glaucoma

glaucoma testing and management

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Glaucoma is a group of eye disorders characterized by progressive optic nerve damage and subsequent vision loss. It is the second leading cause of blindness in the United States.  It is often associated with elevated eye pressure, although not always. Glaucoma can damage your vision so gradually you may not notice any loss of vision until the disease is at an advanced stage. Routine eye health examinations with an eye care specialist are an important step toward early detection and preservation of vision.  

Our eye doctors in Rockville, Maryland are delighted to offer an advanced screening of the entire visual system for the early detection of ocular disease. Utilizing the latest non-invasive technologies, we are able to capture a more detailed understanding of your visual system and overall health.  This testing is especially sensitive to detecting early signs and symptoms of glaucoma.

Types

Primary Open Angle

This is the most common form of glaucoma. Damage to the optic nerve is slow and painless and a large portion of vision can be lost before vision problems are noticed.

Angle Closure or Narrow Angle Glaucoma

This type of glaucoma is a less common form of the disease. It is a medical emergency that can cause vision loss within a day of its onset.  Symptoms include eye pain redness and blurry vision.  Nausea and vomiting may also occur.

Secondary

This type of glaucoma occurs as a result of a variety of medical conditions such as injury, medications or certain eye diseases.

Low/Normal Tension

In this form of glaucoma, eye pressure remains within what is considered to be the “normal” range, but the optic nerve is damaged nevertheless.  

Risk Factors

Age

There is an increased risk for the general population over the age of 60, age 40 for the African American population.  

Race

African Americans are significantly more likely to get glaucoma than are Caucasians.

African Americans are much more likely to suffer permanent vision loss as a result.

People of Asian descent are at higher risk of angle-closure glaucoma.

Family History

Having a family history of glaucoma increases the risk of developing glaucoma.

Medical Conditions

Some studies indicate that diabetes, hypertension and heart disease may increases the risk of developing glaucoma.

Physical Injury to the Eye

Severe trauma, such as being hit in the eye, can result in immediate increased eye pressure and future increases in pressure due to internal damage.

Eye Related Risk Factors

Eye anatomy, specifically corneal thickness and optic nerve appearance indicate risk for development of glaucoma. Conditions such as retinal detachment, eye tumors, and eye inflammations may also induce glaucoma.

Steroid Use

Longtime use of steroids appears to put some people at risk.

How is Glaucoma Diagnosed?

To establish a diagnosis of glaucoma, progressive vision loss, a change in the appearance of the optic nerve, a loss of nerve tissue and a corresponding loss of vision is required.  One should be closely followed with routine comprehensive exams to monitor for change.  

Necessary Testing Includes:

   a.  Visual Field Testing / Peripheral Vision Testing

   b.  Dilated Fundus Examination for proper evaluation of the back of the eye

   c.  Optic Nerve Analysis

   d.  Pachymetry / Corneal Thickness Testing

   e.  Gonioscopy

    f.  Intraocular Pressure / Eye Pressure Testing

Glaucoma Treatment Options

There is currently no cure for glaucoma.

Early diagnosis and continued treatment can preserve eyesight. Treatment is aimed at reducing intraocular pressure.  By keeping eye pressure under control, continued damage to the optic nerve and continued loss of your visual field may slow or stop.  Because glaucoma can progress or change silently, compliance with eye medications and regular eye examinations are essential, as treatment may need to be adjusted periodically.

Prescription Eye Drops

The most common first line treatment of glaucoma.  A number of medications are currently available and new medications are always being developed to help in the fight against glaucoma.  The type of medication may change if it is not providing enough pressure reduction or if the patient is experiencing side-effects from the drops.

Surgery

Surgery may help lower pressure when medication is not sufficient, however it cannot reverse vision loss.

Early detection, prompt treatment and regular monitoring can help to control glaucoma and therefore reduce the chances of progression vision loss. 

Contact us to schedule an appointment with our optometrist in the Rockville, Maryland and Washington, DC area who can help with the treatment for glaucoma.