GlaucomaGlaucoma is one of the most common reasons for vision loss in the world. It is difficult to diagnose because in most patients there are no symptoms until the disease is very advanced and permanent vision loss has occurred. This is one of the reasons regular routine eye exams are important for older patients.

There are two main types of glaucoma. So-called ‘angle-closure’ glaucoma may occur at any age and is accompanied by sudden pain, red-eye, and blurry vision. The most common type of glaucoma is called ‘progressive open-angle’ glaucoma. Patients with this type of glaucoma are typically older. Other risk factors include high intraocular pressure, a history of glaucoma in the family, thin corneal tissue, and a characteristic appearance of the optic nerve when examined. Side or ‘peripheral’ vision is first damaged, and advanced disease may cause blindness.

Treatment of glaucoma depends on the type and severity of the disease. Generally speaking, the goal of glaucoma treatment is to lower intraocular pressure. In many patients, this is accomplished by topical medicated drops. There are many types of glaucoma drops; which drop is best is dependent on a patient’s other medical conditions and many other factors.

Nashua Eye Associates offers a complete range of glaucoma treatments. Some patients may benefit from a glaucoma laser treatment called Selective Laser Trabeculoplasty. This is a non-invasive treatment in which energy is focused on the region of the eye where fluid drains out, facilitating fluid out-flow and lowering eye pressure. Other patients with more advanced disease may benefit from surgical treatment. Nashua Eye offers the services of Dr. Sonalee Desai-Bartoli and Dr. Faith Birnbaum, who are sub-specialty trained in the medical and surgical treatment of glaucoma in patients with advanced disease.

Screening for Glaucoma: Tonometry

Tonometry measures the fluid pressure inside your eye (intraocular pressure). This test helps your eye doctor detect glaucoma, a disease that damages the optic nerve. Several methods to measure intraocular pressure are available, including:

  • Applanation tonometry. This test measures the amount of force needed to temporarily flatten a part of your cornea. You'll be given eyedrops with fluorescein, the same dye used in a regular slit-lamp examination. You'll also receive eyedrops containing an anesthetic. Using the slit lamp, your doctor moves the tonometer to touch your cornea and determine the eye pressure. Because your eye is numbed, the test doesn't hurt.
  • Noncontact tonometry. This method uses a puff of air to estimate the pressure in your eye. No instruments touch your eye, so you won't need an anesthetic. You'll feel a momentary pulse of air on your eye, which can be startling.

If your eye pressure is higher than average or your optic nerve looks unusual, your doctor may use a pachymeter. This instrument uses sound waves to measure the thickness of your cornea. The most common way of measuring corneal thickness is to put an anesthetic drop in your eye, then place a small probe in contact with the front surface of the eye. The measurement takes seconds.

You may need more-specialized tests, depending on your age, medical history and risk of developing eye disease.

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