Dulles Eye Associates

tel:  (703) 723-9633  |  fax:  703-723-9772

Glaucoma

 

Glaucoma is an eye disease that gradually causes loss of peripheral vision without symptoms and over time advance to total blindness.  There are typically no early warning signs or painful symptoms of open-angle glaucoma. It develops slowly and sometimes without noticeable sight loss for many years.

Most people who have open-angle glaucoma feel fine and do not notice a change in their vision at first because the initial loss of vision is of side or peripheral vision, and the visual acuity or sharpness of vision is maintained until late in the disease.

By the time a patient is aware of vision loss, the disease is usually quite advanced. Without proper treatment, glaucoma can lead to blindness. The good news is that with regular eye exams, early detection, and treatment, you can preserve your vision.

Increased Risk

You are at increased risk for glaucoma if your parents or siblings have the disease, if you are African American or Latino, and possibly if you are diabetic or have cardiovascular disease. The risk of glaucoma also increases with age.  The only way to know your risk of developing glaucoma is to schedule an eye exam with a trained and board certified physician.

 

Treatment:

 

1) Glaucoma drops:  Most patients that have multiple risks for glaucoma or with signs of glaucoma will be placed on one or multiple drops

 

2) Laser: Based on your type and severity of glaucoma your doctor may suggest a laser procedure.  This is a very different laser technology than lasik

 

a. Selective Laser Trabeculoplasty (SLT)- SLT is the most advanced laser procedure available today.  It does not involve thermal injury or burn but rather cooling properties are used to allow an immune response to open channels and lower eye pressure.  This is invaluble because the delicate tissues that drain fluid from the eye are not damaged but only expanded.  Also after a few years this can be repeated.   SLT laser technology is available at Dulles Eye Associates so please speak to your eye care professional if you would like a consultation.

b. Laser Peripheral Iridotomy (LPI)- Laser iridotomy is a surgical procedure that is performed on the eye to treat angle closure glaucoma or narrow angle glaucoma.  Angle closure of the eye occurs when the trabecular meshwork, the drainage site for ocular fluid, is blocked by the iris. During an LPI a small hole is made in the iris of the eye, changing its configuration. When this occurs, the iris moves away from the trabecular meshwork, and proper drainage of the intraocular fluid is enabled.  Narrow angle glaucoma may also have no symptoms but some may have early morning headaches, haloes, and transient blurry vision.  Even if no symptoms your eye care professional will evaluate if you have narrow angles and if so will likely recommend LPI for prophylactic treatment.

3) Surgery:

a. Trabeculectomy: A Filtration procedure allowing fluid in the eye to filter through a surgery developed channel. This is the most common surgical treatment currently used to treat advanced glaucoma

b. Glaucoma Valve or Tube:  This surgery uses the same concept as trabeculectomy to create a channel but rather than a filter a tube is inserted to track fluid out of the eye.

c. Glaukos Micro-Invasive Istent Technology:  An exciting new modality for glaucoma that is being offered at Dulles Eye Associates at the same time as your cataract surgery.

The Istent is the smallest FDA approved device implanted in the body. 

 

The procedure is done during cataract surgery and typically adds 10 minutes to the procedure but for most people with mild to moderate glaucoma may lower pressure enough to lessen burden of drops or take away need for further surgery.  The risk profile is very low but the benefit may be life long.  If you have glaucoma and are considering cataract surgery make sure that you do not miss this opportunity to reduce your risk of permanent vision loss from glaucoma while improving your vision with cataract surgery.  Our Surgeons at Dulles Eye Associates are trained and certified in this advanced technology.

 

Macular Degeneration

 

The macula is the center of our vision and accounts for roughly 80-90 percent of our central vision.  Macular degeneration is a condition where cellular debris collects in the retina leading to distortion in a patients vision.  Two forms exist:

1) Dry Macular Degeneration: this is the more common form and usually does not cause symptoms initially.  Over time subtle distortions can occur and images may have a waviness or a loss of clarity.  In severe cases patients central vision may decline leading to very blurry vision.  Currently no treatment is available but progression has been showed to lessen in patients taking certain formula of vitamins namely AREDS formula.

2) Wet Macular Degeneration:  this form is far less common and can co-inside with the dry form.  Patients may notice a sudden distortion in vision alarming them to come to see an eye professional.  The ‘wet’ form is named for a break in the retina leading to bleeding in the back of the eye.  Recently the discovery of VEGF inhibitors has revolutionized the treatment of Wet AMD.  These injections can alter and even restore vision in many patients who would have otherwise had no other options.

Most importantly in any patient experiencing a change in vision or has not had an eye exam by a board-certified eye physician in over a year should schedule an appointment to ensure eye health.

 

Eye Disease, Retinal Disease & Diabetes:

 

 There are many diseases that can affect the Eye and limit vision permanently .  It is important that you see a board certified eye professional if you have any concerns about your vision or have:

-Diabetes

-High Blood Pressure

-Autoimmune disease including Rheumatoid Arthritis and lupus

-Taking medications like plaquinel (hydroxychloriquine) & certain chemotherapeutics

-Seeing any floaters or flashes or blurred vision

Our doctors at Dulles Eye Associates have a caring and compassionate view to each person that comes to our office for care.  No issue is too small or large for our doctors!

 

 

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