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Glaucoma Testing & Treatment

Glaucoma is a leading cause of preventable vision loss and blindness in adults in the United States and Canada and the second leading cause of blindness in the World, even more than macular degeneration.

What is Glaucoma?

Glaucoma is not a single disease. It is actually a group of eye diseases that cause damage to the optic nerve due to an increase in pressure inside the eye, which is called intraocular pressure (IOP). When detected in the early stages, glaucoma can often be controlled, preventing severe vision loss and blindness. However, symptoms of noticeable vision loss often only occur once the disease has progressed. This is why glaucoma is called “the sneak thief of sight”. Unfortunately, once vision is lost from the disease, it usually can’t be restored.

Treatments include medication or surgery that can regulate the IOP and slow down the progression of the disease to prevent further vision loss. The type of treatment depends on the type and the cause of glaucoma.

Risk Factors

Prevention is possible only with early detection and treatment. Since symptoms are often absent, regular eye exams which include a glaucoma screening are essential, particularly for individuals at risk of the disease. While anyone can get glaucoma, the following traits put you at a higher risk:

  • Age over 60
  • Hispanic or Latino descent, Asian descent
  • African Americans over the age of 40 (glaucoma is the leading cause of blindness in African Americans, 6-8 times more common than in Caucasians.)
  • Family history of glaucoma
  • Diabetics
  • People with severe nearsightedness
  • Certain medications (e.g. steroids)
  • Significant eye injury (even if it occurred in childhood)

Understanding Glaucoma

Signs and Symptoms of Glaucoma: Due to a buildup of pressure in the eye, glaucoma causes damage to the optic nerve which is responsible for transmitting visual information from the eye to the brain. How does glaucoma affect your vision?

Types of Glaucoma: There are a number of types of glaucoma, some more acute than others. Learn about the common types of glaucoma and the differences between them.

Diagnosis and Treatment of Glaucoma: Early detection and treatment of glaucoma are essential to stopping or slowing the disease progression and saving vision. Treatment can include medicated eye drops, pills, laser procedures and minor surgical procedures depending on the type and stage of glaucoma.

Signs and Symptoms of Glaucoma

The intraocular pressure caused by glaucoma can slowly damage the optic nerve, causing a gradual loss of vision. Vision loss begins with peripheral (side) vision, resulting in limited tunnel vision. Over time if left untreated, central vision will also be affected which will increase until it eventually causes total blindness. Unfortunately, any vision that is lost from the optic nerve damage cannot be restored.

What are the Symptoms?

Typically, glaucoma sets in without any symptoms. At the early onset of the most common type of glaucoma “open angle” glaucoma, vision remains normal and there is no pain or discomfort. This is why the disease is nicknamed the “sneak thief of sight”.

An acute type of glaucoma, called angle-closure glaucoma, can present sudden symptoms such as foggy, blurred vision, halos around lights, eye pain, headache and even nausea. This is a medical emergency and should be assessed immediately as the intraocular pressure can become extremely high and cause permanent damage within hours.

Types of Glaucoma

The primary forms of glaucoma are open-angle and narrow-angle, with open-angle being the most common type.

Primary open-angle glaucoma (POAG)

POAG gradually progresses without pain or noticeable vision loss initially affecting peripheral vision. By the time visual symptoms appear, irreparable damage has usually occurred, however, the sooner treatment starts the more vision loss can be prevented. When untreated, vision loss will eventually result in total loss of side vision (or tunnel vision) and eventually total vision loss.

Normal-tension glaucoma or low-tension glaucoma

This is another form of open-angle glaucoma in which the intraocular pressure remains within the normal level. The cause of this form of glaucoma is not known, but it is believed to have something to do with insufficient blood flow to the optic nerve, causing damage. Individuals of Japanese descent, women and those with a history of vascular disease or low blood pressure are at higher risk.

Angle-closure glaucoma

Acute angle-closure glaucoma is marked by a sudden increase in eye pressure, which can cause severe pain, blurred vision, halos, nausea, and headaches. The pressure is caused by a blockage in the fluid at the front of the eye which is a medical emergency and should be treated immediately. Without prompt treatment to clear the blockage vision can be permanently lost.

Congenital glaucoma

The inherited form of the disease that is present at birth. In these cases, babies are born with a defect that slows the normal drainage of fluid out of the eye; they are usually diagnosed by the time they turn one. There are typically some noticeable symptoms such as excessive tearing, cloudiness or haziness of the eyes, large or protruding eyes or light sensitivity. Surgery is usually performed, with a very high success rate, to restore full vision.

Secondary glaucomas

Glaucoma can develop as a complication of eye surgeries, injuries or other medical conditions such as cataracts, tumors, or a condition called uveitis which causes inflammation. Uncontrolled high blood pressure or diabetes can result in another serious form called neovascular glaucoma.

Pigmentary glaucoma

A rare form of glaucoma, this occurs when pigment from the iris sheds and clogs the drainage of fluid from the eye resulting in inflammation and damage to the eye and drainage system.

