Glaucoma Treatment in the Washington D.C. area
Effective care for glaucoma
Glaucoma is a painless condition commonly associated with slow, progressive loss of peripheral vision. Glaucoma is usually not noticed by the patient, but it is a leading cause of blindness in adults, and the risk increases as you age.
Glaucoma usually occurs when pressure in the eye increases. This can happen when eye fluid isn’t circulating normally in the front part of the eye. Normally, this fluid, called aqueous humor, flows out of the eye through a mesh-like channel. If this channel becomes blocked, fluid builds up, causing glaucoma. The direct cause of this blockage is unknown, but we do know that it can be inherited. Less common causes of glaucoma include a blunt or chemical injury to the eye, severe eye infection and others. Glaucoma usually occurs in both eyes but may involve each eye to a different extent.
Glaucoma most often occurs in adults over the age of 40, but it can also occur in young adults, children and even infants. In African-Americans, glaucoma occurs more frequently and at an earlier age and with greater loss of vision.
Regular testing is important for identifying those at risk and monitoring treatment plans. There are many types of glaucoma – some with genetic predisposition and others without.
There are two main types of glaucoma:
Open-angle glaucoma – Also called wide-angle glaucoma, this is the most common type of glaucoma. The structures of the eye appear normal, but fluid in the eye does not flow properly through the drain of the eye, called the trabecular meshwork.
Angle-closure glaucoma – Also called acute or chronic angle-closure or narrow-angle glaucoma, this type of glaucoma is less common but can cause a sudden build-up of pressure in the eye. Drainage may be poor because the angle between the iris and the cornea (where a drainage channel for the eye is located) is too narrow.
For most people, there are usually few or no symptoms of glaucoma. The first sign of glaucoma is often the loss of peripheral, or side vision, which can go unnoticed until late in the disease. Detecting glaucoma early is one reason you should have a complete exam with an eye specialist every one to two years. Occasionally, intraocular pressure can rise to severe levels. In these cases, sudden eye pain, headache, blurred vision or the appearance of halos around lights may occur.
But with acute angle-closure glaucoma, symptoms that occur suddenly can include blurry vision, halos around lights, intense eye pain, nausea and vomiting. If you have these symptoms, be sure to see an eye care professional or visit the emergency room immediately so steps can be taken to prevent permanent vision loss.
At Visionary Eye Doctors, we offer innovative technology for early detection of glaucoma, such as visual evoked potential (VEP) and electroretinography (ERG) tests. These tests assess the optic nerve and retina and allow our doctors to track the result over time. In addition, Pentacam® Scheimpflug Camera Technology allows us to painless determine if a patient is at risk for Narrow Angle Glaucoma. Patients who have a narrow angle visible on the Pentacam® Scheimpflug Camera Technology are evaluated for their risk of acute angle closure glaucoma according to objective Pentacam measurements, Gonioscopy contact lens evaluation, family history, eye pressures, and symptoms.
Glaucoma Therapy & Treatment Options
At Visionary Eye Doctors, every eye care professional is expert in treating glaucoma. Many of the procedures can be done in our office with our state-of-the-art equipment.
Therapy usually includes eye drops but may also involve specialized glaucoma eye surgery, including laser. Only a thorough examination can determine if you have glaucoma.
Treatment requires monitoring eye pressure and measuring changes in the peripheral visual field. Controlling glaucoma usually means maintaining eye pressure at an acceptable level when there has been little or no loss of the visual field. Pressure may be controlled by eye drops, oral medications or lasers.
Some of the most common procedures we offer include: argon laser trabeculoplasty (ALT), selective laser trabeculoplasty (SLT), laser peripheral iridotomy (LPI), trabeculectomy or shunt placement.
Laser Trabeculoplasty for Glaucoma
Laser trabeculoplasty uses a very focused beam of light to treat the drainage angle of the eye. This eye surgery makes it easier for fluid to flow out of the front part of the eye, decreasing pressure in the eye.
There are two types of laser trabeculoplasty:
Argon laser trabeculoplasty (ALT) – uses a laser to open up the drainage angle of the eye.
Selective laser trabeculoplasty (SLT) – uses a lower-level laser to open the drainage angle of the eye.
Your eye doctor will decide which type of laser is better for you. Many times the procedure can be done in our offices, and most people experience minimal discomfort during the procedure.
Laser Peripheral Iridotomy (LPI)
Laser peripheral iridotomy is generally recommended for patients with narrow angles, narrow-angle glaucoma or acute-angle closure glaucoma. LPI attempts to “open” alternative pathways for fluid to drain from the eye and prevent more serious glaucoma disease.
iStent: The Newest Advancement in Glaucoma Treatment
Keeping our promise to be state-of-the-art and at the forefront of the latest technologies and techniques
Technology has always played an important role in eye care. Today, almost every aspect of vision is connected to a product or procedure that wasn’t available even ten short years ago. Cataract surgery is a good example of how innovations can make a difference. Every aspect of it utilizes recently developed technology that will help improve vision.
This includes managing your mild-to-moderate open-angle glaucoma – because now we are able to add another step to cataract surgery that treats open-angle glaucoma in a completely new way. This is important because once diagnosed with open-angle glaucoma, most patients will spend the rest of their lives putting in one, two or even three different kinds of drops every day. Unfortunately, all of these drops will not only be inconvenient but potentially very expensive. The iStent Trabecular Micro-Bypass stent is designed to reduce eye pressure and it can be done at the same time as cataract surgery.
Today, this includes managing your mild-to-moderate open-angle glaucoma: now we are able to add another step to cataract surgery that treats open-angle glaucoma in a completely new way. This is important because once diagnosed with open-angle glaucoma, most patients will spend the rest of their lives putting in one, two or even three different kinds of drops every day. Unfortunately, all of these drops will not only be inconvenient but potentially very expensive. The iStent Trabecular Micro-Bypass stent is designed to reduce eye pressure and it can be done at the same time as cataract surgery.
iStent: The world’s smallest medical implant delivers big results in mild-to-moderate open-angle glaucoma
While mild-to-moderate open-angle glaucoma is very common, many people are unaware of their condition, especially in the early stages when their vision may be unaffected. In many people, open-angle glaucoma is characterized by an increase in the intraocular pressure (IOP) of the eye. This pressure is caused by the buildup of fluid within the eye. Too much fluid raises pressure, which can cause the gradual loss of vision. And while glaucoma moves slowly, its damage is irreparable.
The world’s tiniest medical device – iStent – is 20,000 times smaller than the intraocular lenses (IOL) used in cataract surgery. But the size of iStent is only part of its story. By increasing the eye’s ability to drain fluid, this technology is designed to reduce the pressure in the eye.
In a U.S. clinical study, 68% of glaucoma patients who received iStent remained medication-free at 12 months while sustaining a target IOP of = 21 mm Hg vs. only 50% of patients who underwent cataract surgery alone.
For state-of-the-art care and treatment of glaucoma, visit Visionary Eye Doctors . We serve residents of Gaithersburg, Potomac, Bethesda, Silver Spring and Rockville in Montgomery County, MD. Call us at (301) 896-0890 or use our online Request an Appointment form to schedule your consultation.