An Optic Nerve Disease: Glaucoma

Glaucoma is a group of eye conditions that damages the optic nerve.

What is Glaucoma?

The optic nerve consists of 1.2 million neurons that transmit information from the eye to the brain.  The optic nerve is an extension of the brain and its function is dependent on a number of factors.  Many different processes can affect the nerve over the course of our lives. One of the most common conditions of the nerve is called glaucoma. 

Glaucoma is a group of eye conditions that damage the optic nerve. Glaucoma is often associated with abnormally high intraocular pressure, which occurs when either too much fluid is produced in the eye or the drainage or outflow channels (trabecular meshwork) of the eye become blocked. This causes irreversible damage to the optic nerve and may lead to permanent loss of vision. Traditionally, there has been emphasis on intraocular pressures for the initial diagnosis and management of glaucoma.  More recently, the progression of glaucoma at normal eye pressures has been identified and now constitutes the majority of patients.

At South Bay Retina, we monitor for functional changes in the nerve before structural changes occur. Even if you have normal pressures, you may have early-stage glaucoma.

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What are the Symptoms?

Glaucoma does not typically cause many symptoms in its earliest stages, and many patients wait until they are experiencing significant problems with their vision until they seek help. Unfortunately, there is no cure for glaucoma. However, when optic nerve diseases, such as glaucoma, are detected in its earliest stages, treatment can be effective in preserving the patient’s eyesight for a much longer period of time. If you are noticing a decrease in night vision and blind spots, it is important to schedule an appointment to check your optic nerve.

What are the Risk Factors?

  • High or Low Blood Pressure
  • Diabetes
  • Myopia
  • Large Cup to Disc Ratios
  • Family History or Ethnicity
  • Thyroid Disease
  • Ocular Injuries
  • Chronic Steroid Use
  • B12 Deficiency

Are Certain People More Likely to Get Glaucoma?

There are certain health conditions and risk factors that make it more likely for some people to develop glaucoma. These include being older than 40, having a genetic predisposition, or being nearsighted or farsighted. Individuals who are of African, Hispanic, or Asian heritage are also more likely to develop glaucoma.

If you are over the age of 40 we recommend that you receive an annual eye exam, and if you have a family history of serious eye disease, it may become beneficial to get one every six months.

Schedule Integrative Glaucoma Treatment

Effective glaucoma treatment can help to slow the deterioration of your eyesight and extend the amount of time that you enjoy clear vision. Debilitating conditions such as glaucoma are a strong example of the importance of regular eye exams. This disease is often imperceptible to the patient and is detected via a comprehensive eye exam. As we grow older our eyes can begin to deteriorate and serious conditions such as glaucoma can begin to develop.

With early management, surgery is usually not necessary and is reserved for only the most severe cases. Selective laser trabeculoplasty (SLT) was developed as a non-destructive laser treatment for glaucoma that could be repeated without damage to the trabecular meshwork (the drainage system of the eye). SLT delivers short bursts of low-fluence laser energy targeting melanosomes and triggering the release of cytokines in the trabecular meshwork. Cytokines contribute to tissue repair and intercellular communication processes. This, in turn, reduces the progression of glaucoma.

Although this has been postulated to improve outflow and reduce IOP, the potential benefits of SLT are not dependent on treating ocular hypertension. Rather than relying on late indicators of glaucoma such as changes to the nerve structure and increased pressures, we utilize VEP as a putative early metric for glaucoma. SLT is beneficial at earlier stages of glaucomatous nerve dysfunction before permanent structural damage to the nerve occurs.

Additional treatments include Peripheral Iridotomy (PI), oral medications, and eye drops.

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What can I Expect During Selective Laser Trabeculoplasty (SLT) Treatments?

A special contact lens is placed on the numbed eye. Dr. Narain will then apply the laser precisely adjusted to prevent burning or damage into the eye through a mirrored lens. The procedure lasts about 10 minutes. Post-op intraocular pressure (IOP) is measured to make sure the pressure is stable. SLT is expected to lower IOP by 30% from baseline in 80% of patients. A decrease in IOP can take up to 2-3 months and typically lasts for more than one year. More critical than pressure, we hope to see that the nerve continues to function normally and does not deteriorate over time.

SLT can treat glaucoma with many fewer side effects than eye drop medications. In general, SLT appears to be safer and more effective than these pharmaceutical agents.

Request an Appointment in San Jose or Gilroy, California

Early detection, diagnosis, and treatment can lead to the effective management of this incurable disease and the team at South Bay Retina are proud to provide a level of service that allows our patients to successfully manage this disease. Schedule at one of our two locations in the South Bay: San Jose and Gilroy. Call (408) 294-3534 for our San Jose and Gilroy office. You can also schedule an appointment online, using the button below.

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Treatments for An Optic Nerve Disease: Glaucoma


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