At Bloomfield Eye Associates, our ophthalmologists and eye surgeons provide examination, diagnosis and treatment of glaucoma, including eye drops for glaucoma treatment, laser treatment and glaucoma surgery using Minimally Invasive Glaucoma Surgery (MIGS) implantation of microscopic tubes, shunts, valves or stents to help lower eye pressure. Glaucoma is an eye problem that can damage the optic nerve and cause loss of vision. Most serious eye problems typically produce some symptoms that make patients uncomfortable or disturb their vision, but the most common type of glaucoma begins without any symptoms or obvious loss of vision. It is critical to diagnose and treat glaucoma as early as possible through regular eye examinations in order to prevent vision loss as with early detection and diagnosis, in the vast majority of cases, glaucoma can be treated and controlled.
Glaucoma Risks & Types
Depending on your general health, eye health and family history, a number of factors may increase your likelihood of developing glaucoma. An increased risk of glaucoma occurs when you have higher than normal intraocular pressure (IOP), being above 40 and especially above 60 years of age, being of African-American descent or Hispanic and above 60 years of age, being extremely nearsighted, having high blood pressure or diabetes and especially anyone who has a family history of glaucoma is at considerably greater risk. Prolonged use of oral contraceptive birth control pills, as well as the early onset of menopause, may increase glaucoma risk in women. In addition, anyone suffering from sleep apnea needs to be carefully examined as this condition significantly increases glaucoma risk. If you have had trauma to your eyes such as from a sports injury or car accident, or if you have been treated for asthma or other conditions for long periods of time with steroid inhalers, or have a corneal thickness less than 0.5mm, you too might be at greater risk of developing glaucoma. The two main types of glaucoma are Primary Open Angle Glaucoma (POAG), and Angle Closure Glaucoma.
If you have these symptoms, please call Bloomfield Eye Associates at 973-338-1001 for an immediate appointment.
Glaucoma Testing & Diagnosis
During your examination, we may perform a number of tests in order to make the most accurate diagnosis of glaucoma. These include Tonometry to measure eye pressure, Ophthalmoscopy to carefully examine the inside of the eye – especially the optic nerve, Visual Field testing using a computer bowl-like instrument to evaluate your “side” or peripheral vision to see how sensitive your side vision is in various directions, Gonioscopy to directly observe the health and condition of the angle of your eye where the iris meets the cornea, OCT or “optical coherence tomography” digital imaging of the optic nerve and retina, and Pachymetry or corneal thickness measurement as corneal thickness can alter the accuracy of the measurement of intraocular pressure (IOP), and it appears that patients with thin corneas may be inherently more likely to develop glaucoma.
Medical, Laser & Surgical Glaucoma Treatment
The goal of glaucoma treatment is to stabilize and control your eye pressure in order to provide the best chance of preserving your vision. The three main glaucoma treatments are medical-using eye drops, glaucoma laser treatment & glaucoma surgery, most often minimally invasive glaucoma surgery (MIGS).
Medical Treatment of Glaucoma
Primary Open Angle Glaucoma has most often been treated with eye drops. By using one or two types of glaucoma eye drops most patients are able to achieve a stable and lowered eye pressure. Some patients are unable to achieve adequate control with eye drops alone, or may experience intolerable side effects from the eye drops, and do better with an in office glaucoma laser treatment to maintain control as a first choice of treatment. The doctors and glaucoma specialists at Bloomfield Eye Associates may also recommend sustained or extended release implantable devices that can provide medication to treat glaucoma from within the eye over a long period of time.
Laser Treatment of Glaucoma
Selective Laser Trabeculoplasty (SLT) is a type of glaucoma laser treatment for Primary Open Angle Glaucoma that helps to reduce the Intraocular Pressure (IOP) by creating more effective drainage of fluid throughout the trabecular meshwork. We perform this painless procedure in the comfort of our office and often patients are able to obtain good stability and also reduce the number or frequency of eye drops they need to use. Laser Peripheral Iridotomy (LPI) is a type of glaucoma laser treatment for Angle Closure Glaucoma that creates a hole on the outer edge, or rim, of the iris, the colored part of the eye which allows the aqueous humor fluid to easily flow between the anterior chamber, the front part of the eye, and the area behind the iris, the posterior chamber. This is performed for patients with narrow chamber angles or those patients experiencing angle closure to prevent sudden buildup of pressure within the eye, which occurs during an episode of acute closed-angle glaucoma.
Surgical Treatment of Glaucoma
Even with the maximum eye drop medical therapy and glaucoma laser treatment, for some patients it is still not possible to achieve good stable control of their disease and stop the progression of vision loss. We work closely with glaucoma specialists who perform Minimally Invasive Glaucoma Surgery (MIGS). While sometimes traditional glaucoma surgery may be an option and may include removing a tiny piece of the trabecular meshwork-called Trabeculectomy, our glaucoma specialists are able to provide a minimally invasive procedure call Kahook Dual Blade (KDB) Goniotomy a quick and painless outpatient procedure usually performed at the time of cataract surgery. KDB doesn’t require sutures and avoids risks of eye bleb leakage and infection while providing a quick visual recovery. Our affiliated glaucoma specialists & surgeons are able to implant microscopic tubes, shunts, valves or stents such as the iStent® or HYDRUS® MicroStent for cataract patients who need to control their eye pressure. In addition, they are able to use the OMNI procedure to help both those patients having cataract surgery, as well as those patients not requiring cataract surgery, to help lower eye pressure and reduce the need for eye drops.