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Open Angle Glaucoma at
The McMann Eye Institute
It is estimated that over two million Americans have some type
of glaucoma and half of them do not know it. Ninety percent of
glaucoma patients have open-angle glaucoma.
Although it cannot be
cured, it can usually be controlled.
Vision loss may be
minimized with early treatment.
The eye receives its nourishment from a clear fluid that
circulates inside the eye.
Fluid circulating inside eye
This fluid must be constantly returned to the blood stream
through the eye's drainage canal, called the trabecular
meshwork. In the case of
open-angle glaucoma, something has gone wrong with the drainage
canal. When the fluid
cannot drain fast enough, pressure inside the eye begins to
build.
Excess fluid builds pressure
This excess fluid pressure pushes against the delicate optic
nerve that connects the eye to the brain.
If the pressure remains
too high for too long, irreversible vision loss can occur.
Excess fluid pressure pushes
against the optic nerve
Symptoms of open-angle glaucoma:
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In the early stages, there are no symptoms.
There is no pain or
outward sign of trouble.
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Mild aching in the eyes
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Gradual loss of peripheral vision (the top, sides and bottom
areas of vision)
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Seeing halos around lights
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Reduced visual acuity (especially at night, that is not
correctable with glasses)
Who is at risk
Glaucoma can occur in people of all races at any age.
However, the likelihood
of developing glaucoma increases if you:
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are of Filipino, Japanese, Pacific Islander or African
American decent
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have a relative with glaucoma
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are diabetic
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are very nearsighted
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are over 35 years of age
Diagnosing open-angle glaucoma:
Everyone should be checked for glaucoma at around age 35 and
again at age 40. Those considered to be at higher risk,
including those over the age of 60 should have their pressure
checked every year or two.
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Dr. McMann
will use tonometry to check your eye pressure. After
applying numbing drops, the tonometer is gently pressed
against the eye and its resistance is measured and
recorded.
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Tonometry is used to check your eye pressure
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An ophthalmoscope can be used to examine the shape and
color of your optic nerve. The ophthalmoscope magnifies
and lights up the inside of the eye. If the optic nerve
appears to be cupped or is not a healthy pink color,
additional tests will be run.
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An ophthalmoscope is used to examine your optic
nerve
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Perimetry is a test that maps the field of vision.
Looking straight ahead into a white, bowl-shaped area,
you'll indicate when you're able to detect lights as
they are brought into your field of vision. This map
allows
Dr. McMann
to see any pattern of visual changes caused by the early
stages of glaucoma.
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Perimetry maps your field of vision
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Gonioscopy is used to check whether the angle where the
iris meets the cornea is open or closed. This helps
Dr. McMann
determine if he is dealing with open-angle glaucoma or
narrow-angle glaucoma.
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Goniscopy is used to help your glaucoma type
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Treatments for open-angle glaucoma:
To control glaucoma,
Dr. McMann
will use one of three basic types of treatment: medicines, laser
surgery, or filtration surgery. The
goal of treatment is to lower the pressure in the eye.
Medicines
come in pill and eye drop form. They work by either slowing the
production of fluid within the eye or by improving the flow
through the drainage meshwork. To
be effective, most glaucoma medications must be taken between
one to four times every day, without fail.
Some of these
medications have some undesirable side effects, so
Dr. McMann
will work with you to find a medication that controls your
pressure with the least amount of side effects.
Medicines should never
be stopped without consulting
Dr. McMann, and you should
notify all of your other doctors about the medications you are
taking.
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Glaucoma medication
comes in many forms
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Argon Laser Trabeculoplasty
and Selective Laser Trabeculoplasty surgery treat the
drainage canal. Requiring only numbing eye drops, the
laser beam is applied to the trabecular meshwork
resulting in an improved rate of drainage.
When laser surgery is successful, it may reduce the need
for daily medications.
Laser surgery can reduce
the need for daily medication
Filtration surgery
is performed when medicines and/or laser surgery are
unsuccessful in controlling eye pressure. During this
microscopic procedure, a new drainage channel is created to
allow fluid to drain from the eye.
Filtration surgery
McMann Eye Institute
“A Lifetime Commitment to Your Vision Health with the Spirit of
Aloha”
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