Glaucoma is a condition that results in damage to the optic nerve. This can lead to vision loss and even blindness. It is caused by an increase in pressure inside the eye, which puts stress on the optic nerve. Although glaucoma can occur at any age, it is more common in older adults. There are several different types of glaucoma, each with its own set of symptoms. Glaucoma can be treated with medication or surgery, but it is important to catch it early to prevent vision loss. If you think you might have glaucoma, see your eye doctor for a diagnosis.
Everyone has some risk of glaucoma. It is important for everyone to have routine eye exams to look for the early signs of glaucoma. The risk for glaucoma is increased with these factors:
Glaucoma is a disease that damages the optic nerve and causes vision loss – often without warning or symptoms. Like a cable wire, the optic nerve is responsible for carrying the images we see to the brain. Damage to the optic nerve can occur when the pressure within the eye increases, usually due to a build-up of aqueous fluid inside the eye. This leads to the development of blind spots in our field of vision. However, damage may occur without elevation of the intra-ocular pressure. Conversely, the pressure may at times be elevated without damaging the optic nerve. This is a condition known as Ocular Hypertension. Blind spots in the field of vision usually go undetected by the individual until the optic nerve is significantly damaged and a great loss of peripheral or central vision has occurred. A Visual Field evaluation can detect glaucoma damage in its very early stages. If the disease is untreated the optic nerve may be damaged to a point that irreversible blindness will result.
Most people with glaucoma suffer from one of two major types of the disease, “open angle” and “closed angle” glaucoma.
If you are diagnosed with glaucoma, treatment is available to save your vision. The primary goal of glaucoma treatment is to lower the intraocular pressure (IOP) and stop the optic nerve damage. Several kinds of treatment are available to lower IOP. These include eye drops, laser therapy, and surgery.
Eye drop medications lower IOP by either reducing the amount of fluid entering the eye or increasing the amount of fluid exiting the eye. There are several different kinds of glaucoma medications, and each differs in terms of both its ability to lower IOP and its potential side effects. Laser therapy often is used when medications fail to lower IOP; it is also used for patients who cannot tolerate medications due to side effects. If eye drop medications or laser therapy fail to bring the intraocular pressure down to a safe range, surgery is available to lower this level.
Laser trabeculoplasty is a gentle and non-invasive treatment for glaucoma. Selective Laser Trabeculoplasty is an advanced type of laser treatment to manage patients with open-angle glaucoma.
Instead of burning tissue as in ALT, SLT selectively stimulates only precise pigmented cells to activate increased fluid drainage. Both SLT and ALT produce comparable drops in IOP; however, SLT does not have the associated damage to other tissues and adverse scarring effects. For this reason, where ALT is limited to one or two treatments, SLT has the potential to be repeated more often. This procedure is a treatment option for most glaucoma patients but is in particular suited to patients who cannot tolerate or are unable to adequately self-administer important glaucoma medications.
SLT is most often performed in the office and only takes about 5 minutes. Prior to the procedure, eye drops will be given to prepare the eye for treatment. The laser applications are made through a microscope, similar to the one used for eye examinations.
Commonly no special post-operative medications are needed and there are no restrictions on activities after treatment. Most patients will have to return for follow up visits to re-check the treated eye. It often takes several weeks for the pressure to be lowered and for the full response of the procedure to be known. Over-the-counter pain medications are fine to use for any discomfort. Unlike some glaucoma medications, there are no incidences of allergy or systemic side effects with SLT. Complications are minor but may include inflammation, temporary increase in IOP, conjunctivitis, or eye pain. For more information about SLT and how it may benefit you, please ask the doctor.
Trabeculectomy is the most common surgical method used to reduce the pressure associated with glaucoma. During the procedure, the surgeon removes a tiny section of the wall of the eye, creating a drain which allows for the outflow of aqueous fluid. Using instruments under an operating microscope, your surgeon creates an opening in the white of your eye (sclera) and removes a small piece of the trabecular meshwork. The aqueous humor can now freely leave the eye through this hole. As a result, your eye pressure will be lowered. The hole is covered by the conjunctiva, so trabeculectomy leaves no open hole in your eye. You will need several follow-up visits and to use antibiotic and anti-inflammatory eye drops to fight infection and scarring of the newly created drainage opening (bleb).
Today, adding another step to your cataract surgery that may allow you to treat your mild to moderate open-angle glaucoma in an entirely new way. The iStent Trabecular Micro-Bypass Stent is designed to reduce your eye pressure and you have it done at the same time you have cataract surgery. During cataract surgery, iStent is implanted and creates a lasting opening in the drainage system in the eye. This restores the aqueous outflow mechanism lowers and controls pressure within the eye.
Another type of surgical procedure, called drainage implant surgery, may be an option for people with secondary glaucoma or for children with glaucoma. Also known as “aqueous shunts” or “glaucoma drainage devices, ”we’ll refer to them simply as “implants.”
