Diagnosis & Treatment
During your comprehensive eye exam or as part of a special glaucoma testing visit, we may perform a number of tests in order to be able to provide early detection and make the most accurate diagnosis of glaucoma. These may include the following:
- Tonometry-Intraocular Pressure (IOP) measurement.
- Ophthalmoscopy-Examination of the optic nerve through a dilated pupil which may be performed using special instruments or a high magnification lens at the Slit Lamp Biomicroscope.
- Visual Field Perimetry-A computerized examination to plot an actual map of the field of your vision.
- Gonioscopy-Direct examination of the drainage structures of your eye called “trabecular meshwork”-using a specialized contact lens at the Slit Lamp Biomicroscope.
- Computerized Imaging of Optic Nerve & Fibers-OCT uses a method called “optical coherence tomography” to create digital images with beams of light to examine the optic nerve and measure the retinal nerve fiber thickness.
- Pachymetry Measurement of Corneal Thickness
From this testing we will be able to make a diagnosis and recommendations for additional visits and treatment as required. They will be sure to answer all questions you may have and help you understand how we will work together to help maintain your eye health & vision.
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 can initially been treated with eye drops and/or an in office laser treatment called Selective Laser Trabeculoplasty (SLT). 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 the office glaucoma laser treatment to maintain control as a first choice of treatment.
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 through 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. Our surgeons are able to perform Minimally Invasive Glaucoma Surgery (MIGS) for most patients. While sometimes traditional glaucoma surgery may be an option and may include removing a tiny piece of the trabecular meshwork-called Trabeculectomy, a number of minimally invasive glaucoma surgery (MIGS) options including a procedure call Kahook Dual Blade (KDB) which is a quick and painless outpatient procedure often performed at the time of cataract surgery. KDB avoids risks of eye bleb leakage and infection while providing a quick visual recovery. We are often able to implant microscopic stents such as the iStent®, for cataract patients who need to control their eye pressure. In addition, we are able to use STREAMLINE™ to further enhance fluid drainage to control intraocular pressure 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.