Glaucoma is the number one cause of irreversible blindness in the world. As a top eye care provider in the New York and Northern New Jersey region, Dr. Cohen and his team provide the most advanced care for men and women with glaucoma, including techniques to identify the disease in its earliest and most treatable stages.
Glaucoma is a disease that affects the optic nerve located at the back of your eye. The optic nerve is essential for vision, sending messages of the objects you see to your brain where they can be “decoded” and translated into actual images. Glaucoma occurs when the natural fluid inside your eye fails to drain properly, resulting in a buildup of pressure that compresses the nerve fibers, resulting in permanent vision loss. The disease occurs most commonly in people with specific risk factors, including:
family history of glaucoma
high blood pressure
prior eye injury
history of elevated pressure inside the eye
long-term use of steroid medications
presence of some other types of eye diseases
Asian or African descent
The primary risk factor for glaucoma is older age. In fact, the National Eye Institute (NEI) estimates about 3 million people age 45 and older have glaucoma and many don't even know they have the disease.
Glaucoma treatment usually begins with the use of special eye drops to help reduce the pressure inside your eye. Sometimes, oral medications are also prescribed. When medications are not enough to keep the intraocular pressure under control, surgery may be needed to help promote proper drainage and prevent fluid and pressure from building up. Both traditional and laser procedures are available to treat men and women with glaucoma.
Selective laser trabeculoplasty or SLT, is used for patients with open angle types of glaucoma. The laser is utilized to treat the drainage system of the eye known as the trabecular meshwork. Treating this area of the natural internal drainage system is designed to improve the outflow of fluid from the eye. This type of laser surgery will be effective in some patients but not others. Your response is determined by the type of glaucoma you have and the specific structures found in your drainage system. The laser machine is similar to the examination microscope that the doctor uses at each visit to look into your eyes. The laser itself makes little noise and flashes a light about as bright as the flash on a camera. Nearly all patients find the procedure comfortable and pain free. The procedure generally takes from 3-5 minutes.
Endo-Cyclo Photocoagulation (ECP) is a laser treatment to the ciliary body done only during cataract surgery. This part of the eye is responsible for aqueous fluid production, and the laser is performed with the hope that the fluid production will decrease, causing the eye pressure to drop.
Minimally invasive glaucoma surgical procedures, so-called MIGS involve alterations of the drainage area that are performed inside the eye, sometimes during cataract surgery. The iStent® and CyPass are surgical therapies for patients who have mild to moderate open angle glaucoma and have tried topical medications or laser therapy. It is designed to improve the aqueous outflow to better lower the intraocular pressure and reduce the need for medications. The stents are placed in your eye into the drainage area, called Schlemm’s Canal through the trabecular meshwork.
Because glaucoma typically causes no symptoms until it has progressed to the point of vision loss, having regular dilated eye exams with an ophthalmologist skilled in recognizing the disease in its earliest stages is your best defense. It's also important to know your risk factors so you can take steps to reduce or eliminate those risks and decrease the likelihood of developing glaucoma.