Glaucoma is the second-leading cause of blindness in the world. Typically age related with genetic factors, damage can be prevented if it is discovered early and treatment is administered. At Eye Clinic of Austin, we have significant experience and training with glaucoma and understand the best ways to combat the disease.
What is Glaucoma?
Glaucoma is a disease that damages the eye’s optic nerve. There is a fluid called aqueous humor that flows between your cornea and the iris of your eye. Among other things, this fluid maintains the intraocular pressure of your eye and provides essential nutrients to the eye. Aqueous humor leaves the eye from a mesh-like canal. Glaucoma occurs when the canal is blocked or damaged and fluid begins to build up and cause pressure within the eye.
In most cases, this pressure can’t be felt and doesn’t cause damage quickly. Glaucoma is usually only detected when the disease has moderately advanced which is why it’s so important to schedule annual comprehensive eye exams. If you are over the age of 40, you should have an eye exam at least once every two years. If you know of a family member who has or had glaucoma, you should have an eye exam once a year.
If glaucoma causes this damage before treatment, it cannot be reversed. Early detection and appropriate treatment can maintain useful vision over a lifetime.
Types of Glaucoma
There are three types of glaucoma:
Primary Open-Angle Glaucoma
Primary open-angle glaucoma is the most common form of glaucoma. Approximately three million Americans suffer from this type of glaucoma. When your eye’s drainage canals are gradually blocked over time as opposed to becoming suddenly blocked, this is primary open-angle glaucoma.
Angle-closure glaucoma occurs in only about 1% of patients. This type of glaucoma develops when the front eye structure is such that the drainage canals can become suddenly blocked or pinched. Due to the nature of this disease, angle-closure glaucoma happens rather quickly and patients should seek medical help immediately.
Primary Congenital Glaucoma
Primary congenital glaucoma is a very rare form of glaucoma that only affects children between the ages of birth and 3 years. Children with this type of glaucoma were born with a lack of mesh-like canal that assists in draining fluid in the eye.
Primary open-angle glaucoma is typically hereditary. However, injury to the eye, blockage of blood vessels, certain medical conditions, and even severe eye infection can sometimes cause glaucoma.
Angle-closure glaucoma is more prone in certain individuals due to the structure of their eye. If the area at the base of the iris is narrow, blockage can occur more easily. In addition, people whose lens sits more forward than usual can also be more prone to angle-closure glaucoma.
The cause of primary congenital glaucoma in children is also typically hereditary, however in some cases it is not and it is not well known why it occurs.
Open-angle glaucoma causes no pain or symptoms at first. Over time, however, patients with glaucoma begin to lose peripheral vision – as if they are looking through a tunnel. Symptoms can also include headaches, eye pain, nausea, blurred or cloudy vision, red eye, or even feeling as if your eye is swollen.
Angle-closure glaucoma symptoms start very quickly and patients typically feel ache around the eye or sudden and severe pain within the eye. Blurred vision and redness can also occur. Some individuals feel sick or have abdominal pain as well.
Because children with primary congenital glaucoma are often times too young to even speak, it’s important to watch for sensitivity to light, excessive tearing or squeezing of their eyelids.
Diagnosis & Treatment
All types of glaucoma should be treated right away to prevent any major loss of eyesight. Primary open-angle glaucoma typically responds well to medication or laser treatment if treated early enough. However, in more advanced cases, glaucoma surgery may be required to control the pressure in the eye.
For angle-closure glaucoma, laser treatment or surgery is required to stop any future issues. Long-term, eye drops are also recommended to control pressure in the eye.
The primary treatment for children with primary congenital glaucoma is glaucoma surgery, which typically results positively with around 90% of total cases resulting in good visual acuity and health.
Eye Clinic of Austin is dedicated to offering the most advanced technology available and that holds true for advancements in Glaucoma treatment as well. With over 30 years’ experience in treating Glaucoma, our goal is to determine the absolute best type of treatment for the individual patient.
The iStent is one of the latest developments in ophthalmic technology. Manufactured by Glaukos, the iStent is a small medical device that is placed in the eye in order to safely lower eye pressure. The iStent is the smallest medical device ever approved by the FDA and is so tiny that the patient is unable to see or feel the device.
SLT (Selective Laser Trabeculoplasty) Treatment
For some open-angle glaucoma patients at Eye Clinic of Austin we use SLT. SLT has been proven to safely and effectively reduce intraocular pressure due to Glaucoma. The laser is applied to the drainage tissue of the eye which in turn starts a change in the tissue that results in drainage of fluid from the eye thus releasing pressure. Results typically take one to three months to appear.
Trabectome surgery is a type of surgery that helps increase the amount of fluid leaving the eye. An outpatient procedure, the actual surgery typically takes 5 to 15 minutes. According to the Glaucoma Research Foundation, Trabectome usually lowers eye pressure by about 30%, while also decreasing the number of glaucoma eye drops that are needed.
Utilizing a microcatheter or tube to enlarge the drainage canal, a canaloplasty has shown to have long-term results of relieving pressure in the eye. For open-angle glaucoma patients who are at a high risk for infection, canaloplasty is a good option. In addition, contact lens wearers may also be good candidates for this surgery.
EX-PRESS® Filtration Device
The EX-PRESS filtration device is basically a mini shunt which is implanted into the eye to provide an artificial pathway to help drain the eye. The EX-PRESS® procedure differs from a conventional trabeculectomy in that it does not require a sclerectomy or peripheral iridectomy.
Awards & Recognition
Cataract Surgery Patient 7
“He has the best bedside manner, his staff is wonderful, and I’m so glad I did it with him — he’s great.”
Cataract Surgery Patient 6
“The surgery was miraculous! I mean, as soon as he was through, I could already see better. I just can’t say it enough — I’m so happy with it.”
Cataract Surgery Patient 5
“When I got the surgery, even as my eyes were healing, I noticed things were very vivid, very clear.”
Cataract Surgery Patient 4
“The surgery with Dr. Irshad was like nothing. It was over so quickly! I didn’t have to do anything except just lay there and it was really easy.”
Cataract Surgery Patient 3
“Your eyes are pretty precious and you have to trust the people that are going to be working on them, and definitely the group here is great.”
Cataract Surgery Patient
“My vision is totally clear. I can see everything. Everything is just plain as day... It was effortless. Everything went so smoothly.”
Cataract Surgery Patient 2
"The whole world is a lot crisper and clearer and more beautiful to me right now... The whole practice is just professional and wonderful to deal with and completely gave me confidence. I’ve sent a few people over here already. I rave about this place."
Eye Care Blog
In the past few months, Eye Clinic of Austin has unveiled new treatment offerings for our patients.
The FDA has approved AcrySof IQ PanOptix Trifocal IOL, the first and only trifocal lens authorized for patients undergoing cataract surgery.
Dr. Farhan Irshad was the first anterior segment surgeon in Texas to do the DEXTENZA implant for ocular pain following eye surgery.