Glaucoma Diagnosis and Treatment in Oklahoma City

What Is Glaucoma?

Glaucoma is a family of diseases affecting the optic nerve, often associated with increased pressure within the eye. When glaucoma damages the optic nerve, visual information from the retina is impeded from reaching the vision centers of your brain. As the optic nerve is damaged over time, blind spots may appear in your peripheral vision, and your central vision will eventually be affected as well. Glaucoma is one of the leading causes of blindness in the United States and the leading cause of blindness among Blacks/African-Americans. Unfortunately, symptoms usually do not become evident until vision is severely damaged. Dean McGee Eye Institute eye care specialists diagnose and treat patients in Oklahoma City and the surrounding areas with glaucoma. If caught early, we can prevent permanent vision loss and control the disease.

What Causes Glaucoma?

The exact cause of glaucoma is still not entirely known, but we have identified many risk factors. One of the most significant risk factors for glaucoma is increased pressure within the eye. This occurs when there is a buildup of fluid, called aqueous humor, which flows throughout the front portion of the inside of your eye. Aqueous humor is necessary to maintain the eye’s shape and maintain the function of the optically clear parts of the eye, including the lens and cornea. Aqueous humor is drained mostly through a tissue called the trabecular meshwork. If the fluid does not drain properly, it can lead to increased pressure within your eye. As the pressure increases, it can damage your optic nerve and potentially lead to blindness.

Is Glaucoma Hereditary?

The most common type of glaucoma, primary open-angle glaucoma, occurs more often in people whose family members have glaucoma. If multiple immediate family members have glaucoma, your risk increases four to nine times. Some families carry genes directly related to high eye pressure and optic nerve damage.If you are aware of the risk, you can take early action to minimize developing glaucoma in the future.

Other Risk Factors for Glaucoma

Other risk factors for developing glaucoma include:

• Being over the age of 60
• Being Black, Asian, or Hispanic
• Extreme nearsightedness or farsightedness
• Using steroid eye drops for long periods
• Experiencing certain eye injuries or eye surgeries
• Having corneas that are thin in the center

Types of Glaucoma

Most ophthalmologists divide glaucoma into the two major categories of open-angle and closed-angle glaucoma. Within these two categories, there are many types of glaucoma that may have particular characteristics and age of onset.

• Open-Angle Glaucoma – The most common form of glaucoma, open-angle glaucoma, happens when the drainage angle of the eye where the iris meets the cornea is open, but does not work properly. Open-angle glaucoma usually has no symptoms until damage to the optic nerve is more severe.
• Angle-Closure Glaucoma (also called closed-angle glaucoma or narrow-angle glaucoma) – In angle-closure glaucoma, the drainage angle is usually blocked by the iris, which prevents drainage of fluid, known as aqueous humor, inside the eye. In acute cases, it develops very quickly, causing noticeable symptoms and significant damage requiring immediate intervention.

Glaucoma Treatment Options

In its early stages, glaucoma can be difficult to diagnose. If caught early during a glaucoma evaluation, it can be controlled to help prevent permanent vision loss. If you are diagnosed with glaucoma, you will generally need treatment for the rest of your life to prevent progression of the disease. Treatments for glaucoma focus on decreasing intraocular pressure to prevent damage to the optic nerve and the loss of vision or blindness that can result. Depending on the severity of your glaucoma, your ophthalmologist may recommend a combination of the following treatment options:

• Eye Drops – Eye drops can reduce intraocular pressure by either reducing the rate of fluid production in the eye or increasing the outflow of fluid from the eye.
• Laser Treatments – The object of laser treatments for glaucoma, such as laser iridotomy or laser trabeculoplasty, is to improve drainage of fluid from the eye and reduce intraocular pressure. The choice of procedure depends on the type of glaucoma and its severity. Laser iridotomy and laser trabeculoplasty are often done in the office and are relatively painless. Laser cyclophotocoagulation reduces the amount of fluid made by the eye, is generally employed for more advanced glaucoma, and is typically performed in a surgery center setting.
• Glaucoma Surgery – Incisional surgical options may be explored if your glaucoma cannot be controlled by medication or laser treatments. Such surgical approaches include minimally invasive glaucoma surgery (MIGS), trabeculectomy, or aqueous shunt placement.

Glaucoma Research from Dean McGee

The Dean McGee Eye Institute is involved in several areas of clinical research, including glaucoma. Below you can learn about the ongoing glaucoma trials conducted by the clinical researchers at DMEI.

Study Name: Phase 3b Study to Evaluate the Duration of Effect of Bimatoprost SR (TRITON)
Condition(s) under Study: Open-angle Glaucoma or Ocular Hypertension
Sponsor: Allergan
Study Summary: To evaluate the duration of intraocular pressure lowering effect and safety of up to three administrations of bimatoprost SR. Administration is accomplished via intracameral implant of a biodegradable polymer.
Principal Investigator(s): Mahmoud A. Khaimi, MD

Co-Investigator(s): Andrew K. Bailey, MD
ClinicalTrials.gov Information: NCT03850782