Glaucoma- Jacksonville Bowden Eye Associates

Glaucoma is the leading cause of blindness and visual impairment in the United States. Glaucoma is an eye disease that can lead to permanent loss of vision. This ocular disease has been labeled as "A Thief in the Night" because in its most typical form, there are no symptoms. No pain, no swelling, no redness. Patients with glaucoma may not notice the loss of vision until it is too late.

Glaucoma is simply high pressure inside the eye. The eye is filled with a fluid called the aqueous humor. In a normal eye, this fluid is constantly produced and drained. In an eye with glaucoma, this fluid does not properly drain, resulting in a build-up of pressure. Left untreated, this increase in pressure destroys vision by destroying the optic nerve.

Visual loss begins with the peripheral vision. This is why most patients do not notice the loss until it is too late. By the time the loss is noticed by the patient, central vision has been affected. With advanced glaucoma, the patient may have lost so much peripheral vision that they see the world like they're looking through a drinking straw. He or she may read an eye chart at 20/20 but may have difficulty finding the chart. These patients do not meet current visual driving requirements.

 

Patients with glaucoma may not notice vision loss until it is too late. With early diagnosis and treatment, vision loss from glaucoma may be prevented.

Types of Glaucoma

The most common type of glaucoma is chronic glaucoma.

 

There are four types of glaucoma:

  • Chronic. This is the most commonly seen type of glaucoma. The loss of vision is painless and permanent.

  • Acute. This happens suddenly and is very painful. Vomiting and complaints of headaches are commonly seen in these patients. They most always present to our office as an emergency. Medical treatment usually in the form of laser surgery is required immediately to reduce the intraocular pressure. Patients subject to this form of glaucoma can usually be detected during a routine eye examination.

  • Congenital. Present at birth, congenital glaucoma is a rather rare condition. Bowden Eye Associates has many congenital glaucoma patients that started with our practice at birth.

  • Secondary. This glaucoma occurs as a result of systemic disease such as diabetes, from medication use (steroids) or from previous trauma or surgery of the eye.

Your Risk

The following factors increase your risk of developing primary open angle glaucoma:

  • Age. Primary open angle glaucoma becomes more common with increasing age after the age of 40.

  • Family History of Glaucoma. Genetics play a role in glaucoma. The risk of developing glaucoma is about eight times higher if you have a parent or sibling with the disease. Among current glaucoma patients, up to one half will have known family history of the disease.

  • Race. While glaucoma is common in all races, primary open angle glaucoma is most common among Americans of African heritage. African Americans generally develop glaucoma at a younger age, often have more severe glaucoma, and may have a glaucoma that is more difficult to treat.

Other risk factors include:

  • Diabetes
  • Past Eye Trauma or Surgery
  • Steroid Use
  • Nearsightedness

Diagnosing the Disease

Bowden Eye Associates utilizes the latest technological advances in the early detection of glaucoma.

  • Glaucoma- Jacksonville Bowden Eye AssociatesPressure Check – During your yearly complete eye examination your intraocular pressure will be evaluated. This is one of the first areas of detection even though some patients can have glaucoma and not exhibit high intraocular pressure.

  • Dilated Examination – During your yearly complete eye examination, your pupils will be dilated so one of our providers can get a good look at your optic nerve. Changes to the optic nerve should be evaluated to rule out loss of peripheral vision associated with glaucoma.

  • Visual Field Examination – Loss of peripheral vision can be determined by the use of the visual field. This is a painless quick examination that requires the patient to fixate on a lighted target in a “bowl like” machine. While the patient fixates on the target, lights will flash in the bowl. The patient will click a button each time a light flashes while remaining fixated on the target. A loss of peripheral vision requires immediate treatment to prevent further loss.

  • HRT Examination – The Heidelberg Retina Tomograph is a system that combines a laser scanning camera and specialized software that evaluates the optic nerve. The HRT may diagnose glaucoma years before the symptoms become apparent to the patient. The HRT examination takes just a few minutes. It is a painless, non-invasive test that rarely requires dilation of the eyes. The HRT is an accurate way to follow your progress and your Bowden Eye Associates provider may order repeat examinations to check your progress.

  • Stereo Disc photos – If your optic nerve is suspicious for the development of glaucoma, your Bowden Eye Associates provider will order stereo slides for your chart for future comparison. This enables your physician to compare your optic nerves appearance if necessary.

  • Corneal Pachymetry – A recent study revealed that corneal thickness plays a significant role in glaucoma detection. Patients of certain races and those who have moderate to high myopia tend to have thinner corneas. When these patients also have glaucoma or are a glaucoma suspect, treatment by the physician may vary depending on the pachymetry readings. Applanation tonometry of an unusually thin cornea results in a false reading that’s lower than the actual measurement because of the resistance of the corneal tissue to the indention of the cornea. The reverse is also true: Thick corneas yield false high readings. Conversion formulas are used that mathematically “adjust” the IOP for an eye with a thin cornea.

>> Read about Glaucoma treatment
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