Glaucoma Evaluation and Treatment

What is Glaucoma?
Glaucoma refers to a group of diseases that have common features including intraocular pressure too high for the health of the eye, damage to the optic nerve and visual field loss. The drainage canals may become clogged or covered over, but the ciliary tissue continues to produce fluid.

In glaucoma, the increased fluid pressure builds up and pushes the optic nerve back into a cupped or concave shape. If the intraocular pressure remains too high for too long, the extra pressure damages parts of the optic nerve. This damage appears to be gradual, as there are visual changes and the loss of vision. Glaucoma usually occurs in both eyes, but fluid pressure often begins to build up first only in one eye. Glaucoma can occur in people of all ages, from children to older adults, but is more likely to develop in people who are over 60 years old, very nearsighted, or diabetic.

Most types of glaucoma once diagnosed require constant, lifelong care. Continual observation and treatment can control the intraocular pressure, which protects the optic nerve and prevents vision loss. It is very important to keep the eye pressure under control. Eye drops, oral medications, laser surgery, and microsurgery are quite successful in controlling eye pressure over long periods of time. Regular check-ups are necessary even after medications or surgery have successfully controlled the eye pressures.

How Is It Diagnosed?
Doctors diagnose glaucoma by checking the intraocular pressure, the shape and color of the optic nerve, the complete field of vision, and angle where the iris meets the cornea. In addition, a laser instrument called GDx Nerve Fiber Analyzer can measure the nerve fiber layer, and has been found to be a more precise and accurate test than other technologies currently used to detect glaucoma. The laser works by using polarized light to pass through the nerve fiber layer and measures 65,536 points on the tissue layer. It is a powerful computer that "maps" the nerve fibers and instantly compares them to a database of healthy glaucoma-free patients.