Dr. MARTIN SONDAK, SpM
Dr. Martin immediately joined the team at KMN EyeCare after graduating from the University of Sam Ratulangi Me...
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Glaucoma Treatment at KMN EyeCare: What Is Glaucoma?
Glaucoma is an eye disease that damages the eye's optic nerve. The optic nerve can be imagined as an electric cable that contains millions of wires, each wire carrying an image from the retina to the brain through the light-sensitive optic nerve. Changes or damage to the optic nerve thus affect vision.
Glaucoma is usually characterized by increased eye pressure as a result of an imbalance between fluid production inside the eye and excretion from the eye, or a buildup of fluid inside the eye. This could result in permanent optic nerve damage and peripheral vision loss, which can lead to blindness.
About 20% of glaucoma patients may experience normal eye pressure, which is known as "normal tension glaucoma." Therefore, the diagnosis of glaucoma is not just based on eye pressure itself, but consists of the careful evaluation of the optic nerve and other eye structures. Eye pressure, circulation, and anatomy of the eye relate to damages that occur in glaucoma. Glaucoma diagnosis thus requires a dilated exam and other tests including visual field testing, nerve fiber layer analysis, optic nerve photography, examination of the trabecular meshwork with a special contact lens (gonioscopy), and corneal thickness measurement (pachymetry).
Glaucoma is the second leading cause for irreversible blindness in the world, after cataracts. Vision loss due to glaucoma cannot be reversed but can be managed. Glaucoma patients are generally unaware of any vision impairment until the disease is at an advanced stage. It is estimated that around 50% of glaucoma patients are unaware that they suffer from glaucoma. It is suggested that everyone over the age of 50 is screened for glaucoma.
Because the vision impairment caused by glaucoma cannot be reversed, detection, diagnosis, and management must ideally be done as early as possible. For additional information, contact your ophthalmologist or visit KMN EyeCare.
Glaucoma Causes & Symptoms: What Causes Glaucoma?
Glaucoma is caused by failure of the eye to keep an appropriate balance between the amount of fluid being produced inside the eye and the amount of the fluid that is drained out of the eye.
Eyes continuously produce a clear liquid called “aqueous humor.” The aqueous humor flows from the back chamber of the eye to the front chamber of the eye, which results in a pressure that shapes the eye and thus determines one's vision. If there is any blockage of the flow or the flow can not be maintained, the liquid will begin to build up, increasing the pressure inside of the eye. Increasing pressure then pushes on the optic nerve, damaging it permanently. If the optic nerve suffers damage, the patient is diagnosed with glaucoma.
Glaucoma Detection and Diagnosis
In order to detect whether or not a patient has glaucoma, his or her ophthalmologist will ask some questions regarding risk factors, such as the patient's:
- Aging process
- Family history of glaucoma
- Experience of severe shortsightedness or farsightedness
- History of eye trauma
- Systemic disease or health problems, including diabetes or poor blood circulation.
Regular vision check-up is the best way to enable early glaucoma detection and avoid subsequent vision impairment. The following tools and examinations are used to detect glaucoma:
A tool to measure the intraocular pressure.
A measurement of the thickness of the cornea, in which is relevant to obtaining an accurate eye pressure measurement.
A visual field test that can detect optic nerve damage. This test will measure the peripheral side of the vision. It will determine the missing areas in the visual field that are caused by damages that have occurred to the optic nerve.
A non-invasive imaging test that takes cross-sectional pictures of the retina, the light-sensitive tissue lining the back of the eye. OCT enables ophthalmologists to detect which stage the disease is at by allowing each of the retina's distinctive layers to be seen, mapped, and measured. OCT can also measure and document damage to the optic nerve.
Detailed color images of the optic nerve to help document changes to your optic nerve over time.
Glaucoma Symptoms
Glaucoma is known as the "silent thief of sight", as it is a gradual disease with unrecognizable symptoms until the disease has reached an advanced stage.
Open angle glaucoma is the most common form of glaucoma, caused by the imbalance of liquid production and its excretion from the eye. Closed angle glaucoma is caused by blockage of the liquid flow inside of the eye.
If the glaucoma is chronic in both types, there are no symptoms, yet the peripheral visual field loss would be gradual and lead to tunnel vision.
In acute closed angle glaucoma, the symptoms could be:
- Severe pain and headache
- Nausea
- Blurry vision
- Redness of the eye
- Halos around light
Open and closed angle glaucoma may be caused by other conditions such as inflammation, use of medications, trauma of the eye, cataract, or systemic diseases.
Glaucoma may also be found in infants at the time of birth.
Symptoms of glaucoma at birth include enlargement of the eye, bulging eyes, hazy corneas, and sensitivity to light.
Glaucoma Treatment & Management
To date, there is no proven method to reverse vision impairment caused by glaucoma. However, most cases of glaucoma can be managed, which is critical consider that, if glaucoma is left untreated, it can lead to permanent blindness.Glaucoma is mainly treated by lowering the eye pressure to a stage where it stops the optic nerve damage.
