Dr. Kent Bashford and Dr. Josh Apple are our fellowship trained glaucoma specialists. Their experience allows them to treat even the most severe cases of glaucoma and are the only fellowship trained glaucoma specialists in Northern Colorado. Our doctors are also in multiple nationwide FDA clinical studies on the management of intraocular pressure.
The doctors at The Eye Center of Northern Colorado are experienced in the treatment of all stages of glaucoma. We use the most advanced technology available to detect and diagnose glaucoma and the latest medications and surgical techniques to preserve your vision. We are available for consultation, second opinions and management of your glaucoma.
1. What is Glaucoma?
Glaucoma is a disease that damages the optic nerve. Over 3 million Americans (65 million people worldwide) are affected by glaucoma. Half of those with glaucoma are not aware of it. Glaucoma has been called the “silent thief of sight” because there are no warning signs until significant nerve damage and vision loss has occurred.
As the optic nerve degenerates, blind spots develop in the peripheral (side) vision. Because the blind spots are usually in the outer visual field, they go unnoticed. The most common cause of nerve damage is high intraocular pressure (eye pressure). Once the nerve is damaged, it cannot be replaced or repaired. With early detection and proper treatment, total blindness from glaucoma is uncommon.
2. Who is at risk for Glaucoma?
Everyone has some risk of glaucoma. It is important for everyone to have routine eye exams to look for the early signs of glaucoma. The risk for glaucoma is increased with these risk factors:
- Higher eye pressure
- Family history of glaucoma
- African-American, Asian or Hispanic descent
- Over 45 years of age
- Past eye injury
- Severe nearsightedness
- Other medical conditions – diabetes, migraines, poor circulation
- Use of steroid medications
3. What causes Glaucoma?
There are many causes of glaucoma, some we understand and some we do not. The most common cause is high intraocular pressure. The eye is full of fluid called the aqueous humor. The eye is constantly making this fluid and draining this fluid. Fluid is drained out of the eye through a filter, called the trabecular meshwork. If the filter (meshwork) in the eye is clogged, fluid cannot drain properly and the eye pressure rises. As the eye pressure rises, it pushes on the optic nerve and can cause the nerve to be damaged.
There are 2 main types of glaucoma that are named for the different ways fluid outflow is reduced.
- Open Angle Glaucoma is the most common type of glaucoma in the United States, Europe and Africa. In open angle glaucoma, the meshwork appears normal but does not allow fluid to pass through adequately.
- Closed Angle Glaucoma is more common in Asia than in the United States. In closed angle glaucoma, the iris blocks the meshwork decreasing the outflow of fluid from the eye. This can rapidly increase eye pressure causing pain and immediate loss of vision. This can also happen slowly without pain and a slow loss of vision.
4. Symptoms of Glaucoma
Unfortunately, most glaucoma has no noticeable early symptoms. Usually, the eye pressure is not high enough to “feel” unless it is very high. Vision loss usually takes years to progress to the point someone can notice the blind spots.
Symptoms of glaucoma can include blurring of vision, halos around lights and a feeling of pressure or pain around the eye. This usually occurs from wide fluctuations in eye pressure or a rapid rise in eye pressure.
5. Treating Glaucoma
Most glaucoma treatments are aimed at consistently lowering intraocular pressure. Eye drops, oral medications, laser treatment and surgery can be used to lower intraocular pressure. These treatments do not cure glaucoma, but help control the disease.
Eye drops are the most common treatment for glaucoma. Eye drops work to either decrease the amount of fluid the eye makes or increase the outflow of fluid. It is important to use eye drops as they are prescribed and to not miss doses. Oral medications are some of the most powerful ways to lower intraocular pressure. They carry certain side effects that limit long term use.
Lasers are available to help lower eye pressure. Laser trabeculoplasty is the most common laser used for glaucoma and can be used in the early or middle stages of the disease. Lasers can often decrease or eliminate the need for eye drops.
Surgery is available when medicines and lasers do not control the intraocular pressure. The most common types of glaucoma surgery either enhance the natural passageway for fluid to flow out of the eye or create a new passageway for fluid to flow out of the eye. Sometimes a tube or shunt is used to direct fluid out of the eye.
6. Eye Drops – How to use
Eye Drop Technique
- Wash hands and obtain a clean tissue
- Confirm the drop bottle is the correct medication
- Remove the cap and be careful not to touch the tip to anything
- Tilt head back or lie down
- Use the forefinger of one hand to pull down the lower eyelid
- Look up and squeeze the bottle until a drop is released into your eye. If some of the drop runs out of your eye, that is okay.
- Close your eye for 3-5 minutes. Try not to blink.
If taking more than 1 medication, wait at least 5 minutes between drops. This will decrease the chance of washing out the first drop.