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Glaucoma Treatment, Testing and Surgery

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Glaucoma is a collection of diseases that all have a final common effect. That effect is damage to the optic nerve. The optic nerve is a large nerve that exits from and attaches to the back of the eyeball. It is like a cable that takes the information from the eyeball to the brain. When damage occurs from glaucoma to the optic nerve, vision is lost. Typically, people lose vision above, below and slightly nasal to the center of vision.



The images above the photographs of the couple represent formal visual field testing performed at the doctors office. The 2 left figures represent left eyes with inferior defects and the two figures on the right represent right eyes with superior defects. Put into real life situation the photograph of the couple above schematizes what can happen when glaucoma damage becomes advanced. The picture on the left is normal, but notice that the picture on the right has a "tunnel vision” appearance. This occurs when the defects detailed in the upper figures are present in together in one eye.

 

In advanced cases of glaucoma vision loss can extend into the central area and people become functionally, and legally blind. People often note other impacts to their vision as glaucoma progresses. Contrast sensitivity, or the ability to discriminate similar shades of colors is hampered. This can manifest in difficulty identifying each step on a stairwell. In addition, light/dark adaptation is slowed. This results in an abnormally prolonged time to adjust to new lighting conditions, like walking into a dimly lighted house from a sunny day.

The single greatest risk factor for, and often the direct cause of glaucoma is abnormally high eye pressure (normal eye pressure is below 21mmHg). In order for vision to be normal the eye must pressurize itself. There is a very elegant mechanism responsible for this pressurization and can be abnormal in multiple ways resulting in obstruction of the fluid from leaving the eye. This has resulted in glaucoma being classified into 2 categories:

 

 

Not all cases of glaucoma have high eye pressure. Some patients develop progressive glaucomatous optic nerve damage despite maintaining statistically normal eye pressure (22 mmHg or lower). The results of the Normal Tension Glaucoma Study (NTGS) demonstrated that lowering eye pressure by 30% was effective in slowing vision loss in a large percentage of participants in this study.

 

 

For more information on glaucoma diagnosis and prevention, visit the American Glaucoma Society, the American Academy of Ophthalmology, and the Glaucoma Research Foundation

To learn more about the Virginia Eye Institute, or to set up your next eye appointment, contact us via e-mail or call (804) 287-4200 for more information. Call (804) 287-4216 to set up an appointment.

Doctors With This Specialty


Doctor Specialties Options
Walter E. Bundy M.D., F.A.C.S. Walter E.
Bundy M.D., F.A.C.S.
LASIK & Vision Correction Surgery
Glaucoma Treatments
Cataract Surgery
General Ophthalmology
Robert M. Knape M.D. Robert M.
Knape M.D.
Glaucoma Treatments
Cataract Surgery
General Ophthalmology
Francis A. La Rosa M.D., Ph.D. Francis A.
La Rosa M.D., Ph.D.
Glaucoma Treatments
Cataract Surgery
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