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Glaucoma

What Is and How Do We Treat Glaucoma?

Dr. Whitman: Hello and welcome to Key-Whitman. I’m Dr. Jeffrey Whitman and I am being joined today by several doctors on our Key-Whitman team. If you are watching this video it is likely because you or someone you love has been diagnosed with glaucoma, otherwise known as the “sneak thief of sight”. Glaucoma has no cure and is the 2nd leading cause of blindness. However, at Key-Whitman, we have solutions for managing your condition and preventing loss of vision.

What is glaucoma?

Dr. Hong: The anterior chamber or the front of the eye is filled with a fluid called the aqueous humor. This fluid provides a pressure to maintain the shape of the eye like the air in a balloon. This pressure we refer to as IOP or intraocular pressure. In a healthy eye, the fluid flows in and out of the natural drainage system. With most kinds of glaucoma, the drainage system does not work properly and the fluid in the eye does not drain well which causes a raise in the pressure in the eye and leaves the optic nerve in the back of the eye vulnerable to permanent damage from this high pressure.

Are there any symptoms?

Dr. Warren: In the early stages of the disease there are no signs or symptoms. Only during your yearly eye health exam with full dilation can we detect glaucoma when we take a look at your eye pressures and the condition of the optic nerve. If we suspect glaucoma, we will order further tests which will include a visual field test to determine if there has been any subtle loss of peripheral vision. At Key-Whitman we’ll also take a look at your nerve fiber layer with a special machine called an OCT. The OCT stands for O ptical Coherence Tomography and we use it to precisely capture an image of the optic nerve and surrounding nerve fibers. Similar to an ultrasound, the OCT measures the reflection of infrared light, not sound, which is reflected uniquely by different tissues. This test can help detect glaucoma much sooner than other traditional methods.

How is glaucoma treated?

Dr. Whitman: If needed, we will prescribe prescription eye drops which help to lower eye pressure and these must be used exactly as we prescribe for best results. After a few weeks of beginning the new medication, we will have you return to repeat pressure measurements and to see how you are tolerating your new medication. We will continue to monitor your eye pressure by asking you to return every 3 to 6 months to take another look and to repeat some of the testing looking for any advancement of the disease. We cannot emphasize enough how important these follow-up appointments are to preserving your good vision.

Dr. Warren: During your follow-up visits, we may add additional medications to help to further lower pressure and we may suggest more therapeutic treatments like the SLT or Selective Laser Trabeculoplasty. To increase the drainage of the aqueous fluid, a laser is used to help the trabecular meshwork—the normal outflow area for aqueous, to allow more fluid to filter through. Sometimes, the SLT laser helps to reduce the need for additional drops, but please remember to specifically follow our treatment plan and ask questions if you don’t understand.

Dr. Barke: When we don’t get the pressure down with medications or laser, we may have to resort to surgery in order to slow the progress of glaucoma. We may suggest a procedure called a Canalaplasty for treatment of advanced glaucoma. Canalaplasty is an effective and proven procedure that uses microcatheter technology to enlarge your drainage system much like with angioplasty. By restoring your natural drainage system, eye pressure is usually lowered. Other types of surgery are available as well if needed.

Dr. Whitman: Remember, at Key-Whitman we are here to help you. Managing your glaucoma is life-long. If glaucoma is left untreated, if you don’t use your medication like you should or if you don’t keep up your follow-ups appointments, any vision you lose will be permanent. Thank you and we hope this video has helped you understand your condition.

American Academy of Ophthalmology American Board of Eye Surgery Eye Care America Society for Excellence in Eyecare STAAR Surgical Texas Medial Association - Physicians Caring for Texans ISRS - International Society of Refractive Surgery The Texas Optometric Association Inc.

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