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Glaucoma InformationWhen a SURGICAL CONSULTATION is ADVISED If surgery is necessary - The surgeon will generally recommend a surgical procedure known as peripheral iridectomy. This procedure is generally very effective, however, any surgical procedure has associated risks. In your case, surgery is highly recommended because the likelihood of vision loss without surgical treatment far outweighs the risks from surgical complications. During this procedure, the surgeon will create an artificial drain in your iris (the colored portion of your eye) so that fluid will flow out of your eye more easily. Subsequent to your surgery, you may observe a small sector opening (a surgically created filtration area) near the edge of your iris. This opening or drain allows the eye fluid to reach the filtration area of your eye without opposition. By now you know the mechanics of glaucoma. If the fluid drains more easily, your eye pressure should be reduced. Since the fellow eye is always at great risk for developing angle closure glaucoma, your other eye will generally require the same surgical procedure soon after your first surgery. Close monitoring of your intraocular pressures, visual fields and optic nerves will be necessary throughout your lifetime. Find an eye care clinic to treat glaucoma. Top OPTIC NERVE HEAD ASSESSMENT My testing has noted that the appearance of the optic nerve in one or both of your eyes reveals conclusive glaucomatous change. One of the most accurate clinical evaluations of the disease of glaucoma is the careful study of the delicate tissues of the optic nerve head. We have also confirmed that this evaluation is consistent with your visual field loss. I will be following your progress very closely to monitor changes and to help prevent further vision loss. Find an eye care clinic to treat glaucoma. Top DAILY FLUCTUATIONS IN EYE PRESSURE Over the course of a day, the pressure in your eye may change as much as 3 to 6mmHg. This normal change in eye pressure is called the dinurnal variation. Patients with glaucoma, however, may have much wider swings in pressure than average. In most cases, the pressure in your eye is highest in the morning and lower during evening and sleeping hours. Most of these changes are caused by fluctuations in the rate of formation of the aqueous humor (the watery fluid that makes up the front part of the eye). Because pressure varies during the day, I want to measure your pressure at different times of the day to accurately monitor your progress. For those who have already been diagnosed with glaucoma, this will allow me to make certain that the medication you are taking to control eye pressure is keeping your pressure at a desirable point throughout the day and night. Find an eye care clinic to treat glaucoma. Top COMPUTER-ASSISTED VISUAL FIELD EXAMINATION (Perimetry) Perimetry (visual field testing) is one of the most important clinical functions of a complete eye examination. Perimetry refers to the testing of peripheral vision of the eye. Analysis of data from the visual field computer allows us to construct a map of the visual responses of your retina and other neurological tissues. This detailed map is called a visual field. Visual field testing gives the doctor essential information about major blindness-causing diseases. Field testing is a primary tool in diagnosing and monitoring glaucoma as well as many other ocular and neurological diseases. Comprehensive or threshold visual field testing allows early detection and close monitoring of the progress of these diseases, significantly enhancing the chances for successful treatment. Visual field testing is a fast and easy way to ensure that your eye examination includes the most sophisticated testing available. Modern computerized perimetry optimizes the chances for accurate results and effective eye care. Computer visual field testing can identify subtle problem areas long before symptoms arise or serious damage occurs. Find an eye care clinic to treat glaucoma. Top DIAGNOSTIC EVALUATION (Gonioscopy) Gonioscopy is an important examination technique used to evaluate otherwise hard-to-see anatomical features of the human eye. This early warning procedure is most commonly used in the careful diagnosis of a healthy eye from an eye with a tendency towards certain types of glaucoma. The gonioscopic procedure includes the administration of an anesthetic drop to facilitate complete patient comfort. This is followed by the placement of a special mirrored contact lens on the eye. This mirrored lens permits the observation of important structures of the eye that cannot be seen by conventional examination procedures. Most patients are apprehensive about something being placed on their eye; however, gonioscopy is a very comfortable procedure with no lasting side effects or inconveniences. Gonioscopy is a "side-view mirror" look into the fluid filtration angles of your eye. Find an eye care clinic to treat glaucoma. Top OPTIC NERVE STUDIES - RETINA TOMOGRAPH One of the most accurate evaluations of the disease of glaucoma or simply an evaluation of a person with risk factors categorizing them as a glaucoma suspect, is the careful study of the delicate tissues of the optic nerve head. With this test, called the retina tomograph, a single laser beam of light is directed onto the optic nerve on the back of the retina. The laser beam scans the optic nerve and feeds the information back to a computer for analysis. The tomograph procedure is absolutely painless and in just 1.6 seconds it records 32 segmented images of the optic nerve revealing two million points on the computer screen in full color. The retina tomograph provides us with the first truly objective live images of the interior of the eye. The measurement of eye pressure alone does not provide a conclusive evaluation of glaucoma. The data received from optic nerve head studies utilizing the retina tomograph is a dynamic breakthrough in the objective assessment of the glaucoma suspect as well as in the management and treatment of glaucoma. Find an eye care clinic to treat glaucoma. Top DARK ROOM PROVOCATIVE TEST To evaluate a patient with a strong predisposition for glaucoma, the provocative dark room or dark adaption test may help us determine if caution is advised. In this test, you will be placed in a dark room for 60-90 minutes and your eye pressures will be measured at regular intervals. If you have a tendency for developing closed angle (or narrow angle glaucoma), your eye pressure may rise during the procedure assisting us in evaluating your status. Find an eye care clinic to treat glaucoma. Top THINGS YOUR OPTOMETRISTS NEED TO KNOW The following is a partial listing of things we need to know prior to medical treatment of glaucoma. If any of these conditions apply to you, inform me or my staff immediately.
Find an eye care clinic to treat glaucoma. Top SHOPPING FOR MEDICATION Since the cost for your eye medication may vary by a factor of 2 between neighboring pharmacies, you may want to comparison shop for your eyedrops. Many of my patients have found that ordering by mail is very cost effective. If you decide to do this, inform my staff so that I can write out a prescription. It may be convenient to order several months' supply of medication at one time. Once you receive the medication, make sure you check the expiration date. If the medication has expired, return it to the pharmacist immediately. I generally recommend that you store unopened bottles of medication in the refrigerator. While this is unnecessary in most cases, it can prevent premature deterioration of the medication from heat and light. Find an eye care clinic to treat glaucoma. Top ORALLY ADMINISTERED BETA-BLOCKERS While a topical beta-blocker for glaucoma is frequently used in addition to a systemic beta-blocker used for high blood pressure or chest pain, it is very important for you to report to me now or in the future if you are placed on a systemic beta-blocker. The following lists some of these systemic medications:
Find an Glaucoma eye care clinic to treat glaucoma. Top |
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