What is Glaucoma?
Glaucoma is an eye disease that damages the optic nerve which carries images from the eye to the brain. If not detected or treated, glaucoma can lead to permanent vision loss and blindness. Fortunately, with early detection and treatment, serious vision loss can be avoided in most cases.
Glaucoma is commonly associated with a buildup of pressure inside the eye. Normally, fluid circulates in the front part of the eye before draining out through a mesh-like channel. In glaucoma, this channel becomes blocked resulting in a buildup of fluid pressure that can damage the optic nerve.
At Joseph Eye & Laser Center, we guide you through your options and help you determine the procedure that is customized for your specific needs. Dr. Christopher Joseph, DO, FACS, is an expert in glaucoma treatment and surgery, as well as cataract surgery. He completed an extra year of training by completing a fellowship in Pittsburgh, PA, which specialized in minimally invasive glaucoma surgery (MIGS). Dr. Joseph is also one of the few ophthalmologist in the United States recognized for his excellence by the America College of Surgeons (ACS). In 2018, the ACS nominated Dr. Joseph as a fellow of the American College of Surgeons (FACS).
Glaucoma is treated by lowering the pressure inside the eye with medication, laser, surgery, or a combination of glaucoma treatments. As sight loss from glaucoma cannot be reversed, early detection and treatment is essential to prevent further vision loss.
It can be helpful to bring a list of your medications to your eye appointment. Medications, typically eye drops, can be used to lower eye pressure. These medications work by reducing fluid production inside the eye or helping fluid drain from the eye. Glaucoma medications must be taken regularly each day to work effectively. Some patients may require more than one type of eye drop.
Side effects from glaucoma eye drops may include stinging, red eyes, eyelash growth, change in eye color or appearance of skin around the eye, dry mouth, blurred vision, breathing problems, low pulse rate or blood pressure, and decreased energy or mood. More than 75% of patients report side effects from their glaucoma drops. If you are having side effects from your medication, you should tell your eye doctor. Your eye doctor may suggest changing to a different medication or an alternative treatment to reduce your need for eye drop medications. It is important to tell your eye doctor about any medical conditions and what medications you are currently taking.
Selective Laser Trabeculoplasty
This low power laser is directed onto the mesh-like drainage channel to unclog it and help fluid drain more freely. It is typically used in open-angle glaucoma. This laser treatment (SLT) is highly effective and extremely low risk. It is considered a first line treatment for any level of glaucoma by the American Glaucoma Society and should be offered as a primary treatment. SLT should also be used to lessen the use of glaucoma drops, especially in patients that are having side effects to drops.
In some patients with glaucoma, surgery is recommended. Glaucoma surgery improves the drainage of fluid from the eye, lowering eye pressure. The type of surgery that is right for you depends on many factors including your age, general health, type and severity of glaucoma, eye pressure, and other eye conditions (e.g. cataract). Speak to your ophthalmologist about which treatment is right for you.
What is MIGS?
MIGS stands for minimally invasive glaucoma surgery. These are relatively new procedures that use tiny incisions and microscopic equipment to lower eye pressure. Traditional operations, while effective at lowering eye pressure, have a long list of potential complications. MIGS procedures have been designed to provide a greater degree of safety, enabling them to be used earlier in glaucoma treatment. These procedures may be combined with cataract surgery to reduce or eliminate the need for glaucoma eye drops.
Recently, the FDA has approved the use of the iStent Inject, which is the smallest implantable device approved for use in the human body. It is a titanium device that is implanted from inside of the eye (an ab interno approach) into the trabecular meshwork in order to bypass it and improve outflow of eye fluid. IStents are typically implanted during the time of cataract surgery, and in most cases two iStent Injects are implanted. As with other MIGS procedures, iStent Inject combined with cataract surgery typically lowers eye pressure to the mid-teens.
Whether iStent, SLT, or another MIGS procedure is right for you depends on many factors, all of which can only be assessed by your eye surgeon. These procedures are extremely safe, and have a high success rate, however, the use of cutting-edge technology can be difficult to master, so picking the right surgeon is critical. Dr. Joseph is fellowship-trained in minimally invasive glaucoma surgery (MIGS) and laser glaucoma surgery (SLT).
As well as, LASER cataract surgery, dropless cataract surgery, and high-tech lens implants (IOLs). If you would like to further learn about any of our MIGS or SLT procedures, contact the trusted experts at Joseph Eye & Laser Center today.