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Saint Johns, FL 32259

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Glaucoma

Glaucoma is a leading cause of preventable vision loss and blindness in adults in the United States and Canada and the second leading cause of blindness in the World.

What is Glaucoma?

Glaucoma is actually a group of eye diseases that cause damage to the optic nerve due to an increase in pressure inside the eye or intraocular pressure (IOP). When detected in the early stages, glaucoma can often be controlled, preventing severe vision loss and blindness. However, symptoms of noticeable vision loss often only occur once the disease has progressed. This is why glaucoma is called “the sneak thief of sight”. Unfortunately, once vision is lost from the disease, it usually can’t be restored.

Treatments include medication or surgery that can regulate the IOP and slow down the progression of the disease to prevent further vision loss. The type of treatment depends on the type and the cause of the glaucoma.

Risk Factors

Prevention is possible only with early detection and treatment. Since symptoms are often absent, regular eye exams which include a glaucoma screening are essential, particularly for individuals at risk of the disease. While anyone can get glaucoma, the following traits put you at a higher risk:

  • Age over 60
  • Hispanic or Latino descent, Asian descent
  • African Americans over the age of 40 (glaucoma is the leading cause of blindness in African Americans, 6-8 times more common than in Caucasians.)
  • Family history of glaucoma
  • Diabetics
  • People with severe nearsightedness
  • Certain medications (e.g. steroids)
  • Significant eye injury (even if it occurred in childhood)

Signs and Symptoms of Glaucoma: Due to a buildup of pressure in the eye, glaucoma causes damage to the optic nerve which is responsible for transmitting visual information from the eye to the brain. How does glaucoma affect your vision?

Types of Glaucoma: There are a number of types of glaucoma, some more acute than others. Learn about the common types of glaucoma and the differences between them.

Diagnosis and Treatment of Glaucoma: Early detection and treatment of glaucoma is essential to stopping or slowing the disease progression and saving vision. Treatment can include medicated eye drops, pills, laser procedures and minor surgical procedures depending on the type and stage of glaucoma.

Signs and Symptoms of Glaucoma

The intraocular pressure caused by glaucoma can slowly damage the optic nerve, causing a gradual loss in vision. Vision loss begins with peripheral (side) vision, resulting in limited tunnel vision. Over time if left untreated, central vision will also be affected which will increase until it eventually causes total blindness. Unfortunately any vision that is lost from the optic nerve damage cannot be restored.

What are the Symptoms?

Typically, glaucoma sets in without any symptoms. At the early onset of the most common type of glaucoma “open angle” glaucoma, vision remains normal and there is no pain or discomfort. This is why the disease is nicknamed the “sneak thief of sight”.

An acute type of glaucoma, called angle-closure glaucoma, can present sudden symptoms such as foggy, blurred vision, halos around lights, eye pain, headache and even nausea. This is a medical emergency and should be assessed immediately as the intraocular pressure can become extremely high and cause permanent damage within hours.

Types of Glaucoma

The primary forms of glaucoma are open-angle and narrow-angle, with open-angle being the most common type.

Primary open-angle glaucoma (POAG) gradually progresses without pain or noticeable vision loss initially affecting peripheral vision. By the time visual symptoms appear, irreparable damage has usually occurred, however the sooner treatment starts the more further vision loss can be prevented. When untreated, vision loss will eventually result in total loss of side vision (or tunnel vision) and eventually total vision loss.

Normal-tension glaucoma or low-tension glaucoma is another form of open-angle glaucoma in which the intraocular pressure remains within the normal level. The cause of this form of glaucoma is not known, but it is believed to have something to do with insufficient blood flow to the optic nerve, causing damage. Individuals of Japanese descent, women and those with a history of vascular disease or low blood pressure are at higher risk.

Angle-closure glaucoma can be a sudden increase in eye pressure causing severe pain, blurred vision, halos, nausea and headaches. The pressure is caused by a blockage in fluid at the front of the eye which is a medical emergency and should be treated immediately. Without prompt treatment to clear the blockage vision can be permanently lost.

Congenital glaucoma is an inherited form of the disease that is present at birth. The babies are born with a defect that slows the normal drainage of fluid out of the eye and are usually diagnosed by the time they turn one. In these cases there are typically some noticeable symptoms such as excessive tearing, cloudiness or haziness of the eyes, large or protruding eyes or light sensitivity. Surgery is usually performed with a very high success rate of restoring full vision.

Secondary glaucomas are complications that develop from eye surgeries, injuries or other medical conditions such as cataracts, tumors, or a condition called uveitis which causes inflammation. Uncontrolled high blood pressure or diabetes can result of another serious form called neovascular glaucoma.

Pigmentary glaucoma is a rare form in which pigment from the iris sheds and clogs the drainage of fluid from the eye resulting in inflammation and damage to the eye and drainage system. .

