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Glaucoma
GlaucomaWhat is Glaucoma?

Nearly two and a half million people have Glaucoma. More than half of these people do not even realize they have the disease because there are often no warning symptoms. Glaucoma is known as the “silent-thief” of sight because it silently steals your vision without you even realizing it. If you do not have routine eye exams to check the status of your eye health, glaucoma and other diseases can steal your vision. Glaucoma is the second leading cause of blindness in the U.S. and the leading cause of preventable blindness.

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Glaucoma is a disease that damages the optic nerve and causes vision loss - often without warning and symptoms. Like a cable wire, the optic nerve is responsible for carrying the images we see to the brain. Damage to the optic nerve can occur when the pressure within the eye increases, usually due to a build-up of aqueous fluid inside the eye. This leads to the development of blind spots in our field of vision. However, damage may occur without elevation of the intra-ocular pressure. Conversely, the pressure may at times be elevated without damaging the optic nerve. This is a condition known as Ocular Hypertension. Blind spots in the field of vision usually go undetected by the individual until the optic nerve is significantly damaged and a great loss of peripheral or central vision has occurred.

At Vance Thompson Vision, Glaucoma treatment, surgery, and research are one of the pillars of our specialized care. By reviewing this literature with a family member or loved one you are taking the first steps to understanding Glaucoma.

Types of Glaucoma
Not every type of Glaucoma is the same or will have the same impact on your life. If you have been diagnosed with Glaucoma please make sure to familiarize yourself with the different types of glaucoma listed below. The Glaucoma Specialists at Vance Thompson Vision happy to provide additional information regarding your specific type of glaucoma and what this will mean to your life.


Chronic open-angle glaucoma:
This is the most common type of glaucoma. The drainage angle, where the fluids in the eye drain, is open, but working less efficiently. The inability to drain causes pressure within the eye to rise, which results in a gradual loss of side-vision. This can be likened to an air filter, which gathers dust over time & eventually becomes too laden with dust to work properly.

Angle-closure glaucoma:

This type of glaucoma occurs when the drainage angle is completely blocked, often by the iris. This prevents any fluid to drain from the eye & causes the pressure within the eye to suddenly rise. This extreme rise in pressure causes blurred vision, headaches, severe eye pain as well as the appearance of halos around lights.

Chronic angle-closure glaucoma:
This is painless and more gradual closing of the drainage angle, which occurs most frequently in people of Asian descent.

Secondary Glaucoma:
This type of glaucoma progresses very much like chronic open-angle glaucoma. It occurs when scar tissue blocks the drainage angle. The first symptom is loss of side-vision.

Congenital Glaucoma:
This is a birth defect, which affects the drainage angle. To prevent blindness, this condition must be treated shortly after birth. Symptoms include enlarged eyes, a cloudy cornea, light sensitivity and excessive tearing.
Who is at risk for Glaucoma?

Since glaucoma can affect anyone it is important to receive regular comprehensive eye examinations. Everyone may be at risk for glaucoma, but there are certain factors that can increase your risk of glaucoma:
  • 45 years or older
  • Increased eye presume
  • Family history of glaucoma
  • Severe nearsightedness
  • African-American, Hispanic or Asian descent
  • History of eye injury causing bleeding in the eye
Regular eye exams by the doctors at Vance Thompson Vision are the only way to detect glaucoma. Depending on your age, your frequency of glaucoma exams should be as follows:
  • 40 and under: once every three years
  • 40-65: once every two years
  • 65 and older: every year
Symptoms of Glaucoma

In the early stages of glaucoma there are no early symptoms, which is why it is important that you visit your eye doctor regularly. As glaucoma develops it is possible that you will experience a loss of vision. Once this damage is noticed it is usually severe and is almost impossible to reverse. Certain symptoms including intermittent pain, blurred vision or seeing colored rings around lights may indicate glaucoma. If you experience any of those symptoms, or any sudden and severe eye pain or loss of vision, you should contact your eye doctor immediately.
Treatment Options

If you have been diagnosed with glaucoma it is important that you are proactive in your treatments. Glaucoma is a chronic disease that can’t be cured and once vision is lost, meaning it can’t be restored. Certain treatments, such as medicine and surgery can prevent further loss of vision but it can’t improve vision that has already been lost. With the addition of South Dakota Glaucoma specialist, John Berdahl, M.D. the staff at Vance Thompson Vision have great confidence in helping our patients manage this terrible eye disease.

