Protect Your Sight: Expert Diabetic Eye Disease & Glaucoma Care

Glaucoma is a group of eye diseases that damage the optic nerve, a cluster of a million small nerve fibers. These nerve fibers relay visual information from the back of the eye to the brain. Glaucoma is often caused by very high eye pressure, but genetics and other issues can play a role in its development. Some people with glaucoma may even have normal eye pressure. The groups at greatest risk for the disease are anyone over 60 (over 40 if you’re Black), those with diabetes, and people with a family history of glaucoma. Glaucoma is a top cause of blindness in older adults.

Although there is currently no cure for glaucoma, there are several effective treatment options to slow or halt progression of this disease.

Medication, usually in the form of eye drops, can help relieve pressure within the eye.

Recent advances in laser surgery make it possible to improve the underlying condition that contributes to elevation of pressure within the eye. Open-angle glaucoma can be treated with ALT (Argon Laser Trabelculoplasty), and a peripheral iridotomy procedure can be performed to treat closed-angle glaucoma.

Most of the time, the efficiency of the drainage canals can be improved by treatment with medicated eye drops and/or laser therapy. However, if these treatments are not effective, the most common surgical option, trabeculectomy, can be performed to alter the eye’s drainage system.

Two innovative approaches to treating glaucoma have become available relatively recently, the ExPRESS mini shunt, and—for those who have both cataract and glaucoma—the iStent®.

iStent® is the smallest medical device ever approved by the FDA, and is placed in the eye during cataract surgery. It is so small, you won’t be able to see or feel it after surgery, but it works continuously to help reduce eye pressure by improving outflow of fluid from the eyes. After implantation, many patients are able to control their eye pressure. In a U.S. clinical trial, iStent patients who achieved a target pressure of < 21 were more likely not to need their medications than patients with cataract surgery only.

ExPRESS® glaucoma filtration device. This device, which is inserted beneath the sclera (the white surface of the eye) shunts aqueous fluid into a reservoir and gives greater control of outflow.

If glaucoma is left untreated or poorly managed, it can indeed lead to vision loss and potentially blindness over time. Glaucoma is often referred to as the "silent thief of sight" because it typically progresses slowly and without noticeable symptoms in its early stages. The damage to the optic nerve caused by elevated intraocular pressure (IOP) in glaucoma is irreversible, and once vision is lost, it cannot be restored.

However, the good news is that with early detection and appropriate treatment, the progression of glaucoma can often be slowed or halted, preserving vision and preventing further damage. Treatment options for glaucoma typically include medications (eye drops), laser therapy (such as selective laser trabeculoplasty or SLT), and in some cases, surgical procedures (like trabeculectomy or shunt implantation) to lower IOP and manage the condition effectively.

Regular eye exams are crucial for detecting glaucoma early, especially for individuals at higher risk, such as those with a family history of glaucoma, older age, or certain medical conditions. If you suspect you may have glaucoma or have been diagnosed with it, it's important to follow your eye doctor's recommendations closely to preserve your vision and maintain eye health.

Glaucoma can develop at any age, but it is more commonly diagnosed in older adults, typically after the age of 40. The risk of developing glaucoma increases with age, and it becomes more prevalent as people get older.

There are different types of glaucoma, and the age of onset can vary depending on the type:

Primary Open-Angle Glaucoma (POAG): This is the most common type of glaucoma and often develops in adults over 40 years old. It progresses slowly and may not cause noticeable symptoms until vision loss has occurred.

Angle-Closure Glaucoma: This type can occur suddenly (acute angle-closure glaucoma) or gradually (chronic angle-closure glaucoma). Acute angle-closure glaucoma is more common in people over 40, while chronic angle-closure glaucoma can develop at any age.

Secondary Glaucoma: This can develop at any age and is usually caused by another eye condition, injury, or medical condition.

Congenital Glaucoma: Rarely, glaucoma can be present at birth or develop in early childhood due to abnormalities in the eye's drainage system.

Since glaucoma often progresses without noticeable symptoms in its early stages, regular eye exams are crucial for early detection, especially as you get older. If you have a family history of glaucoma or other risk factors, your eye doctor may recommend more frequent screenings to monitor for signs of the disease. Early detection and treatment are key to managing glaucoma and preserving vision.