Glaucoma is the leading cause of blindness and visual impairment in the United States. A simple, painless eye exam can detect the disease. With early detection and treatment, glaucoma can usually be controlled and blindness prevented.
Glaucoma can affect anyone from newborn infants to the elderly. It has been estimated that up to 3 million Americans have glaucoma. At least half of those people do not know they have it because glaucoma usually has no symptoms. People who are at a greater risk for glaucoma usually have the following conditions:
- At least 45 years old without regular eye exams
- A family history of glaucoma
- Abnormally high eye pressure
- African descent
- Previous eye injury
- Regular, long-term use of cortisone/steroid products
The only sure way to detect glaucoma is to have a comprehensive medical eye examination. During this evaluation, your physician will measure your intraocular pressure, inspect the drainage angle of your eye, evaluate whether or not there is optic nerve damage and test the peripheral vision of each eye.
Some cases of glaucoma can be treated with medications. For others, laser or traditional surgery is required to lower eye pressure. Common surgeries include:
- Laser Peripheral Iridotomy (LPI) – For patients with narrow-angle glaucoma. A small hole is made in the iris to increase the angle between the iris and cornea and encourage fluid drainage.
- Argon Laser Trabeculoplasty (ALT) and Selective Laser Trabeculoplasty (SLT) – For patients with primary open angle glaucoma (POAG). The trabecular passages are opened to increase fluid drainage. ALT is effective in about 75% of patients, and SLT may be repeated.
- Nd: YAG Laser Cyclophotocoagulation (YAG CP) – For patients with severe glaucoma damage who have not been helped with other surgeries. The ciliary body that produces intraocular fluid is destroyed.
- Filtering Microsurgery (Trabeculectomy) – For patients who have not been helped with laser surgery or medications. A new drainage passage is created by cutting a small hole in the sclera (the white part of the eye) and creating a collection pouch between the sclera and conjunctiva (the outer covering of the eye).
- Tube Shunt Surgery – May be recommended for patients with neovascular glaucoma, failed trabeculectomy, or susceptibility to developing scar tissue. A thin, flexible tube (a shunt) with a silicone pouch is inserted in the eye to facilitate drainage.
Dry Eye Treatment
Dry eye occurs when the eyes aren’t sufficiently moisturized, leading to itching, redness and pain from dry spots on the surface of the eye. The eyes may become dry and irritated because the tear ducts don’t produce enough tears, or because the tears themselves have a chemical imbalance.
People usually begin experiencing dry eye symptoms as they age, but the condition can also result from certain medications, conditions or injuries.
Dry eye is not only painful, it can also damage the eye’s tissues and impair vision. Fortunately, many treatment options are available.
Non-surgical treatments for dry eye include blinking exercises, increasing humidity at home or work, and use of artificial tears or moisturizing ointment. If these methods fail, small punctal plugs may be inserted in the corners of the eyes to limit tear drainage, or the drainage tubes in the eyes may be surgically closed. Eyelid surgery is also a solution if an eyelid condition is causing your dry eyes.
Corneal Disease Treatment
The cornea is a thin, clear, spherical layer of tissue on the surface of the eye that provides a window for light to pass through. In a healthy eye, the cornea bends or refracts light rays so they focus precisely on the retina in the back of the eye.
There are many diseases that can affect the cornea, causing pain or loss of vision. Disease, infection or injury can cause the cornea to swell (called “edema”) or degrade (become cloudy and reduce vision). Common diseases and disorders that affect the cornea include:
- Bullous Keratopathy
- Conjunctivitis (“Pink Eye”)
- Dry Eye
- Corneal Dystrophies including Fuchs’ Dystrophy and Lattice Dystrophy
- Glaucoma (High Eye Pressure)
- Keratitis (Viral Inflammation)
- Ocular Herpes
- Shingles (Herpes Zoster)
- Stevens-Johnson Syndrome
Treatment for corneal disease can take many forms, depending on the underlying problem as well as the patient’s preferences. Some conditions resolve on their own and many can be treated with medication. If the cornea is severely damaged or if there is a risk of blindness, a corneal transplant may be recommended to preserve vision.