Glaucoma Medications
Medical technology can often times bring miracles. Glaucoma is usually treated with daily eye drops that decrease eye pressure either by slowing the amount of fluid produced within the eye or by improving the flow through the drainage angle. Glaucoma medications may produce side effects, so be sure to talk to your doctor if you experience any unusual symptoms.

Surgery
In a standard, operating room procedure, your doctor can also use fine, microsurgical instruments to create a new drainage channel for outflow of aqueous fluid. Though serious complications of modern glaucoma surgery are uncommon, they can occur. Surgery is recommended if your ophthalmologist feels that it is necessary to prevent further damage to the optic nerve. Before considering surgery it is important you visit a qualified surgeon who can educate you about all of your surgical options. At Vance Thompson Vision, our glaucoma surgeons, led by Dr. John Berdahl, specialize in glaucoma surgery and glaucoma research. This ensures that you will know all of your options prior to your surgery and will be a participant in deciding the best option for your visual needs.

Trabeculectomy
Trabeculectomy is a surgical procedure performed by an ophthalmologist used to lower eye pressure. By trying to lower the eye pressure damage can be halted from further pressure increases but that damage already done is not reversible.



The trabeculectomy procedure involves the surgeon creating a tiny passageway from the inside to the outside of your eye. This helps fluid drain better from the areas it is presently not draining. A trabeculectomy can lower the pressure in your eye and help prevent more damage to the optic nerve. Trabeculectomy is more commonly used after other treatment options have not been successful or are simply not stopping the increasing IOP. (Intraocular Pressure)

  • Medicines do not work as planned
  • Laser surgery to lower the eye pressure has not worked

SLT – Selective Laser Trabeculoplasty
Selective Laser Trabeculoplasty is an excellent new painless treatment option for glaucoma. By engaging in this laser technology the ophthalmologists can now lower pressure that can possibly help a patient avoid a more invasive surgery. The surgery might even reduce the dependence on medications or drops.
Impact on Your Life

Glaucoma can be extremely problematic to your vision, and it is the second-leading cause of blindness in the U.S. As the population ages, glaucoma now needs to be taken even more seriously. Once you have been diagnosed with glaucoma you will need to make simple lifestyle changes in order manage your disease. If you have been diagnosed at an early point the eye doctor will then make a suggested treatment protocol based on taking medication or SLT. Most people with glaucoma lead a completely normal life. IF medication is prescribed, developing a daily routine can ensure medication is taken properly or the disease can progress. Successful patients often try to take the medicine or drops at times such as waking, sleep time, or meals and snacks.

Although patients can be depressed at the onset of this disease it is important to not be consumed with the negative aspects. This disease does not have to limit your lifestyle. Continue with regular activities and try not be consumed with the emotional aspects of having a disease. If you have a business start new initiatives, if you play golf, go hit some golf balls or if you enjoy cooking, try some new recipes. There may some more physical activities such as athletics or driving that will become hard to do. It is common for some glaucoma patients to experience light sensitivity or specific problems with light glare. Because driving can endanger others it is important to discuss this matter with your eye doctor.


Please feel free to consult with our staff or the surgeons at Vance Thompson Vision. Because we specialize in treating and managing this disease we have a unique perspective and care about helping our patients function as best they can while living with glaucoma.

There are many individuals stepping up to help the glaucoma research initiatives. After the sports world was shocked with the sudden blindness of MVP baseball star Kirby Puckett more awareness of this disease has emerged. The eye care community, including the Glaucoma Research Foundation, surges forward in an effort to find better methods to treat glaucoma. Someday there may even be a cure for this disease.

Remember, glaucoma has no symptoms until it is too late and it runs in families. If you or a loved one has not had an eye exam recently, see your local eye doctor for a complete exam. If you eye doctor detects glaucoma they can initiate treatment or refer it to a glaucoma specialist. Either way, it is important to have a primary eye doctor.

Dr. John Berdahl is a nationally recognized glaucoma researcher and surgeon. He has authored numerous book chapters and scientific articles in addition to lecturing nationally and internationally. Dr. John Berdahl and the team are committed to using the world’s most advanced technology and techniques to halting the progression of glaucoma so you can live a life full of sight.

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