Glaucoma is a leading cause of blindness in the United States today. Glaucoma affects almost 2.3 million Americans age 40 and older. Ultimately glaucoma results in damage to the optic nerve with loss of their peripheral vision (side vision).
Before and after peripheral vision loss.
The eye is a pressured system; it needs to have a pressure within itself in order to maintain its size, shape, and function. Aqueous humor is a clear nutrient rich fluid produced by the eye that helps to pressurize the eye. The eye pressure (IOP) is a dynamic process; it is a balance between fluid production and fluid drainage. If the drainage system does not work well then the intraocular pressure (IOP) will rise and ultimately the optic nerve (the cable between the eye and the brain) will become damaged.
Clinical Examination
Intraocular Pressure (IOP) Measurement
Visual Field Testing with Progressed Field Loss
Visual Field Testing with Progressed Field Loss
Optic Nerve Imaging with OCT
After glaucoma has been diagnosed the cornerstone of glaucoma treatment is to lower the intraocular pressure. The three main modalities to lower the pressure is either by:
- Medications (topical drops or oral);
- Laser therapy; or
- Incisional surgery. Usually when medications and laser treatment fail to adequately lower the pressure glaucoma surgery is recommended. Depending on the type of glaucoma and its severity the York Eye Institute offers numerous types of surgical procedures (use of anti-metabolites, shunts, and minimally invasive procedures) to allow drainage of the aqueous fluid from the eye to a space outside the eye-wall under the conjunctiva.
The York Eye Institute is frequently consulted to diagnose and to treat patients that are suspicious for glaucoma. The office is state of the art being equipped with visual field perimetry analyzers, pachymetry, Corneal Topography, Optical Coherence Tomography (OCT) testing for Retinal Nerve Fiber layer and Ganglion Cell Complex, OCT for anterior segment structure, digital external, slit lamp and fundus photography, and Yag and Argon lasers.
Accurate assessment of the optic nerve to determine the extent of glaucomatous damage is facilitated with the latest Optovue OCT with it most recent software. At the York Eye Institute and its state of art equipment a new patient will be informed and educated about their ophthalmic problems (retina, cataract, or glaucoma) at the completion of the first office visit. The electronic health records and its ancillary equipment are linked to each exam room.
David Bene, MD FACS descrbing OCT results with an eye model for patient education.