Glaucoma Center
Glaucoma
Glaucoma is a group of eye conditions associated with elevated intraocular pressure (IOP) that can affect newborns to the elderly and as a result of optic nerve damage can cause a gradual loss of peripheral vision and in severe cases, may cause blindness. In the United States, glaucoma is the leading cause of blindness and visual impairment and has been called the “silent thief of sight” because often it causes no symptoms until very late. Sadly, up to half of the more than 3 million Americans that have glaucoma may not be aware that they have it.
Patients with the following conditions may be at greater risk for glaucoma:
- At least 45 years old without regular eye exams
- A family history of glaucoma
- African or Asian descent
- Higher eye pressures
- Nearsightedness (Myopia)
- Diabetes
- Previous eye injury
- Use of cortisone and steroid products
The best way to detect early signs of glaucoma is through routine eye exams, during which a tonometer may be used to measure the internal pressure of your eyes. At risk patients may require further diagnostic testing including optic nerve imaging and field of vision testing. Fortunately, most glaucoma can usually be controlled and blindness prevented with early detection and treatment.
Glaucoma Treatment
Although there is no cure for glaucoma, the goal is to preserve a patient’s remaining, functional vision. Delta Eye provides all forms of glaucoma treatment at all three of our locations (Stockton, Tracy & Lodi). In mild cases, glaucoma may be treated with prescription eye drops and/or rarely oral medication. If these treatments fail or are not well tolerated, glaucoma laser or surgery maybe required. Although surgery may reduce and lower intraocular pressure and help to prevent further vision loss, it will not reverse vision loss which has already occurred from optic nerve damage.
Glaucoma Treatment at Delta Eye
Delta Eye doctors are equipped with the latest lasers and surgical technologies for effective glaucoma treatments at all our locations including Stockton & Tracy. Surgical alternatives may include:
- Peripheral Iridectomy Laser Treatment
- SLT Laser treatment
- iStent
- MIGS
- Trabeculectomy
- Filtering Valve Procedures
- Goniotomy
- Hydrus Microstent
Peripheral Iridectomy Laser Treatment
Peripheral iridectomy is a procedure that involves using laser energy to open a small, full-thickness hole in the peripheral iris to allow a more normalization of fluid pressures and deepening of the anterior chamber of the eye. This is performed on an outpatient basis under topical anesthetic and is most commonly performed for narrow-angle glaucoma.
SLT (Selective Laser Trabeculoplasty) and ALT (Argon Lasr Trabeculoplasty)
SLT and ALT are advanced laser procedures used to safely and effectively lower intraocular pressure (IOP) by using laser energy to stimulate the eye’s natural mechanism of outflow drainage of aqueous humor thereby lowering IOP. The SLT laser selectively targets pigmented cells in the trabecular meshwork (drainage channels) and because this preserves the surrounding tissue without thermal damage, it is a procedure that can be repeated if indicated.
iStent
iStent: An iStent is a tiny glaucoma bypass drain implanted into the eye to lower eye pressure. The iStent is a MIGS procedure for people who have open-angle glaucoma.
Although very tiny, about the size of a grain of rice, the iStent has been proven to effectively manage eye pressure. A benefit of the iStent is that your eye doctor can do this procedure at the same time as cataract surgery.
MIGS
MIGS: MIGS, also known as minimally invasive glaucoma surgery, is a group of procedures that reduces eye pressure. Many MIGS procedures include the use of microscopic devices placed into the eye to lower eye pressure.
Trabeculectomy
Trabeculectomy (filtration surgery) is the most common type of glaucoma surgery. During the procedure, a small piece of tissue in the drainage angle of the eye is removed to create a new opening to relieve high pressure within the eye by enabling more efficient fluid drainage. The opening is partially covered with a flap of scleral tissue (white part of the eye) and the clear conjunctiva (skin-like tissue covering the sclera). This new opening allows proper fluid drainage by bypassing the trabecular meshwork (internal tiny channels responsible for fluid drainage) which can become clogged in some patients with glaucoma. After surgery, a small bubble known as a bleb is created as the fluid drains through the new opening. By observing the bleb during regular office visits, the eye physician is able to tell whether the fluid is draining properly and keeping the intraocular pressure in a good target range.
Filtering Valve Procedures
Filtering valves are generally performed only after a failed trabeculectomy and involves the surgical placement of a valve and tube-like device that helps to enable proper fluid drainage within the eye. This device is placed in the eye against the white sclera and sutured into place under the conjunctiva. A tube is then inserted into the front of the eye over the iris (colored part of the eye) to channel fluid into the valve and then sutured in place. A small patch of donor sclera may also be placed over the tube for additional protection.
Goniotomy
Goniotomy: Many eye doctors consider goniotomy in cases where laser procedures or medicated eye drops do not effectively lower the eye pressure. The goniotomy procedure aims to create broader openings in the meshwork that the fluid must drain through to leave the eye.
During a goniotomy, your eye doctor will remove a portion of the meshwork that is the eye’s natural drain. Removing a position of this meshwork allows for a broader channel for the fluid to flow, reducing the eye pressure.
Hydrus Microstent
Hydrus Microstent: Our eye doctors at Delta Eye Medical Group use another MIGS device called the Hydrus microstent. The Hydrus microstent is an implant used to help lower eye pressure and, similar to the iStent, can be done at the same time as cataract surgery.
The Hydrus device is a tiny tube placed in the eye to help decrease eye pressure. This device allows the fluid to bypass the natural drainage structure of the eye, increasing the outflow of fluid from the eye.
