What people in Laguna Hills really want to know about glaucoma treatment

The National Eye Institute reports that over 2.7 million Americans aged 40 and older, have glaucoma. That number is expected to at least double by 2050. Have you or someone you love been diagnosed with glaucoma? You likely have serious concerns and plenty of questions about treatment. Renowned Laguna Hills ophthalmologist, Dr. George Salib, provides this insight.

Basics about glaucoma

Glaucoma is damage to the optic nerve from build-up of fluid in the front portion of the eye. This is how it occurs.

In a healthy eye, light enters through a clear cornea. It travels past the pupil (something like the aperture on a camera) to the lens, which focuses the light on sensory tissues at the back of the eye called the retina. As it senses light, the retina creates electrical impulses that make their way to the brain through a system of fibers originating with the optic nerve.

A transparent fluid, called aqueous humour, fills the back portion of the eye, and circulates through the front area. To maintain optimal eye pressure, equal amounts of this liquid are simultaneously produced, and drained through the trabecular meshwork and a series of canals. Even small variations in drainage can have a big impact on ocular pressure.

The drainage angle is the route for excess aqueous humor to escape. If the meshwork becomes clogged, pressure increases, injuring the optic nerve. This type, open-angle glaucoma, is especially dangerous because there is no pain or vision change in the early stages. It can only be detected through a comprehensive ophthalmologic examination.

Angle-closure glaucoma can happen when the iris (the pigmented part of the eye that controls the pupil) is too close to the drainage angle. If the iris shifts slightly, it blocks drainage, triggering fast escalation in eye pressure. An acute attack can quickly cause blindness, so it is imperative to get to an emergency room or ophthalmologist immediate if you experience:

Headache.
Nausea or vomiting.
Rainbow halos around lights.
Severe eye pain.
Sudden blurred vision.

Risk factors

Glaucoma is a potential vision threat to everyone. However, increased risk factors include:

Age – Incidence is higher for individuals over age 60.
Ethnicity – African and Mexican Americans are more prone to open-angle glaucoma, and those with Asian or Inuit background to closed-angle.
Heredity – Glaucoma can run in families, due to traits such as thin corneas, cupping at the center of the optic nerve, or naturally high eye pressure.
Severe nearsightedness.
Obesity and diabetes.
High blood pressure.
Eye injury or surgery.
Use of corticosteroids.
Smoking and excessive caffeine consumption.
Sun exposure without eye protection.
Poor nutrition.

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(949) 441-5444

What is glaucoma treatment?

How glaucoma is treated depends on the type, and on the medical history and physiology of the patient.

For some patients, eye pressure can be lowered and controlled with eyedrops. Some of these medications reduce the amount of aqueous fluid produced by the eye, while others increase flow through the drainage angle. While glaucoma drops help to preserve vision, possible side effects include:

Itching and stinging.
Redness in or around the eyes.
Changes in heart rate, energy level, and breathing.
Dry mouth.
Blurry vision.
Changes in color of the eye and skin around eyes.

Laser surgery may also be a treatment option. This procedure helps aqueous fluid drain from the eye more efficiently. Surgery is performed by Dr. Salib on an outpatient basis at the Orange County Eye Institute in Laguna Hills, CA. Treatment for open-angle glaucoma is called trabeculoplasty. This surgery allows the drainage angle to work more efficiently. Dr. Salib creates a flap in the white part of the eye (sclera), then makes a small opening that releases fluid. The laser procedure for patients with closed-angle glaucoma is called iridotomy. Dr. Salib uses a laser instrument to create a tiny hole in the iris, helping fluid flow through the drainage angle.

In some cases, a new drainage channel can be created with a conventional surgery. Trabeculectomy involves forming a bubble in the conjunctiva to hold excess aqueous fluid while it is gradually absorbed by tissues around the eye. A drainage device can be implanted into the eye, channeling fluid to a reservoir beneath the conjunctiva where, again, it can be absorbed by normal body processes.

The most important step to preserve your vision is scheduling an examination with Dr. Salib. Call the Orange County Eye Institute at (949) 441-5444 for treatment tailored to your lifestyle.