The idea behind implants is to enhance standard glaucoma surgery by positioning a device that will help keep the surgically-created drainage opening from healing and closing down. Many current implants include a tube through which the aqueous fluid passes. Others are solid and promote the flow of fluid along the surface of the implant. Regardless of type, implants have a common goal – to lower IOP by increasing outflow. Some implants commonly used are “valved” (Ahmed ) and “non-valved” (Molteno, Baerveldt) designs.
A hole or bleb is created similarly to conventionally trabeculectomy surgery. With implant surgery, most of the device is positioned on the outside of the eye under the conjunctiva. A small tube or filament is carefully inserted into the anterior chamber of the eye, just in front of the iris (colored part of the eye). The fluid drains through the tube, or along the filament, into the area around the back of the implant where fluid collects. The tube provides a passageway for the movement of this fluid out of the eye and into a place where the capillaries and lymphatic system reabsorb it back into the body.
There is often an inflammatory reaction immediately after surgery. This is commonly associated with variable IOP (often IOP elevation), and usually stabilizes within four to six weeks There is the possibility of IOP being too low. This is known as “hypotony.” Additionally, the implant may interfere with other ocular tissues such as extraocular muscles (muscles that move the eye from side to side) and the cornea. Like most surgeries, those with a smooth uncomplicated surgical course do the best over time.
Our qualified glaucoma doctors will diagnose and properly set a treatment option in place. Call us today for more information on how we can help with the glaucoma eye disease.
What a wonderful place, staff, and location. Dr Crosby was very knowledgeable and professional, truly, top notch. The rest of the staff was just as incredible. I was very pleased with my whole experience. That's coming from a skeptic. I would go back for Dr. Crosby alone, but the rest of the staff were also very helpful. They even tightened my glasses because my 13-month-old decided to bend them a little bit too much 😂. It's that little attention to detail, and the knowledgeable staff like Dr Crosby that made me want to give this place a five star! From the friendly faces at the check-in desk to the delicious coffee machine to the knowledgeable medical staff, and the amazing doctor. All five stars!
Dr. Purser was extremely knowledgeable about patient needs. She was also willing to go above and beyond what I’ve seen most doctors do by helping find a way to reduce drug cost.
Dr Tetrault and his techs were very thorough and although I didn’t get the best news that I was hoping for, my eyes didn’t get any worse. Also, Penny in the optical department was very helpful in getting my glasses!
Kassidy was very thorough, knowledgeable and patient. Certainly an asset to this organization
Always a great experience. We have been clients of DES since we moved to Denver in 1993. Everyone from reception to checkout is 1st rate.
Dr Crosby did a good job in explaining to me how to treat my dry eye condition. The Dr also suggested I see a cataract specialist to have my right eye corrected.
I hit 2 as far as satisfaction when I meant to type 1- sorry- service was wonderful, the doctor & staff were winderful. Professional & efficient. No complaints at all!
Dr Tetrault has managed my glaucoma for many years and he and the staff there have provided excellent care at every appointment. I feel confident I am receiving the best care possible and highly recommended him and Denver Eye Surgeons. We have my step daughter going there now to deal with macular degeneration.
The female surgeon I saw was very professional and gave me information about my eye that should have been given at my last visit about a spot on back of my eye. She was informative and thorough.
The staff and the doctor I saw for my upcoming cataract surgery was fantastic they were polite courteous and answered every question that I had I'm getting my first cataract surgery done next month
I recently saw Claire Purser, OD and Kassidy Campton, contac lens technician at Denver Eye Surgeons. They were both professional, knowledgeable and personable. Took time to answer all questions. The entire staff at the office deserve 5 star ratings.
I want to commend Kayla M. for her care and understanding with patients during check in. She is always cheerful and calm, never rushing anyone. A true professional!
They have taken excellent care of our eyes for years! I am confident they know what they are doing. The appointments are easy to schedule and there are plenty of comfortable chairs to wait for your appointment. The waiting time is brief. We are always satisfied!
Incredible customer service!!! Everyone was engaging, kind, supportive and professional ~all the way from the front desk, visit, exit. Dr Noguchi was excellent- bedside manner, medical intervention, demeanor. He is a world class physician and a classy gentleman. Thank you all for treating me like family
Tania was very nice and personable. She answered all my questions. Very very friendly! Dr. Costin was also very personable and good.
Tania came in to the exam room to perform the pre appointment examination before meeting with Dr. Purser. Tania was very thorough, professional and personable. A very good experience.
I was so impressed by your staff. One person really went out of her way, Tonia. Very helpful and kind. She has great patient care ethics. Great job team.
Everyone was wonderful and explained everything very thoroughly, including billing. Both office staff and doctors were great! I had a past retinal detachment and they treated it very seriously.
Kassidy did a fantastic job fitting me for my contacts. She was very patient and friendly and I am seeing great in my new monovision set up. Thanks Kassidy!
Great experience with Kassidy after cataract surgery for contact lens fitting. She explains everything in layman’s terms that make it easy to understand what I am experiencing very easy to understand. Thank you Kassidy.
Dr Costin was amazing. She is highly professional, very honest, and would recommend her to anyone. In fact, the entire staff was amazing.
