Talking about Glaucoma

Open-angle glaucoma, the most common form of glaucoma, affects about 3 million Americans. Half of these people do not even know that they have glaucoma. While there is no current cure for glaucoma, earyl detection and treatment can help prevent further loss of vision and blindness. Glaucoma is an eye disease in which the normal fluid pressure inside the eyes slowly rises, which can lead to vision loss, or even blindness. At the front of the eye there is a space called the anterior chamber. Clear fluid (aqueous fluid) continuously flows in and out of this space and drains out of the eye. In glaucoma, the fluid drains too slowly out of the eye or too much is produced. As the fluid builds up, the pressure inside the eye rises. Unless this pressure is controlled, it may cause damage to the optic nerve and cause vision loss. Early in the disease process Glaucoma has no noticeable symptoms. Vision stays normal and there is no associated pain. As glaucoma remains untreated, people often notice that they see things clearly in front of them, yet they cannot see objects to the side and out of the corner of their eye.Without treatment, people with glaucoma may find that they suddenly have no side vision. It may seem as though they are looking through a tunnel. Over time, the remaining forward vision may diminish until there is no vision left.

Open angle glaucoma treatment concentrates on lowering the pressure inside the eye to prevent damage to the optic nerve. The most common treatments for glaucoma have been use of medications usually in the form of eye drops and laser treatment. Laser treatments and some medications allow for faster drainage of the aqueous fluid, while other medications reduce the amount of aqueous fluid produced. If medications and laser fail to reduce the pressure to an adequate level incision surgery may be required to create a new drainage channel. Because some medications may cause undesirable side effects or simply fail to reduce the eye pressure enough laser therapy may provide a better alternative. With traditional argon laser trabeculoplasty (ALT) small evenly spaced burns are made in the trabecular meshwork, the drainage area of the eye. These burns facilitate the drainage of fluid from the eye. However because of scarring from the ALT burns the success of ALT may be limited and it may prevent the repetition of the treatment.

Selective laser trabeculoplasty (SLT) is an advanced type of laser treatment to manage glaucoma. Instead of burning tissue as in ALT, SLT selectively changes only specified pigmented cells in the trabecular meshwork to achieve the improved drainage of fluid. Both SLT and ALT produce similar results in terms of pressure lowering however SLT is generally more gently and does not produce the scarring seen with ALT. The lack of scarring allows for repetition of SLT when necessary. The SLT treatment is performed in the office and takes only about 5 minutes to complete. SLT as well as laser iridotomies which are performed for angle closure glaucoma are performed in office in our Riverhead, Smithtown and Southampton offices as well as our outpatient surgical facility. With now eight offices and evening and Saturday hours, Dr. Bainnson and the other board certified ophthalmologists are available for consultation.

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