Glaucoma

Nashville's Top Choice for Vision Care

Dr. Shofner offers diagnosis and treatment for patients with glaucoma.

Glaucoma is a leading cause of blindness in the United States, especially for older people. But loss of sight from glaucoma can often be prevented with early treatment.

Glaucoma

Glaucoma is a disease of the optic nerve -- the part of the eye that carries the images we see to the brain. The optic nerve is made up of many nerve fibers, like an electric cable containing numerous wires. When damage to the optic nerve fibers occurs, blind spots develop. These blind spots usually go undetected until the optic nerve is significantly damaged. If the entire nerve is destroyed, blindness results.

Early detection and treatment by your ophthalmologist are the keys to preventing optic nerve damage and blindness from glaucoma.

Glaucoma is a leading cause of blindness in the United States, especially for older people. But loss of sight from glaucoma can often be prevented with early treatment. Dr. Stewart Shofner is one of the first surgeons in the United States to successfully treat glaucoma by performing eye surgery using the iStent, the smallest medical device ever approved by the FDA. Learn more about the iStent Procedure.

What causes 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 this fluid is produced constantly while an equal amount flows out of the eye through a microscopic drainage system. (This liquid is not part of the tears on the outer surface of the eye.)

Because the eye is a closed structure, if the drainage area for the aqueous humor -- called the drainage angle -- is blocked, the excess fluid cannot flow out of the eye. Fluid pressure within the eye increases, pushing against the optic nerve and causing damage.

Common Glaucoma Symptoms Include:

• blurred vision
• severe eye pain
• headache
• rainbow colored halos around lights
• nausea and vomiting

Glaucoma Treatment

As a rule, damage caused by glaucoma cannot be reversed. Eye drops, laser surgery, and surgery in the operating room are used to lower eye pressure and help prevent further damage. In some cases, oral medications may also be prescribed.

With any type of glaucoma, periodic examinations are very easy to prevent vision loss. Because glaucoma can progress without your knowledge, adjustments to your treatment may be necessary from time to time.

iStent Procedure

Dr. Stewart Shofner is one of the first surgeons in the United States to successfully treat glaucoma by performing eye surgery using the iStent, the smallest medical device ever approved by the FDA. Once Dr. Shofner places this device in a glaucoma patient's eye, their need for expensive drops to control glaucoma is either reduced significantly or possibly eliminated. In a clinical study reported by Glaukos, over 68% of glaucoma patients who received the iStent remained medication free at 12 months.

Medications

Glaucoma is usually controlled with eye drops taken daily. These medications lower eye pressure, either by decreasing the amount of aqueous fluid produced within the eye or by improving the flow through the drainage angle.

Never change or stop taking your medications without consulting your ophthalmologist. If you are about to run out of your medication, ask you ophthalmologist if you should have your prescription refilled.

Glaucoma medications can preserve your vision, but they may also produce side effects. You should notify your ophthalmologist if you think you may be experiencing side effects.

Types of Glaucoma

Chronic open-angle glaucoma: This is the most common form of glaucoma in the United States.

The risk of developing chronic open-angle glaucoma increases with age. The drainage angle of the eye becomes less efficient over time, and pressure within the eye gradually increases, which can damage the optic nerve. In some patients, the optic nerve becomes sensitive even to normal eye pressure and is at risk for damage. Treatment is necessary to prevent further vision loss.

Typically, open-angle glaucoma has no symptoms in its early stages, and vision remains normal. As the optic nerve becomes more damaged, blank spots begin to appear in your field of vision. You typically won't notice these blank spots in your day-to-day activities until the optic nerve is significantly damaged and these spots become large. If all the optic nerve fibers die, blindness results.

Closed-angle glaucoma: Some eyes are formed with the iris (the colored part of the eye) too close to the drainage angle. In these eyes, which are often small and farsighted, the iris can be pushed forward, blocking the drainage channel completely. Since the fluid cannot exit the eye, pressure inside the eye builds rapidly and causes an acute closed-angle attack.

Risk Factors for Glaucoma

Your ophthalmologist considers many kinds of information to determine your risk for developing the disease.

• age
• elevated eye pressure
• family history of glaucoma
• African or Hispanic Ancestry
• farsightedness or nearsightedness
• past eye injuries