Glaucoma management can be achieved through a number of methods including eye drops, laser, or surgery.
Glaucoma eyedrops are often the first choice in managing eye pressure in glaucoma patients. For most glaucoma patients, the use of glaucoma eyedrops can be very effective in controlling the eye pressure. Once diagnosed with glaucoma, the use of glaucoma eyedrops are for continuous usage throughout one's lifetime. Glaucoma eye drops have several classifications with different active chemical ingredient that can help in reducing eye pressure. For example, there are eyedrops that contain only one certain active chemical ingredient, while others contain a combination of two active ingredients. Some side effects of glaucoma eyedrops include red eye, swollen eyelids, discomfort, eyelash growth, darkening of the eyelids or changes in breathing. Your eye doctor at KMN EyeCare will help to decide with eyedrops suits you best. Consult your eye doctor if you are experiencing any of the mentioned side effects.
Laser treatment in glaucoma is used mainly in closed angle glaucoma. This laser is called “iridotomy,” which creates a small opening on the iris so as to widen the angles. There is also a laser treatment called “iridoplasty”, which stretches the iris to open the angles and reduce pressure.
Laser treatment can also be used to treat open angle glaucoma, with is known as trabeculoplasty. This improves the drainage angle.
Laser treatment is of the same purpose when used in closed or open glaucoma treatment – to enhance the outflow of fluid from the eye, thus reducing eye pressure.
Complications in laser treatment for glaucoma are mild and include inflammation, mild eye pressure spikes, and glare.
When glaucoma eyedrops and laser treatment fail to reduce eye pressure, glaucoma surgery is the next option. Glaucoma surgery aims to create a new drainage channel for the aqueous fluid to leave the eye, thus reducing eye pressure.
There are two types of glaucoma surgery:
Trabeculectomy
The trabeculectomy procedure is done by making a small flap on the sclera (white area of the eye), while a hole is made under the flap to create a new channel where aqueous fluid can exit the eye. Eye pressure is relieved because aqueous fluid can now flow from the hole through the flap and be collected outside of the eye.
Glaucoma drainage device
This procedure uses a tiny plastic tube with a plate as a reservoir. The tube connects the inside of the eye to the posterior part of the eye, where the fluid is collected in a plate. With this tube in place, a permanent pathway is created for the fluid to drain, thereby reducing buildup and the pressure it causes.
Your doctor at KMN EyeCare will consult you in regards to which glaucoma treatment best suits your eye condition.
Successful glaucoma management depends on great team work between the patient and the eye doctor. The patient's compliance with the glaucoma treatment plan as established by the eye doctor is key to effective glaucoma management.
This information is for general use only. For further detail, contact your ophthalmologist or visit KMN EyeCare. KMN EyeCare glaucoma doctors will conduct a comprehensive glaucoma exam and provide best expert medical advice.
Glaucoma Testimonials
Pricillia Priska Sianita
"It started with a decrease in visual acuity, accompanied by severe dizziness and vomiting. A condition certainly affecting my performance as a dentist and lecturer. I met with a Glaucoma specialist doctor at KMN, who was quite knowledgeable treating my symptoms. It went very good and many of my colleagues and students asked where I had been treated, because they were amazed with the results of my treatment. Thank you KMN. Thank you Dr. Martin, SpM, for the high quality treatment I’ve received."
Pricillia Priska Sianita
"It started with a decrease in visual acuity, accompanied by severe dizziness and vomiting. A condition certainly affecting my performance as a dentist and lecturer. I met with a Glaucoma specialist doctor at KMN, who was quite knowledgeable treating my symptoms. It went very good and many of my colleagues and students asked where I had been treated, because they were amazed with the results of my treatment. Thank you KMN. Thank you Dr. Martin, SpM, for the high quality treatment I’ve received."
Pricillia Priska Sianita
"It started with a decrease in visual acuity, accompanied by severe dizziness and vomiting. A condition certainly affecting my performance as a dentist and lecturer. I met with a Glaucoma specialist doctor at KMN, who was quite knowledgeable treating my symptoms. It went very good and many of my colleagues and students asked where I had been treated, because they were amazed with the results of my treatment. Thank you KMN. Thank you Dr. Martin, SpM, for the high quality treatment I’ve received."
Glaucoma Doctors at KMN EyeCare
Experienced glaucoma specialists at KMN EyeCare
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Dr. MAYA E. SUWANDONO, SpM
Dr. Maya joined the KMN EyeCare team after graduating from the University of Indonesia Medical School in 2010....
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Dr. VINSENSIUS G. BUDIMAN, SpM
After completing his ophthalmology residency at the University of Sam Ratulangi Medical School, Dr. Vinsen pra...
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Dr. WIDOWATI S. WIJARSO, SpM
After completing her residency in ophthalmology at the University of Indonesia, Dr. Widowati (Dr. Ike) continu...
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