expertise to diagnose and treat this relatively common eye disease.
What is Glaucoma?
Glaucoma is due to increased pressure in the eye and/or decreased blood supply to the optic nerve, the structure that transmits vision from the eye to the brain.
EYE PRESSURE
The inner part of the front of your eye is filled with a fluid that serves to both hold your eye’s shape and provide vital nourishment to the cells and membranes that help you see. This fluid is a special type of liquid that is continually produced from glands within your eye. Your eye also contains special drainage areas for this fluid to escape as new fluid is produced.
In a healthy eye, the balance between the rate that new fluid is produced and the excess fluid drains is maintained perfectly. This creates a consistent amount of pressure inside your eye, allowing it to remain inflated and constantly nourished with new fluid.
Glaucoma is in part a condition that exists when the drainage system of the eye becomes damaged or impaired in some fashion causing increased pressure inside your eye. This increase in pressure is hazardous. If the pressure should become too great, it will cause damage to the optic nerve. In addition decreased blood supply to the optic nerve, commonly seen in conditions like diabetes and high blood pressure, also contribute to optic nerve loss resulting in glaucoma.
When a person suffers from glaucoma, he or she will begin to lose their peripheral vision, vision that most people do not notice. Untreated, the disease will eventually progress to complete blindness. The most troubling fact is that glaucoma rarely has noticeable symptoms other than the gradual loss of peripheral vision, which usually occurs over many years. That is why routine eye exams are essential for everyone, especially people over the age of 35, because early detection could mean the difference between a life with vision or permanent blindness.
Am I at Risk for Glaucoma?
Glaucoma can affect anyone, and the risk for developing glaucoma increases as we age. However, studies have identified a number of factors that increase a person’s risk substantially. If you fall into one of these categories, it’s even more critical that you have annual eye exams.
Higher risk factor groups include:
A Family History of Glaucoma. The most common type of glaucoma, open-angle glaucoma, is proven to be hereditary. Should you have a family history of glaucoma, your chances of eventually developing the disease increase up to nine times.
African-Americans. People of African-American ethnicity are more likely to develop glaucoma than any other race. In fact, glaucoma is the leading cause of blindness among African-Americans.
People over the age of 50. As stated before, everyone has some risk of developing the disease, but your risk increases dramatically as you age.
Hispanics. Hispanics have a higher risk for glaucoma than Caucasians, especially in the elderly.
Other risk factors include:
People with a smoking history
People with diabetes
People suffering from hypertension
People with high cholesterol
Those with a family history of heart attacks or strokes
Again, anyone who falls into one of the categories above needs to pay more attention to their eye health because they are at a higher risk of developing glaucoma and other eye diseases. The best way to prevent problems with your vision is to maintain a regular eye exam schedule with your ophthalmologist.
Different types of Glaucoma
Glaucoma is a general term used to describe several different health issues regarding the drainage system of your eye. The types of glaucoma are:
Open-angle glaucoma
Open-angle glaucoma is the most common type of glaucoma, and the one most associated with heredity. When someone has open-angle glaucoma, the drainage system of his or her eye works less efficiently. While fluid is allowed to escape, it doesn’t drain fast enough to counterbalance the production of new fluid in the eye. The result is a very gradual pressure increase in the eye, resulting in gradual damage to the optic nerve. In many cases, the pressure increase so gradual, symptoms of open-angle glaucoma go undetected for years. That’s why it is known as the ‘silent-thief’ of vision. The only symptom of open-angle glaucoma is the gradual disappearance of your peripheral vision.
Angle-closure glaucoma
The most serious form of glaucoma, angle-closure glaucoma exists when the drainage system of the eye becomes completely blocked and stops working. There are multiple causes of an angle-closure glaucoma attack, all of which cause an immediate spike increase in eye pressure. Symptoms include sudden blurred or loss of vision, headaches and eye pain, glare and halos, red eyes, nausea and vomiting. An angle-closure glaucoma attack is a medical emergency, and any experience of these symptoms requires immediate medical attention to avoid permanent damage to your optic nerve.
Narrow angle glaucoma
This form of glaucoma is similar to angle-closure glaucoma, except the blockage in the filtering system of the eye is intermittent and incomplete. People usually can’t tell they have a problem and like open angle glaucoma, damage occurs gradually.
Secondary Glaucoma
In secondary glaucoma, something is happening inside the eye that causes the blockage in the drainage system and the pressure increase. Some causes include eye injury, blood or pigment the eye, and cataracts.
Congenital Glaucoma
Congenital glaucoma is a birth defect in which the drainage angle of the eye is closed upon birth. This is a serious condition that requires immediate medical treatment to prevent blindness in the child.
