Glaucoma is related to elevated pressure in the eye that causes permanent damage to the optic nerve and early loss of peripheral vision. Glaucoma is categorized into 2 different types, open-angle and angle closure.
Open-angle glaucoma is the most common and has several subtypes that your Ophthalmologist will determine during examination. Angle-closure glaucoma is an acute condition caused by the iris blocking the eye's drainage mechanism. It must be treated quickly, as pressure builds rapidly and can cause severe pain as well as partial or total blindness.
Open-angle glaucoma is not painful and has no symptoms until severe damage has occurred to the optic nerve. The loss of sight begins in the peripheral vision and is not noticed until it is significant. Patients with open-angle glaucoma must be followed regularly for testing and medication adjustments. Open-angle glaucoma does not have a cure, but proper diagnosis and treatment will slow down the progression of the disease. Early diagnosis and treatment of Glaucoma can minimize or prevent optic nerve damage and limit vision loss.
Diagnosis and treatment of open-angle glaucoma consists of: testing; monitoring of intraocular pressure; eye drop regimen and if necessary surgical or laser procedures. Testing consists of visual field analysis; OCT, and a detailed eye exam to see if all the inner structures of the eye are healthy. The visual field analysis can pinpoint areas that have been lost to glaucoma. The OCT is a computer-generated map of the retina and can demonstrate damage to the retinal nerve fiber layer before visual loss is noted.
Once it has been determined that you have open-angle glaucoma, the Ophthalmologist will offer an SLT laser procedure or begin a drop regimen that will either attempt to decrease the production of aqueous humor (fluid that fills the anterior chamber of the eye) or increase drainage of aqueous humor through the drainage mechanism. You must keep all appointments to monitor the pressure in your eye and to determine if the eye drop medication is controlling the pressure enough to limit damage to the optic nerve.
If Dr. Montenegro determines that SLT or eye drops alone are not controlling the pressure in your eye, a variety of surgical procedures can be performed. These procedures include goniotomy, canaloplasty, trabeculectomy, and shunt devices. All of these procedures are performed to control eye pressure, and sometimes, eye drops must be continued to control eye pressure.