Treatment of glaucoma is dependant upon the severity and type of glaucoma present.

Glaucoma Diagnosis and Treatment

Detecting Glaucoma

During a routine comprehensive eye exam to check for glaucoma, your eye doctor will dilate your eye to examine the optic nerve for signs of glaucoma and will also measure the intraocular pressure (IOP) with an instrument called a tonometer. Tonometry involves numbing the eye with drops and then gently pressing on the surface of the eye to measure the pressure. Since your IOP can fluctuate throughout the day and glaucoma can exist without elevated IOP this is not enough to rule out the disease. If there are signs of the disease, further testing will be performed.

Visual Field Test

A visual field test is designed to detect any blind spots in your peripheral or side field of vision. You will be asked to place your head in front of a machine while looking ahead and indicate when you see a signal in your peripheral field of view.

Your doctor may also measure the thickness of the cornea with an ultrasonic wave instrument in a test called pachymetry or use imaging techniques such as digital retina scanning or optical coherence tomography (OCT) to create an image of your optic nerve to look for glaucoma damage.

Treating Glaucoma

Treatment for glaucoma depends on the type and severity of the disease and can include medication such as eye drops or pills or laser or traditional surgery.

Medication and drops to lower IOP are often the first resort for controlling pressure-related glaucoma. These drops may have some uncomfortable side effects, but compliance with the treatment plan is essential for preserving vision and halting the progression of the disease.

Surgical procedures are designed to control the flow of fluids through the eye by either decreasing the amount of fluid produced or improving the drainage. Your doctor may decide that a combination of surgery and medication will be the most effective in many cases.

It cannot be stressed enough that the most effective treatment for glaucoma happens when the disease is detected and treated early before significant vision loss occurs. Any vision that is lost can not be restored. This is why the best prevention is awareness by knowing your risks and taking responsibility by having your eyes examined on a regular basis.

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Update on COVID-19 (03/30/2020)

We wanted to thank you for your continued support of our office during this challenging time. We will continue to be open from 9:00am-1:00pm Monday through Friday to dispense contact lens and eyeglasses orders. We will also be able to order additional contact lenses for patients who may be running low.

While all routine eye care is still deferred during this time, we will remain available to triage eye emergencies. We will send out additional notifications as soon as it becomes possible to resume routine eyecare.

Please call or text us at (904)287-4567 or email us at cfec2@2drfishers.com with any questions for concerns.

*****CONTACT WEARERS*****

With the day to day changes surrounding COVID-19, we do not know how much longer we will be open to the public. With that being said, if you are a contact lens wearer, and currently have less than a 3 month supply of lenses, we highly recommend that you place an order now. We will offer free shipping on lenses directly to your home (with a minimum of 2 boxes). We will also extend contact lenses prescriptions, as needed, for those expiring within the next three months.

Please call or text us at (904)287-4567 or email us at cfec2@2drfishers.com.

Hours: As of March 30, we will be open from 9:00am – 1:00pm Monday through Friday only to dispense contact lens and eyeglass orders. We will have a doctor available to see ocular emergencies if needed.

Routine Eye Exams: If you are scheduled for a routine eye examination appointment during our closure, we will reschedule your appointment. As of March 30, 2020, we will begin rescheduling routine eye examination appointments for April 13th and later.

I need to replace my glasses. What do I do? Please contact us at (904)287-4567. We may be able to extend your prescription during this time and will help you with your eyewear needs.

I’m nearly out of contact lenses. What do I do? Please contact us at (904)287-4567. We may be able to extend your prescription during this time, and/or place an order for your contact lenses and have them shipped to your house (with a minimum of 2 boxes).

I need a refill on the medication prescribed to me by the practice. What do I do? Please contact us at (904)287-4567 or cfec2@2drfishers.com. We can transmit a refill for your prescription directly to your pharmacy so that you have the medication that you need.

I need to pick up my order. What do I do? We will be open from 9:00am – 1:00pm Monday through Friday only to dispense contact lens and eyeglass orders.

I don’t feel comfortable coming into the office to pick up my order. What do I do? Please contact us at (904)287-4567 and we can bring your contact lens or glasses order out to your car. Since we are working with reduced staff, please allow us extra time for curbside pick-up. Also, when you place your contact lens order, you can elect to have them shipped to your home.

What about an eye emergency after your shortened business hours? What can I do? If you have an ocular emergency, please call (904)287-4567 and wait for instructions at the end of the message.

Our doctors will do their best to accommodate your needs whenever possible during this time. We have reduced our staff hours until further notice to protect them, our patients, our community, and our nation. Despite the financial and emotional hardships this will cause, we ask every one of you to do the same.

Together, we will weather this storm.