Seeing clearly after glaucoma

May 4, 2009 TYPES: Primary open-angle glaucoma happens when microscopic drainage channels in the eye called the trabecular meshwork are partially obstructed, causing fluid to drain out of the eye too slowly. This type of glaucoma is painless and slow-progressing. In angle-closure glaucoma, or closed-angle glaucoma, the iris bulges forward so far it blocks drainage of fluid from the eye. This kind of glaucoma usually occurs suddenly and can be triggered by sudden dilation of the pupils in response to darkness, stress, excitement or certain medications. Two other forms of this condition are low-tension glaucoma and pigmentary glaucoma. In low-tension, damage to the optic nerve takes place even though eye pressure stays normal. In pigmentary, pigment granules arise from the iris and build up on the trabecular meshwork.

SYMPTOMS: To catch glaucoma early, watch out for symptoms like failing side vision. This means objects to the side are hard or impossible to see. As glaucoma worsens, this field of vision slowly narrows. The best way to prevent glaucoma from reaching an inoperable point is to visit the eye doctor regularly. The "air puff" test and pupil dilation are both ways eye doctors look for signs of the disease.

TRADITIONAL TREATMENT: Although open-angle glaucoma can't be cured, it can be controlled through medication, laser surgery or traditional surgery. Medications work from both ends. Some slow the flow of fluid into the eye while others improve fluid drainage out of the eye. In laser surgery, a strong beam of light is used to alter the anterior chamber where fluid leaves the eye to improve flow out of the eye. For patients who won't respond to medications or laser surgery, conventional surgery is sometimes recommended. During surgery, the surgeon makes small injections around the eye to numb it and removes a small piece of tissue from the eye to create a new channel for fluid drainage. The National Eye Institute says this type of surgery is about 60 to 80 percent effective at lowering eye pressure.

A NEW OPTION: A new device allows eye surgeons to use electrical ablation rather than a scalpel to remove tissue from the eye. Called Trabectome, it works best on patients in the early to moderate stages of glaucoma. After the Trabectome procedure, patients can go home the same day and return to normal activity in about one week.


Judy Martin
Media Relations
Washington University School of Medicine
St. Louis, MO
(314) 286-0105

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