Treatment of glaucoma is dependant upon the severity and type of glaucoma present.

Glaucoma Diagnosis and Treatment

Detecting Glaucoma

During a routine comprehensive eye exam to check for glaucoma, your eye doctor will dilate your eye to examine the optic nerve for signs of glaucoma and will also measure the intraocular pressure (IOP) with an instrument called a tonometer.

IOP Measurement

Tonometry involves numbing the eye with drops and then gently pressing on the surface of the eye to measure the pressure. Since your IOP can fluctuate throughout the day and glaucoma can exist without elevated IOP this is not enough to rule out the disease. If there are signs of the disease, further testing will be performed.

Visual Field Test

A visual field test is designed to detect any blind spots in your peripheral or side field of vision. You will be asked to place your head in front of a machine while looking ahead and indicate when you see a signal in your peripheral field of view.

Retina Testing

Your doctor may also measure the thickness of the cornea with an ultrasonic wave instrument in a test called pachymetry or use imaging techniques such as digital retina scanning or optical coherence tomography (OCT) to create an image of your optic nerve to look for glaucoma damage.

Treating Glaucoma

Treatment for glaucoma depends on the type and severity of the disease and can include medication such as eye drops or pills or laser or traditional surgery.

Medication

Medication and drops to lower IOP are often the first resort for controlling pressure-related glaucoma. These drops may have some uncomfortable side effects, but compliance with the treatment plan is essential for preserving vision and halting the progression of the disease.

Surgery

Surgical procedures are designed to control the flow of fluids through the eye by either decreasing the amount of fluid produced or improving the drainage. Your doctor may decide that a combination of surgery and medication will be the most effective in many cases.

Prevention

It cannot be stressed enough that the most effective treatment for glaucoma happens when the disease is detected and treated early before significant vision loss occurs. Any vision that is lost cannot be restored. This is why the best prevention is awareness by knowing your risks and taking responsibility by having your eyes examined on a regular basis.

Dear Valued Patient:

We plan to re-open on May 20, 2020 to a limited schedule by appointment only—please set appointment online or call or email first.

We look forward to see you again soon!  We place the highest priority on the health and safety of our patients and our eye care staff.  Please read below:

Please read the following carefully to prepare for your visit to our office. We are implementing many new and more stringent procedures to ensure the health and safety of our patients and eye care personnel based on guidelines from the Alameda County Health Department and the CDC to help prevent the spread of COVID-19. During this time we are requiring the following for every patient and in-office encounter:

+We are starting with a limited schedule of appointments for better social distancing and for the safety of our patients (thank you in advance for your patience and understanding).

+All visits are by appointment only, there are no walk-in visits available

+All patients are required to wear their own personal mask before entering the office

+All patients are required to check in over the phone before their appointment

+Insurance coverage verifications must be taken care of before entering office for appointment

+Patient will wait outside in car until notified by text or email when they can come in for their appointment, upon entering, patient’s temperature will be taken and their hands sanitized with alcohol cleaner

+There will be no waiting area in the office, patient will be seen right away-please be on time

+Family or caregivers will need to wait outside in the car, as we will only allow patient to enter office.  Verbal consent for minors is acceptable. Updates will be given family or caregiver over the phone as needed.

+All glasses, contact lens orders will be by curb side pick up only—please call or email and we can help you set up a time to pick up your eye wear safely, maintaining social distancing

Our doctors and staff will increase our cleaning and sanitizing protocols:

+We have the latest HEPA air filters with UVC light disinfection to destroy bacteria and viruses

+Wearing protective face shields and surgical masks and medical grade disposable gloves

+All exam equipment and every surface is sanitized fully with hospital grade sanitizer after each patient encounter

+We have a new safe system of disinfection for all frames which have been touched or tried

+We screen all patients by phone to assure they have been healthy prior to their appointment

+All staff and doctors have passed additional training in more stringent sanitizing protocol

Thank you for your patience and compliance to these new and required guidelines. Our goal is to take care of your eye care needs while keeping you and your family healthy. We also want to help our community overcome this pandemic.

We will get through this together.

Please let us know if you have any questions or need more immediate assistance. 

You can set up a future appointment online at EyeCareDrLee.com or send an email to EyeCareDrLee@gmail.com or DrLeongOK@gmail.com  or call 510-668-0877

Please stay safe and stay healthy.

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Stay up to date on our COVID-19 pandamic protocols Read Our Blog Post…

Our office continues to monitor the local health announcements on a daily basis. Optometry is an essential service and we will open to new health guidelines to help our patients while keeping everyone healthy. Please read our blog updates for our open date and new safety guidelines. Let us know if you have any questions or immediate eye care needs. Need contact lenses? Let us know, as we can send orders to you with free shipping.
We are responding faster to direct email:

eyecareDrLee@gmail.com

drLeongOK@gmail.com (for ortho-k)

Thank you, stay safe and stay healthy.

COVID-19 guidelines from CDC: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention-H.pdf