How do I know if I have Glaucoma?
People can experience pressure increases in their eye without it being glaucoma. Glaucoma is only present when actual damage to your optical nerve is present. However since the most common form of glaucoma occurs gradually over time, it is impossible for a person to know they have it until it is too late.
The only way to determine that you have glaucoma is through a medical examination by an experienced Ophthalmologist with the experience and technology to detect early glaucoma. The pressure in your eye can be controlled through a variety of treatments, but the key is early detection. Yearly eye exams are an essential part of an overall preventative health plan, and they could mean the difference in any potential vision loss.
To detect glaucoma, your eye doctor will administer these common PAINLESS tests:
Visual Acuity:
This is the common eye chart test, where the doctor is measuring your ability to see objects at various distances straight on.
Visual Field:
This is a light test that is used to measure your entire field of vision. It is the most important test for glaucoma, because it can accurately measure any decrease in you peripheral vision. At the Eye Associates of Brazos Valley, we have the newest state-of-the-art visual field technology to accurately and rapidly detect visual field changes.
Pupil Dilation:
In this test, the doctor will give you some eye drops that cause your pupils to open fully. This lets the doctor examine your optic nerve and look for any signs of damage.
Digital optic nerve analysis:
Our new ultra high-resolution photography system allows us to track and compare your optic nerve appearance over time, for the rest of your life using a computer.
Ocular Coherence Tomography (OCT):
The latest technology that allows for detailed microscopic imaging and measurements of optic nerve tissue. OCT is like a cat scan of the eye, but does NOT involve x-rays and is perfectly safe no matter how many times you have one done. All patients at the Eye Associates of Brazos Valley have OCT performed if glaucoma is suspected. We were the first in the area with OCT. It is the premier glaucoma test.
Corneal Pachymetry:
Ultrasound measurement are obtained to accurately determine the true pressure within the eye.
Treatment for Glaucoma
Unfortunately, glaucoma cannot be “cured” like a cataract. The good news is there are several treatment options that can effectively lower the pressure in your eye, and alleviate any risks of future optic nerve damage.
Common treatments for glaucoma include:
Prescription Medicine
The most common treatment for glaucoma is the administration of medicine on a continual basis.
With glaucoma, it is essential to maintain a constant eye pressure, and several medications are engineered to do just that. They accomplish this by increasing the drainage of aqueous fluid, decreasing fluid production, or a combination of both. The medication is most often administered through eye drops.
Laser Surgery
For more severe glaucoma cases, or patients who do not respond well to medication, laser surgery is usually a simple and effective next treatment option. The result is increased drainage of fluid, and decreased pressure buildup.
It is important to understand that surgery is never the first option, but when necessary, laser surgery for glaucoma is a simple and effective treatment option that can often last years. It is performed on an outpatient basis, with the patient capable of returning to normal activities the very same day. Unfortunately the treatment is not permanent, and other treatment options will need to be revisited once the pressure rises again in the future.
Conventional Surgery
Conventional glaucoma surgery, also known as a trabeculectomy, is only considered in cases when medicines and laser treatment are deemed ineffective. A drainage pathway is created and fluid from inside the eye collects underneath the outer covering of the eye.
Glaucoma Shunt
A glaucoma shunt is essentially a small tube that is manually implanted into the eye to create additional drainage. It should ONLY be reserved for those with very rare and extreme forms of glaucoma where ALL OTHER TREATMENTS HAVE FAILED. Glaucoma shunts are associated with many complications. Fortunately, due to great advances in glaucoma medications, all glaucoma surgery is very rarely needed. Note that glaucoma surgeries are temporary, usually lasting at most 5 years. In addition, complications during the surgery or at any time after the surgery can occur. GLAUCOMA SURGERY SHOULD ALWAYS BE THE LAST OPTION.
What’s Next?
Active research is being conducted on future glaucoma treatments, and many exciting developments are on the horizon that may one day be able to provide a permanent cure to one of the leading causes of blindness in the United States.
While there is currently no permanent cure for glaucoma, there are several successful treatment options that prevent visual loss, provided the disease is caught early. Since there are essentially no recognizable symptoms until visual loss does occur, annual eye exams are essential. Be sure and commit to seeing your Ophthalmologist at least once a year.
If you haven’t had an eye exam in the last year with a Board Certified MD Ophthalmologist, please schedule an exam today with the Eye Associates of Brazos Valley. We are highly experienced at the detection and treatment of glaucoma. The best way to assure yourself a lifetime of quality vision is with early detection of eye diseases through routine examinations.
