Glaucoma is a leading cause of undetected vision loss in patients. Glaucoma occurs when the pressure inside the eye remains elevated for a prolonged period of time, subsequently resulting in damage to the optic nerve. Periodic eye exams are critical in following the progression of the disease with specialized testing playing an integral part. At Valley Eye Institute we offer the most sophisticated testing equipment such as Pascal Tonometry, and Visual Field Testing to provide necessary information on the stability of the glaucoma.
Open-angle glaucoma is the most common form of the disease and accounts for 90% of cases. This condition can go undetected for a number of years because there is no pain or discomfort, but damage is slowly being done to the eye.
Early stages of open-angle glaucoma are treated with eye drops to lower eye pressure. Alternative methods of reducing intraocular pressure include a laser procedure called SLT or Selective Laser Trabeculoplasty. This consists of a brief laser treatment to the eye’s drainage mechanism to reduce the pressure. It may be used either as a primary or adjunctive form of therapy. The pressure-lowering effects are generally seen within a few weeks following the treatment.
Angle-closure glaucoma is the less common form of glaucoma that affects less than 10 percent of patients. Onset is usually much faster and symptoms more severe than open-angle glaucoma. This is a potentially vision-threatening condition which requires immediate treatment with a laser surgical procedure.
Treatment For Glaucoma
ExPRESS mini shunt
The Ex-PRESS mini shunt is a straightforward procedure, in which you divert the fluid through an extremely small tube to the outside of the eye. Although the device is as small as a grain of rice, it acts just like a heart stent keeping a pathway open so blood or fluid can successfully go around the blockage. The Ex-PRESS provides precise control of the amount of fluid that is allowed to flow out helping the eye maintain a healthy level of internal pressure. The Express Mini-Shunt is a device that is available as an alternate to traditional glaucoma filtering (Trabeculectomy) surgery.
iStent is the first MIGS device that improves your eye’s natural fluid outflow to safely lower eye pressure by creating a permanent opening in the trabecular meshwork. Proven safe and effective, the iStent Trabecular Micro-Bypass:
- Is safely implanted during cataract surgery
- Spares important eye tissue that is often damaged 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.
At Valley Eye, patients with glaucoma that are having cataract surgery also undergo an additional procedure called ECP or Endo-laser. This laser treatment is a brief 5 minute procedure performed during the cataract removal that acts to reduce the amount of fluid being produced inside the eye with a subsequent reduction of intraocular pressure of approximately 30%. Dr. Stark was one of the first Ophthalmologists in Ohio to perform the ECP procedure, with 70% of patients being able to reduce or eliminate their glaucoma drops post-operatively.
Patients with advanced or uncontrolled glaucoma requiring additional pressure-lowering are offered the option of having the “Express Mini-Shunt” and/or Trans-Ciliary Filtration (TCF) using the Fugo Blade (plasma blade) to create a filtration site for fluid to move safely from inside to outside the eye.