Nebraska Medicine eye care professionals specialize in the diagnosis and treatment of eye-related disease and conditions.
Few eye care centers have as many sub-specialists under one roof. Our glaucoma specialists use advanced treatments to reduce eye pressure in order to prevent any vision loss associated with glaucoma. We are experts in treating all forms of glaucoma, from actual open-angle and angle-closure glaucomas to acute-angle and childhood glaucomas.
What is Glaucoma?
Glaucoma is a disease of the optic nerve, which transmits the images you see from the eye to the brain. The optic nerve is made up of many nerve fibers (like an electric cable with its numerous wires). Glaucoma damages nerve fibers, which can cause blind spots and vision loss.
What Causes Glaucoma?
Glaucoma has to do with the pressure inside the eye, known as intraocular pressure (IOP). When the aqueous humor (a clear liquid that normally flows in and out of the eye) cannot drain properly, pressure builds up in the eye. The resulting increase in IOP can damage the optic nerve and lead to vision loss.
What Are the Different Forms of Glaucoma?
Primary open-angle glaucoma
The most common form of glaucoma. Occurs when the aqueous fluid is blocked from flowing back out of the eye at a normal rate through a tiny drainage system. Most people who develop primary open-angle glaucoma notice no symptoms until their vision is impaired. Ocular hypertension is often a forerunner to actual open-angle glaucoma. When ocular pressure is above normal, the risk of developing glaucoma increases.
The iris (the colored part of the eye) may drop over and completely close off the drainage angle, abruptly blocking the flow of aqueous fluid and leading to increased IOP or optic nerve damage.
Acute angle-closure glaucoma
Occurs when there is a sudden increase in IOP due to the buildup of aqueous fluid. This condition is considered an emergency because optic nerve damage and vision loss can occur within hours of the problem. Symptoms can include nausea, vomiting, seeing halos around lights, and eye pain.
The optic nerve is damaged even though the IOP is considered normal. Normal-tension glaucoma is not well understood, but lowering IOP has been shown to slow progression of this form of glaucoma.
Starts in infancy, childhood, or adolescence, and is rare. Like primary open-angle glaucoma, there are few, if any, symptoms in the early stage. Blindness can result if it is left untreated. Like most types of glaucoma, childhood glaucoma may run in families. Signs of this disease include clouding of the cornea, tearing and an enlarged eye.
What Are the Risk Factors for Glaucoma?
Your optometrist or ophthalmologist may tell you that you are at risk for glaucoma if you have one or more risk factors, including having an elevated IOP, a family history of glaucoma, certain optic nerve conditions, are of a particular ethnic background, or are of advanced age. Regular examinations with your providers are important if you are at risk for this condition.
How is Glaucoma Treated?
The goal of glaucoma treatment is to lower your eye pressure to prevent or slow further vision loss. Your optometrist or ophthalmologist will recommend treatment if the risk of vision loss is high. Treatment often consists of eye drops but can include laser treatment or surgery to create a new drain in the eye. Glaucoma is a chronic disease that can be controlled but not cured. Ongoing monitoring (every three to six months) is needed to watch for changes.
New Laser Treatment
Nebraska Medical Center offers one of the fastest growing minimally invasive glaucoma surgical procedures in the country called endocyclophotocoagulation (ECP). This procedure can help reduce or eliminate dependence on eye drops in people with mild to moderate glaucoma. It also allows us to treat people with acute glaucoma and those with the most severe cases who have not had success with other surgical procedures. The laser can be used to reshape and reposition the ciliary processes, which allows us to open the drain and reduce fluid production at the same time. The procedure is safer and more precise than other ablative procedures, which are typically used to treat glaucoma. Because ECP is minimally invasive, recovery time is generally a few days to about a week as opposed to several weeks with other types of glaucoma surgery.