Dr. Sam Cohlmia, M.D. is a Wichita ophthalmologist & eye doctor specializing in the treatment of glaucoma and glaucoma surgery.
What is Glaucoma?
One of the most common causes for irreversible visual loss is glaucoma. Glaucoma is damage to the nerve fiber layer of the retina that is typically caused by an elevation in the intraocular eye pressure. It can go undetected until extreme visual loss has taken place. In general, most glaucomas are painless and asymptomatic. The visual loss that initially occurs is in the periphery of the visual field, so that most people do not even notice the visual loss. As glaucoma progresses, and if left untreated, it can affect the central vision in an irreversible fashion.
What Causes Glaucoma?
People at risk for glaucoma include those with a family history of glaucoma, diabetics, individuals of African-American decent, and those of increasing age.
What are Symptoms of Glaucoma
Early on, glaucoma doesn’t have any symptoms which is why it’s such a dangerous eye condition. If you notice problems with your eyesight, there may be irreversible vision loss from glaucoma. Objects may become blurry in your peripheral vision or halos may start showing around lights. It’s estimated that half of those with glaucoma do not even know they have it. This is why routine eye exams are so important.
Screening and Testing for Glaucoma
Glaucoma is diagnosed on a routine screening eye examination from your glaucoma eye doctor. Dr. Cohlmia, your ophthalmologist, will test your eye’s intraocular pressure (IOP). Abnormally high eye pressure may indicate you have glaucoma.
Glaucoma Visual Field Blind Spot Testing
Visual field tests assess the potential presence of blind spots (scotomas), which could indicate eye diseases. A blind spot in the field of vision can be linked to a variety of specific eye diseases, depending on the size and shape of the scotoma.
This type of test is only part of a glaucoma evaluation. Visual field tests help diagnose and categorize glaucoma and sets a baseline for future exams.
Glaucoma Nerve Fiber Layer Testing
The GDx test is a relatively new test that has proved its usefulness in the diagnosis and management of glaucoma. The GDx is a tool that uses laser to determine the thickness of the nerve fiber layer. Older glaucoma tests have centered around measuring eye pressure or measuring the effect that glaucoma has on your overall visual field. Although these tests are extremely important in the treatment and management of glaucoma, it would be helpful to measure or test early what damage glaucoma can cause to the nerve fiber layer in the back of the eye.
The GDx is currently used by the Cohlmia Eye Center as a baseline exam. The test provides important information that is useful in following your optic nerve status throughout the years. The GDx also helps Dr. Cohlmia decide whether you truly have glaucoma or could be considered a glaucoma suspect. The GDx test, alone, does not make the diagnosis of glaucoma; therefore, Dr. Cohlmia must use all of the baseline and follow-up data of each patient to make a decision regarding treatment.
Treatment for Glaucoma
The initial treatment for glaucoma is the use of eye drops in order to reduce the intraocular eye pressure. If eye drops fail, then laser eye surgery or glaucoma surgery is necessary. That is why it is crucial for an individual to undergo an annual glaucoma eye examination, especially if there is a risk factor for such a blinding disease.
Glaucoma Filtering & Valve Procedures
A glaucoma valve is a medical shunt used in the surgical treatment of glaucoma to reduce the eye’s intraocular pressure (IOP). The glaucoma valve implant is used for glaucoma patients not responding to maximal medical therapy, with previous failed guarded filtering surgery (trabeculectomy) or in cases where conventional drainage surgery is unlikely to succeed. Common situations where the use of a glaucoma implant as a primary procedure is indicated include:
- Neovascular glaucoma – glaucoma associated with vascular disease of the eye (often diabetes).
- Cases of Uveitis – acute or chronic inflammation of the eye.
- Traumatic glaucoma – glaucoma associated with injury to the eye.
- Silicone glaucoma – glaucoma due to Silicone used to repair a detached retina.
- Infantile/Juvenile glaucoma – often associated with developmental defects of the eye.