Glaucoma
Glaucoma is one of the leading causes of preventable blindness in the world. It is an eye disease of the optic nerve. This nerve carries visual information from the eye to the brain. The disease affects peripheral vision first.
What are risk factors for glaucoma?
The loss of vision occurs over a long period of time. There are usually no symptoms of the disease until the damage is advanced. Once the visual field is damaged, the lost function cannot be recovered.
Important risk factors include:
- age
- family history
- elevated eye pressure
- thin corneas
- African American or Hispanic ancestry,
- past eye trauma
- Diabetes
Patients with risk factors are considered glaucoma suspects. Early diagnosis can prevent vision loss from this devastating disease.
All of our ophthalmologists specialize in the early detection of this blinding disease.
This takes place with a complete, dilated ophthalmologic exam. If our doctors find a suspicious finding or there is a known risk factor, additional diagnostic testing may be performed in our office.
Intraocular pressures are measured with anesthetic drops and Goldmann tonometry and applanation. There is no puff of air. Raised intraocular pressure is a significant risk factor for developing the disease. However, patients can develop nerve damage even with normal intraocular pressures (normal tension).
Some patients develop glaucoma at relatively low pressures while others have high eye pressures and never develop damage to their optic nerve.
Diagnostic Tests For Glaucoma
Corneal pachymetry measures central corneal thickness. Thin corneas are a risk factor for glaucoma. Thick corneas are protective. Corneal pachymetry helps our doctors decide a patient’s true intraocular pressure.
Dilated fundus examinations allow the ophthalmologist to examine the optic nerve stereoscopically and look for any early changes suggestive of nerve damage. Dilation also allows for a thorough view of the retina searching for other ophthalmologic and systemic diseases.
Formal peripheral Humphrey Visual Field testing can detect early changes and serve as a baseline for future reference. This test takes place in our office and requires time, attention and expertise in interpretation.
Optical Coherence Tomography allows for a quick scanning of the retinal nerve fiber layer surrounding the optic nerve and too serves as a baseline and excellent screening tool. This additional test is used if the doctor is concerned about the health of a patient’s optic nerve.
Types of Glaucoma
Glaucoma is divided into two major categories: open angle and narrow angle. A detailed, comprehensive examination by an ophthalmologist is imperative in correctly diagnosing the disease. Open angle glaucoma (Chronic Open Angle Glaucoma, or, COAG) has many subcategories. The type of glaucoma, risk factors, health of the optic nerve and visual field help the doctors determine what the best course of treatment is for each individual patient.
Treatment
Narrow angle glaucoma may require a prophylactic laser procedure (iridotomy) to prevent serious complications such as closed angle glaucoma. Treatment for glaucoma may include close observation alone, eye drops, laser surgery or filtering surgery. Our doctors specialize in both the medical and surgical treatment of glaucoma. Newer drops can prevent vision loss in most cases. Some patients may require advance surgery involving a tube or shunt drainage device.
Dr. Frank S. Ashburn, Jr. is one of the most experienced glaucoma specialist and surgeon in the Washington, DC area and specializes in the medical and surgical treatment of complicated patients having the disease. He is one of the few surgeons locally who performs Endolaser procedures. Patients travel from across the world to seek his medical and surgical expertise. Dr. Ashburn is medical director of the Friends of the Congressional Glaucoma Caucus Foundation.
Physicians and research staff at Eye Associates were extensively involved in two landmark clinical trials in the field of Glaucoma: AGIS and OHTS. AGIS (Advanced Glaucoma Intervention Study) assessed the long-range outcomes of sequences of interventions involving trabeculectomy and argon laser trabeculoplasty in eyes that have failed initial medical treatment for glaucoma. OHTS (Ocular Hypertensive Treatment Study) determined whether medical reduction of intraocular pressure prevents or delays the onset of glaucomatous visual field loss and/or optic disc damage in ocular hypertensive subjects judged to be at moderate risk for developing open-angle glaucoma.
Now Offering Fovea-FriendlyTM MicroPulseⓇ Laser Therapy for Glaucoma
MicroPulse laser therapy is a tissue-sparing solution for the treatment of retinal diseases and glaucoma. With MicroPulse, a continuous-wave laser beam is chopped into a train of tiny, repetitive, low energy pulses separated by a brief rest period which allows the tissue to cool between laser pulses. MicroPulse laser therapy also can be used in conjunction with drug therapy, allowing complete and optimized management of your glaucoma without laser-induced damage.
