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What is Glaucoma?

Introduction to Glaucoma 

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Glaucoma is a disease that affects the optic nerve, which is the part of the eye that transports the images we perceive to the brain. The optic nerve is made up of many fibers, much like an electricity cable which contains many filaments. When damage occurs in the optic nerves fibers, blind spots appear.  These blurry spots are normally not detected until the damage to the optic nerve is significant. If the optic nerve is destroyed, blindness occurs.  The ophthalmologist's detection and treatment processes are key in the prevention of any damage to the optic nerve and blindness produced by glaucoma.  Glaucoma is the main cause of blindness in the United States, especially in older people. But very often, the blindness brought on by glaucoma can be prevented if treated quickly.

What are the different types of Glaucoma?

Treatment for Glaucoma

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Open angle glaucoma: This is the most common form of glaucoma in the United States. The risk of developing open angle glaucoma increases with age. The eye's drainage angle becomes less efficient with time, and the pressure inside the eye increases gradually, causing damage to the optic nerve. In some patients, the optic nerve becomes more sensitive to the eye's normal pressure, running the risk of suffering lesions. It's necessary to follow treatment to prevent additional loss of vision.   Usually, open angle glaucoma is symptom free in the early stages and vision is normal. As the optic nerve suffers more damage, dark patches begin to appear in the patient's visual field. Normally, the patient won't notice the dark patches during his/her daily activities until the optic nerve has suffered severe damage and the dark patches grow larger. If all of the optic nerve's fibers die, blindness occurs.

Closed angle glaucoma: Some eyes develop with the iris being very close to the drainage angle (the iris is the colored part of the eye). In these kinds of eyes -frequently small and hyperoptic- the iris can be SELECTED towards the drainage angle, blocking it completely. Since the liquid can't drain, the pressure inside the eye increases rapidly causing an accute closed angle glaucoma attack.

The symptoms may include:

  •     Blurry vision.
  •     Severe eye pain.
  •     Headache.
  •     Colored halos around lights.
  •     Nausea and vomit.

This is a real emergency. If you have any of these symptoms, call your ophthalmologist immediately. This type of glaucoma can cause blindness, unless treated quickly.
Unfortunately, two thirds of the people with closed angle glaucoma develop it slowly and without symptoms of a previous attack.

Who is at risk for glaucoma?
Your ophthalmologist takes into account all kinds of information to determine your risk for this disease. The most important risk factors are:

  • Age.
  • Elevated intraocular pressure.
  • Family history of glaucoma.
  • African or hispanic ancestors.
  • Hyperopia or myopia.
  • Previous damage to the eye.
  • Thin corneas.
  • Systematic health problems such as diabetes, migraines and circulation.

Your ophthalmologist will evaluate all these factors before deciding if you need treatment for glaucoma, or if you require a strict control if glaucoma is suspected. This means that your risk for developing glaucoma is higher than normal, and that you must have your eyes examined regularly to detect the early signs of damage to the optic nerve.

How is Glaucoma treated?
As a general rule, the damage caused by glaucoma is irreversible. Eye drops, laser surgery, and surgery performed in the operating room are methods used to help prevent greater damage. In some cases, oral medications can also be prescribed.

With any type of glaucoma, it's important to get periodic eye exams to prevent loss of sight.  Since glaucoma can progress without you knowing, it's possible that adjustments in your treatment might be necessary from time to time.

Loss of sight can be prevented
Regular eye exams can help prevent unnecessary loss of sight. The recommended frequency for eye exams is:

  • From 20-29 years of age: People with african ancestors or with a family history of glaucoma must have their eyes examined every 3-5 years. Others should have an examination at least once during this period.
  • From 30-39 years of age: People with african ancestors or with a family history of glaucoma must have their eyes examined every 2-4 years. Others should have an examination at least once during this period.
  • From 40-64 years of age: Every 2-4 years.
  • From age 65 and up: Every 1-2 years.

Iridotomies with Yag Laser:  In this procedure, a laser ray applied goes through the iris and communicates easily the anterior and posterior chambers.  This treatment is use in Close-Angle Glaucoma.  To perform these procedures, anesthetic eye drops are applied to the patient and a magnifying lens (contact lens) is set in place.

 Trabeculoplasty with Yag Laser: Is a procedure for patient suffering Open-Angle Glaucoma. In this procedure a laser is applied directly to the patient’s trabeculum visualizing it with special magnifying lens, facilitation with it the exiting flow by a natural way. 

Less invasive Surgeries: 

Trabectome:  Trabectome is a new technology use in Glaucoma, where CODET Vision Institute participated directly in the development of this new procedure in glaucoma, becoming the first Investigation Center in the World, project in charge of Dr. Marina Ramirez, MD, jointly with the University of California in Irving.



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