John D. Mitchell, MD | Emily Ash Morin, MD | Jacquelyn Weber, MD
130 Park Street SE, Suite 300 Vienna, Virginia 22180 / Phone:703-938-2266
8218 Wisconsin Avenue, Suite P-10 Bethesda, Maryland 20814 / Phone:301-656-2027
John D. Mitchell, MD
Emily Ash Morin, MD
Jacquelyn Weber, MD
130 Park Street SE, Suite 300
Vienna, Virginia 22180
8218 Wisconsin Avenue, Suite P-10
Bethesda, Maryland 20814
Glaucoma is a common disease of the eye that affects the optic nerve. Upwards to 15% of the population will develop glaucoma at some point during their lifetime. If undiagnosed, or left untreated, it can lead to blindness.
Types of Glaucoma
There are many types of glaucoma, but most can be divided into two main categories: Open Angle Glaucoma (OAG) and Narrow Angle Glaucoma (NAG).
Open Angle Glaucoma is the most common form, and is generally a steadily progressive process of optic nerve damage, causing visual field loss and eventual blindness if left untreated. Fortunately it is usually successfully treated with eye pressure reducing eyedrops. If medical therapy with eye drops does not halt progression of the disease, then surgical alternatives are available to lower the eye pressure even further. Dr. Mitchell and Dr. Morin regularly treat patients with glaucoma, and perform surgical glaucoma procedures for patients who have failed to respond to medical therapy. No surgical intervention can restore vision lost to glaucoma, rather it is intended to preserve the remaining vision, and underscores the importance in early diagnosis, treatment and intervention in this disease. Fortunately regular annual eye exams will usually identify glaucoma in the early treatable stages and is a routine screening part of any complete eye exam.
Narrow Angle Glaucoma is a much less common form of glaucoma that has the potential to suddenly occur causing a rapid rise in intraocular pressure within a few hours. Optic nerve damage can occur within hours to days instead of years. The patient usually is farsighted and has a short eye. This anatomic variant causes some crowding in the front chamber of the eye, and when the pupil dilates, it can cause the fluid circulation to become obstructed. This can cause an abrupt rise in pressure blocking the filter drain in the eye. The vision becomes hazy and foggy and eye pain and headache can occur. Patients typically complain of lights having a halo around them. This is a very uncomfortable acute event, not a chronic condition. This condition requires urgent treatment aimed at pressure reduction, and the condition is cured by a simple laser treatment which makes a small accessory hole in the iris to provide an alternative path for fluid circulation. Often patients at risk for this condition can be identified during a routine eye exam and a prophylactic laser treatment (peripheral iridotomy or PI) can be performed to protect the patient against ever having an attack.
Glaucoma surgery is designed to achieve a lower eye pressure than drops or medical therapy can provide. Often a patient is initially responsive to medical therapy, but as time goes by, the effectiveness wears off in some patients and the eye pressure starts to gradually rise again. Surgical intervention is focused on facilitating outflow of aqueous fluid from the eye. Often the natural filter drain becomes clogged and less efficient with age. This causes some back-pressure to occur in the eye. Surgical treatments help provide accessory channels for excess fluid to leave the eye, thereby relieving the pressure. The majority of times this surgery is so successful, that many patients can reduce or eliminate their need to use pressure reducing eye drops.