Glaucoma

Glaucoma is a serious eye disease that affects the optic nerve, which carries the signal from the eye to the brain.  It is often associated with elevated eye pressure and can be more common in patients with a family history or certain medical conditions.  Glaucoma usually affects peripheral vision which can make it difficult to detect until it is in more advanced stages and is why it is called “the silent thief of sight.”  Regular eye exams for patients over 40 and anyone with a family history are crucial to detect glaucoma before it becomes visually significant since glaucoma damage is irreversible and can result in blindness.

There are many factors that can result in glaucoma progression and loss of vision; however, the main modifiable risk factor is lowering the eye pressure.  At Highland Eye Clinic, we have many levels of treatment options available to slow or stop glaucoma progression.  Our doctors are able to tailor a treatment plan for each patient to preserve vision and improve quality of life for years to come. 

These treatment options include:

Glaucoma medications:

There are a variety of eye drops and oral medications that can be used to reduce the intraocular pressure in several different ways: reducing production of aqueous humor (the fluid inside the front chamber of the eye), increasing outflow through the trabecular meshwork (the main drainage area of the eye), and increasing uveoscleral outflow.  Your doctor will work closely with you to determine the best medication, or combination of medications, to lower your eye pressure.

Laser surgery:

Selective Laser Trabeculoplasty is a first- or second-line treatment for glaucoma that is effective in 65-80% of patients.  By using a specialized laser to target the internal drainage area of the eye, the doctor can increase the outflow of fluid, thus reducing intraocular pressure and slowing the progression of glaucoma.  This laser is well-tolerated and causes no visible damage to the eye.  Many patients choose SLT to avoid the side effects of drops over time.

Minimally invasive glaucoma surgeries (MIGS):

Minimally (or micro-) invasive glaucoma surgeries represent a significant advancement in glaucoma treatment.  These cutting-edge surgical techniques involve the use of tiny surgery devices to improve drainage of fluid from the eye, which can result in lower eye pressures and can reduce dependence on drops.  Patients with glaucoma who are contemplating cataract surgery should strongly consider having a combined procedure since many of these procedures are only approved at the time of cataract surgery.

Traditional glaucoma surgeries:

Trabeculectomy (considered the gold standard for glaucoma treatment) is a filtering surgery that bypasses the normal drainage area of the eye.  This surgery can eliminate the need for eye drops and, for some patients, lower the eye pressure more than drops and lasers can.  A tube shunt also creates a new drain in the eye using a tube that is placed under the conjunctiva.  Dr. Guy specializes in all types of glaucoma surgery and will work with her patients to choose the best option for them.