Glaucoma is a disease of the optic nerve. The nerve connects the eye to the brain. If the nerve is damaged, transmission of information to the brain is affected resulting in eventual vision loss. At The Eye Institute of Utah, our team of glaucoma specialists – Dr. Kristin Chapman, Dr. Alan Crandall and Dr. Zachary Zavodni – can offer clinical and surgical treatments to battle glaucoma.

Open-Angle Glaucoma

Glaucoma is called the “sneak-thief of sight” because in its early stage, there are no symptoms. Although it cannot be cured, it can usually be controlled. Left untreated, damage to the optic nerve can result in loss of vision and could eventually lead to blindness. The eye receives its nourishment from a clear fluid that circulates inside the eye called aqueous that is produced behind the iris, flows through the pupil and returns to the bloodstream through a drainage canal called the trabecular meshwork. In the case of open-angle glaucoma, this drainage canal stops working properly and the aqueous fluid exits the eye too slowly. This increase in fluid creates pressure on the delicate optic nerve. The optic nerve is responsible for sending visual signals to the brain. A part of your exam usually involves checking for high pressure and taking a magnified look at the optic nerve for any sign of change. To control glaucoma, your doctor will choose from three basic types of treatment: medicines that lower the intraocular pressure inside the eye, laser surgery (YAG or SLT) or filtration surgery using devices such as the Express Shunt or iStent. The goal of all three of these treatments is to lower the pressure in the eye.

Narrow-Angle Glaucoma

A small percentage of people with glaucoma have a condition known as narrow-angle glaucoma. This type of glaucoma can occur slowly and progressively or very quickly and can only be detected through an eye exam. Narrow-angle glaucoma occurs when increased pressure causes the iris to be pushed forwards, blocking the drainage channel completely. Because fluid cannot exit the eye, pressure in the eye spikes rapidly. This can quickly result in emergency condition called acute closed-angle glaucoma, which can result if blindness if not immediately diagnosed and treated. Possible symptoms of narrow-angle glaucoma include blurred vision, severe eye pain, headaches, halos, or nausea and vomiting. A very important reason to make sure and see your optometrist or ophthalmologist on a yearly basis is to monitor for these conditions.  When caught early, they can be controlled and vision can be preserved.

Commonly Asked Questions

How do I know if I have glaucoma?

With rare exceptions, glaucoma has no symptoms. There is no pain or discomfort to the eye, only a gradual loss of vision. This change may occur over weeks, months, or even years before you realize you are losing vision. But take heart, The Eye Institute of Utah utilizes a sophisticated instrument option that can detect glaucoma even before symptoms occur.

Who gets glaucoma?

Those most at risk for the disease include people over 40 years old, African-Americans aged 35 years and older, people with a family history of glaucoma, diabetics, long-term steroid users and very near-sighted people.

What causes glaucoma?

In most cases, glaucoma is caused by elevated pressure inside the eye. Yet pressure is not the only risk factor. There are many patients with normal pressures who still have the disease. That’s why it’s important to visit The Eye Institute of Utah on a regular basis to determine if you are developing glaucoma.

How do doctors detect glaucoma?

Measurement of eye pressure, optic nerve health evaluation and side vision testing all provide valuable information in establishing a diagnosis of glaucoma. The Eye Institute uses an infrared laser to measure the thickness of the retinal nerve fiber layer, which is the tissue directly affected by glaucoma. The screening is comfortable and convenient. A computer maps the nerve fibers and instantly compares them to a database of normal readings. Thin nerve fiber readings indicate the onset of glaucoma and the need for further testing.

How is glaucoma treated?

One of our glaucoma specialists at The Eye Institute of Utah, Dr. Alan Crandall or Dr. Zachary Zavodni, may recommend medication for treatment. This is usually in the form of eye drops. Medication won’t cure the disease, but can keep it under control. If medication proves ineffective, you may need surgery. This may involve the use of a laser or an operative procedure to create a more efficient, pressure-controlling, drainage system. The surgical staff at The Eye Institute has successfully performed thousands of these procedures.

iStent® Trabecular Micro-Bypass

Patients suffering from mild-to-moderate open-angle glaucoma now have access to an exciting new treatment option designed to help reduce pressure in the eye and slow the progression of glaucoma. The iStent® Trabecular Micro-Bypass is the smallest medical device ever approved by the FDA. iStent® is designed to create a permanent opening in your trabecular meshwork, and works continuously to improve the outflow of fluid from your eyes to help control eye pressure.

Mild-to-moderate open-angle glaucoma is the most common type of glaucoma, which occurs when pressure in the eye builds to abnormal levels. If the drainage system in the eye is clogged or not working properly, this eye pressure (also known as intraocular pressure) may increase to unhealthy levels, causing damage to the optic nerve. This can result in permanent vision loss. The iStent® implant is meant to slow the progression of glaucoma by improving the eye’s ability to drain excess fluid and reduce the pressure in your eye.

Most people with this type of glaucoma take one, two or even three types of medications daily to control intraocular pressure. Unfortunately, these drops can be inconvenient and expensive. The iStent® may be a blessing, allowing many patients to reduce or possibility eliminate the need for glaucoma medications at the discretion of his or her physician. It is important that patients who receive the iStent® continue to regularly visit his or her eye care professional to monitor the progression of their glaucoma.

iStent inject® Trabecular Micro-Bypass System

At The Eye Institute of Utah, we strive to stay abreast of advancements in ophthalmology in order to bring our patients the most effective treatment options available. We are thrilled to offer the newest generation of the iStent implant to treat glaucoma, the iStent inject® Trabecular Micro-Bypass System. This FDA-approved device is designed to regulate eye pressure by creating a pathway for fluid to drain. The iStent inject® is just as tiny as the original iStent, but has a redesigned shape that allows it to be inserted with a more direct path to the trabecular meshwork. An additional benefit of the iStent inject® is a revised delivery method that enables your surgeon to place two iStent devices at once, without exiting and reentering eye. Multiple eye stents may produce a lower intraocular pressure. Similar to the original iStent®, the iStent inject is intended for insertion in conjunction with cataract surgery for patients with mild to moderate primary open angle glaucoma.

Am I a candidate for the iStent® or iStent® Inject?

The iStent® is indicated for use in patients suffering from mild-to-moderate open-angle glaucoma in conjunction with cataract surgery who currently are being treated with ocular hypotensive medication. After scheduling an appointment with one of our world-class ophthalmologists, your doctor can help you determine if you are a good candidate for the iStent®.

Why choose The Eye Institute of Utah for your glaucoma treatment?

MIGS Center of Excellence Glaukos logoDr. Robert Cionni and Dr. Alan Crandall, of The Eye Institute of Utah, were the first eye surgeons in the state of Utah to perform surgery using the iStent® implant, outside of clinical trials. This treatment option for glaucoma patients is new and only offered by a select handful of eye surgeons across the country. At The Eye Institute of Utah, we focus on offering the latest technology and treatment options for patients, and continue being involved in the research and development of cutting edge eye care technology.

If you are interested in learning more about this groundbreaking technology, call The Eye Institute of Utah today at 800-760-4171 to schedule an appointment and find out if the iStent® is right for you!

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