Monitoring Glaucoma: The key to preventing further vision loss
Carefully monitoring the progression of your glaucoma is a significant step in preventing vision loss. Subtle changes that occur in the eye which may not be noticeable to you, must be detected promptly to prevent vision loss. As a patient of the Glaucoma Program at Tyson Eye, you may be asked to return to see your doctor every three months, depending on your stage of glaucoma. At these visits, different diagnostic tests will be performed and compared to the results of your previous tests. These tests are done using state-of-the-art equipment, most of which is computer assisted and capable of providing greatly detailed information about the health of your eyes and your optic nerves. The Tyson Eye Glaucoma Program is a recommended plan to monitor the progression of glaucoma. It is similar to the programs at most major university eye departments. On the next page is the recommended schedule for monitoring the disease.
As a glaucoma patient at Tyson Eye, you are one of many patients that are part of the only structured Glaucoma Program in Southwest Florida. We understand the importance of preserving your precious vision and want to do everything in our power to help you escape the damage caused by â€śthe silent thief of sight,â€ť also known as glaucoma.
What you can do to protect your sight from glaucoma:
- Follow the recommended pressure check regimen prescribed by your doctor. Be sure to schedule your appointments and return to the office for your scheduled pressure checks and eye examinations.
- Use your medications as directed at all times.Stay informed and learn as much as you can about glaucoma.
- Call the Glaucoma Program Team at Tyson Eye if you have any questions or concerns.
Goals of our Glaucoma Program
- To provide a customized treatment plan to monitor the progression of your glaucoma.
- To provide state-of-the-art technology while maintaining the old-fashioned concern for which Tyson Eye is recognized.
- To deliver to all of our patients long-term maximum preservation of vision. We understand your eye-sight is precious.
- To provide a specialized team of ophthalmic professionals dedicated to monitoring your compliance.
- To create accessibility and familiarity with our staff so that you have answers to all of your questions.
The Tyson Eye
Glaucoma Program Schedule
(Based on programs at major university eye departments)
Treatment Options for Glaucoma
iStentÂ® Ostende TrabecularMicro-Bypass
iStent is the first device that improves your eyeâ€™s natural fluid outflow to safely lower eye pressure by creating a permanent opening in the eye meshwork. Proven safe and effective, the iStent Trabecular Micro-Bypass:
- Implanted during cataract surgery
- Spares important eye tissue that is often dam-aged by traditional surgeries
- Does not limit treatment options that could help maintain your vision in the future
iStent is the smallest medical device ever approved by the FDA for treatment of mild to moderate open angle glaucoma. It is placed in your eye during cataract surgery and is so small that you wonâ€™t be able to see or feel it after the procedure is over. iStent is the first device that improves your eye’s natural fluid output to safely lower eye pressure by creating a permanent opening in your trabecular meshwork.
For patients with combined cataract and open angle glaucoma, iStent reduces intraocular pressure (IOP) by improving aqueous humor outflow. Inserted through a 1.5-mm corneal incision, iStent is the only FDA-approved device for the treatment of mild to moderate open-angle glaucoma.
Endoscopic CycloPhotocoagulation or ECP, is an exciting development in the management of many types of glaucoma including the more common open-angle glaucoma and narrow-angle glaucoma. ECP is performed on an outpatient basis.
ECP is often performed on patients at the time of cataract surgery or afterward. It can also be performed on those patients who had SLT or ALT laser procedures, glaucoma filtration surgery or other surgical procedures that were not successful at controlling intraocular pressure.
The ciliary body is a small gland running around the circumference of the eye located behind the iris, which creates fluid. In this procedure, the ciliary body is treated with a laser. This reduces fluid production that in turn, reduces intraocular pressure. It should not be done on a patient who has not had their cataracts removed.
This state-of-the-art technology uses a laser beam and camera to treat glaucoma by targeting the ciliary body. Studies have shown that the majority of patients have their glaucoma medications reduced or completely eliminated after the procedure.
Tyson Eye is one of only two Eye Centers in the country where surgeons are trained in Endoscopic CycloPhotocoagulation (ECP).
Eye drops can be used effectively to help maintain and keep your eye at a healthy eye pressure and are an important part of the treatment routine for most people with glaucoma. A variety of glaucoma eye drops are now available by prescription that either increase the drainage of the aqueous humor or slow its production. Sometimes a combination of eye drops is prescribed to obtain the best results.
Various lasers are available to treat the different types of glaucoma. In the United States, laser treatment is growing in popularity as the primary treatment for glaucoma, even over eye drop medications. In many cases, it reduces or eliminates the need for daily drops, a necessary daily ritual that many find expensive and undesirable.
- Selective Laser Trabeculoplasty (SLT)
One of the newest advances in treating open-angle glaucoma. Similar to the ALT, this laser works on the trabecular meshwork to improve drainage. It selects only certain cells to minimize damage to surrounding cells and can be repeated several times if needed. It is appropriate for patients who have or have not had their cataracts removed.
- Argon Laser Trabeculoplasty (ALT)
A five to ten minute in-office procedure used to treat open angle glaucoma. The treatment is usually painless and should only be done twice per eye in your lifetime. The laser produces a high energy beam which turns into heat when it reaches the trabecular meshwork. This laser is being replaced with the SLT in most ophthalmology practices.
- Laser Peripheral Iridotomy (LPI)
This type of laser surgery is used to treat narrow angle glaucoma. This laser treatment involves making a tiny hole in the iris to allow improved drainage of the aqueous humor.
Seldom used today due to new advances in laser treatment for glaucoma, these traditional surgical procedures are usually turned to as a last resort when all other treatment methods have failed to slow the progression of the glaucoma. These surgical procedures must be done in an operating room under sterile conditions to minimize the risk of infection and complications.
Trabeculectomy or “filtering surgery,” involves removing a piece of tissue from the sclera (the white part of your eye). This creates a “flap valve” in the trabecular meshwork. This new pathway allows fluid to flow out more easily. This fluid pools in a little bubble under the eyelid, called a “bleb.” There, it is reabsorbed into the body via the circulatory system. Your surgeon may elect to insert a tube shunt to prevent the bleb from closing.
It is similar to the Trabeculectomy, but it does not require a bleb. It redistributes fluid internally and is sometimes referred to as the “non-penetrating” glaucoma surgery. A deep piece of the sclera is removed which creates a new internal channel through which fluid can now leave the eye. It allows fluid to drain out slowly, which is better for the anterior chamber (if it drains too quickly it could leave the anterior chamber flat).