Glaucoma

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Glaucoma is a disease that affects the optic nerve, the part of the eye which receives images collected by the retina and sends them to the brain. Every eye maintains a certain amount of internal pressure, called intraocular pressure. When this pressure rises to abnormal levels however, it can put extra stress on the optic nerve, causing significant damage. Optic nerve damage results in loss of vision, and ultimately blindness.

Certain parts of the eye constantly produce a fluid called aqueous humor. A healthy eye will continually produce small amounts of aqueous humor to ensure consistent pressure within the eye. When normal drainage becomes slowed or blocked, or there is excessive production, pressure increases, and may lead to glaucoma. There are several different types of glaucoma, the two most common types being chronic open-angle glaucoma and closed-angle glaucoma.

Chronic open-angle glaucoma is the most common form of the disease and usually develops with age. With this type of glaucoma, pressure gradually increases around the eye causing it to work less effectively over a period of time. There are no symptoms in the early stages of open-angle glaucoma. Peripheral vision is usually the first to deteriorate. As the disease becomes more advanced, blank spots begin to appear in one’s vision. If left untreated, it eventually develops to blindness. The best way to avoid serious vision loss is early diagnosis and treatment.

Risk factors for chronic open-angle glaucoma include:

  • Advanced age.
  • Family history of the disease.
  • Higher-than-normal intraocular pressure.
  • Certain ethnic races, particularly those of African descent.
  • Certain diseases or conditions, especially diabetes, farsightedness or nearsightedness, or previous eye trauma or surgery.

Closed-angle glaucoma is less prevalent, but is considered an eye emergency. This type of glaucoma occurs when a patient’s pupil moves or dilates and actually blocks off the drainage channel in the eye. This is considered a medical emergency in which an ophthalmologist should be contacted immediately to avoid any loss of vision.

Symptoms of closed-angle glaucoma include:

  • Severe eye pain.
  • Headache.
  • Blurred vision.
  • Nausea or vomiting.
  • Rainbow halos around lights.

High risk factors for closed-angle glaucoma include:

  • Extreme farsightedness.
  • An iris that is abnormally large or bows forward in the eye.
  • Advanced age.
  • Heredity.
  • Certain ethnic races, especially Asians.

Treatments for glaucoma:

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There are a wide range of treatments for open-angle glaucoma, including medication, laser surgery and traditional surgery. The treatment (or combination of treatments) for an individual is chosen based upon the type of glaucoma and other details of the particular case. One option is medication such as prescription eye drops which help to reduce intraocular pressure, or pills called carbonic anhydrase inhibitors which slow down fluid production within the eye.

Laser surgery has also become a more common treatment option for glaucoma. For open-angle glaucoma Dr. Delianides may choose a trabeculoplasty, a painless laser procedure (SLT) which uses light to stimulate eye tissue to allow more drainage of fluid. For closed-angle cases, in which the iris is blocking drainage of aqueous humor, a laser surgery called iridotomy may be preformed.

Other glaucoma treatment options involve various traditional surgeries. A common surgery for open-angle glaucoma is trabeculectomy, where Dr. Delianides creates a small flap in the sclera (white part of the eye). Underneath the surface of the sclera, Dr. Delianides creates a small reservoir, called a filtration bleb, into which aqueous fluid may drain and then be disbursed, further reducing intraocular pressure.

There are a number of treatments available for Glaucoma patients. If diagnosed with glaucoma, Dr. Delianides will discuss your options with you in order to maintain the best possible health of your eyes.

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