Services | Glaucoma

Glaucoma | Manhattan | New York City Glaucoma is the term used when the pressure inside the eye rises high enough to damage the optic nerve. The condition often develops over many years without causing pain. The patient may not experience vision loss until the disease has progressed. Glaucoma cannot be prevented, and vision lost to it cannot be restored. Left untreated, glaucoma can cause blindness. For these reasons, regular eye exams and early detection are critical.

The high eye pressure associated with glaucoma is caused by a blockage in the eye’s fluid drains. No one knows yet why the blockage forms.

Glaucoma | Manhattan | New York City Symptoms are occasionally present and should be taken as warning signs that glaucoma may be developing. These include blurred vision, loss of peripheral vision, halo effects around lights and painful or reddened eyes. People at the greatest risk include those who are over the age of 40, diabetic, near-sighted, African-American, or who have a family history of glaucoma.

There are many types of glaucoma;

Chronic (Open Angle) Glaucoma
This is the most common type. In open angle glaucoma, aqueous fluid (the thick watery substance filling the space between the lens and the cornea) drains too slowly and pressure inside the eye builds up. It usually results from aging of the drainage channel, which doesn't work as well over time. However, younger people can also get this type of glaucoma.

Normal Tension Glaucoma
This is a form of open angle glaucoma not related to high pressure. People with normal tension glaucoma may be unusually sensitive to normal levels of pressure. Reduced blood supply to the optic nerve may also play a role in normal tension glaucoma.

Acute (Angle Closure) Glaucoma
Less than 10 percent of Caucasians or African-Americans have this form, but for those of Asian and Native American descent, the risks are as high as for open angle glaucoma. Hispanics are midway between these groups. It causes a sudden rise in pressure, requiring immediate, emergency medical care. The signs are usually serious and may include blurred vision, severe headaches, eye pain, nausea, vomiting or seeing rainbow-like halos around lights. Occasionally, the condition may be without symptoms; similar to open angle glaucoma.

Secondary Glaucoma
Another 10 percent of glaucoma cases come from certain diseases and conditions that damage the eye's drainage system. These include diabetes, leukemia, sickle-cell anemia, some forms of arthritis, cataracts, eye injuries or inflammation of the eye, steroid drug use and growth of unhealthy blood vessels.

Post-Surgical Glaucoma
Some surgeries, such as retinal reattachments, increase the chance of getting glaucoma.

Once diagnosed, glaucoma can be controlled. Some cases of glaucoma can be treated with medications. For others, laser or traditional surgery is required to lower eye pressure.

Common surgeries include:

Laser Peripheral Iridotomy (LPI) – For patients with narrow-angle glaucoma. A small hole is made in the iris to increase the angle between the iris and cornea and encourage fluid drainage.
Argon Laser Trabeculoplasty (ALT) and Selective Laser Trabeculoplasty (SLT) – For patients with primary open angle glaucoma (POAG). The trabecular passages are opened to increase fluid drainage. ALT is effective in about 75% of patients, and SLT may be repeated.
Nd: YAG Laser Cyclophotocoagulation (YAG CP) – For patients with severe glaucoma damage who have not been helped with other surgeries. The ciliary body that produces intraocular fluid is destroyed.
Filtering Microsurgery (Trabeculectomy) – For patients who have not been helped with laser surgery or medications. A new drainage passage is created by cutting a small hole in the sclera (the white part of the eye) and creating a collection pouch between the sclera and conjunctiva (the outer covering of the eye).
Tube Shunt Surgery – May be recommended for patients with neovascular glaucoma, failed trabeculectomy, or susceptibility to developing scar tissue. A thin, flexible tube (a shunt) with a silicone pouch is inserted in the eye to facilitate drainage.

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