Glaucoma Michigan Medical, P.C.
Ophthalmology
Dr. Marko Habekovic
Information and Treatment
The healthy eye
• Light rays enter the eye
through the cornea, pupil and
lens.
• These light rays are focused
directly onto the retina, the
light-sensitive tissue lining the
back of the eye.
• The retina converts light rays
into impulses; sent through the
optic nerve to your brain, where
they are recognized as images.
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What is glaucoma?
• Disease of the optic nerve.
• When damage to the optic nerve fibers
occurs, blind spots develop; blind spots
usually go undetected until optic nerve is Normal vision
significantly damaged.
• Leading cause of blindness in the United
States, especially for older people.
• Early detection and treatment are keys to
preventing vision loss from glaucoma.
Vision as it might be
affected by glaucoma
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Anatomy of glaucoma
• Clear liquid called aqueous humor circulates inside the front
portion of the eye.
• To maintain a healthy level of pressure within the eye, a small
amount of aqueous humor is produced constantly, while an equal
amount flows out of the eye through a microscopic drainage
system—the trabecular meshwork.
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Anatomy of glaucoma
• With glaucoma, aqueous humor does not flow through the
trabecular meshwork properly.
• Over time, eye pressure increases, damaging the optic nerve
fibers.
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Types of glaucoma
Two main categories of glaucoma:
• Open-angle glaucoma: the most common form of glaucoma.
• Closed-angle glaucoma: a less common and more urgent form of
glaucoma.
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Types of glaucoma
Open-angle glaucoma
• Trabecular meshwork becomes less
efficient at draining aqueous humor.
• Intraocular pressure (IOP) builds up,
which leads to damage of the optic
nerve.
• Damage to the optic nerve occurs at
different eye pressures among
different patients.
• Typically, glaucoma has no
symptoms in its early stages. Open-angle glaucoma
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Types of glaucoma
Closed-angle (or narrow-angle) glaucoma
• The drainage angle of trabecular
meshwork becomes blocked by
the iris (the colored part of the
eye).
• IOP builds up very fast.
• Symptoms include severe eye or
brow pain, redness of the eye,
decreased or blurred vision.
• Must be treated as a medical
emergency—see your Closed-angle glaucoma
ophthalmologist immediately.
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Glaucoma risk factors
Risk factors for glaucoma include:
• Age
• Family history
• Elevated eye pressure (IOP)
• Nearsightedness or farsightedness
• African, Hispanic or Asian ancestry
• Diabetes
• Previous eye injury
• Thin cornea
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Detecting glaucoma
• Regular eye examinations by
your ophthalmologist are the
best way to detect glaucoma.
• Glaucoma screening that
checks only eye pressure is not
sufficient to detect glaucoma.
Ophthalmoscope examination
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What happens during an exam
• Tonometry measures eye
pressure (IOP).
• High tonometry reading is often
one of the first signs of
glaucoma.
Tonometry examination
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What happens during an exam
• Gonioscopy inspects drainage
angle of aqueous humor.
• Allows ophthalmologist to
determine type of glaucoma
(open- or closed-angle).
Gonioscopic image of the eye
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What happens during an exam
• Optic nerve exam, in which
ophthalmologist dilates your
pupils to detect optic nerve
damage.
• Subtle changes of optic nerve
reveal early signs of glaucoma.
Normal optic nerve Optic nerve damaged by glaucoma
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What happens during an exam
• Visual field exam, testing for
blank spots in peripheral
vision.
Visual field exam
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Treating glaucoma
• Treatment for glaucoma depends on:
Specific type of glaucoma
Severity of glaucoma
How glaucoma responds to treatment
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Treating glaucoma
Open-angle glaucoma
• Medication.
• Eyedrops are most common
treatment.
Eyedrop application for open-
angle glaucoma
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Treating glaucoma
Glaucoma surgery
• Laser trabeculoplasty:
stimulates the trabecular
meshwork (drainage angle) to
function more efficiently.
Laser trabeculoplasty
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Treating glaucoma
Glaucoma surgery
• Trabeculectomy: creates new
drainage channel for the eye.
• Goal is to stabilize disease and
prevent further damage/vision
loss.
• Does not reverse damage to the
optic nerve.
• Performed on an outpatient Trabeculectomy
basis.
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Treating glaucoma
Glaucoma surgery
• Aqueous shunt or seton: small plastic tube drains fluid from front
of eye to lower eye pressure (IOP); performed in eyes at high risk
for failure with trabeculectomy.
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Treating glaucoma
Glaucoma surgery
• Laser iridotomy: creates a
small hole in the iris to
improve flow of aqueous
humor into drainage angle.
Laser iridotomy
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Glaucoma is controllable
• Vision loss from glaucoma usually can be prevented if detected
and treated early.
• If you are prescribed eyedrops for glaucoma, you must take them
regularly.
• If you are at risk for glaucoma, visit your ophthalmologist
regularly.
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Preserve good vision with regular eye exams
Everyone should regularly visit their ophthalmologist at the
following intervals:
• Age 20-29 years: At least once during this period.
Those with risk factors for glaucoma (people of African descent or those who
have a family history of glaucoma) should be seen every 3-5 years.
• Age 30-39 years: At least twice during this period.
Those with risk factors for glaucoma (people of African descent or those who
have a family history of glaucoma) should be seen every 2-4 years.
• Age 40-64 years: Every 2-4 years.
• Age 65 years or older: Every 1-2 years.
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