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Glaucoma Treatment

What is Glaucoma?

Glaucoma is one of the leading causes of blindness and visual impairment in the US, and can affect patients of all ages, many of whom do not experience any symptoms and may not be aware that they have the disease. Glaucoma actually refers to a group of diseases that cause damage to the optic nerve as a result of increased pressure within the eye.

There are two main types of glaucoma:

Open-angle glaucoma is the most common type of glaucoma. The pressure in the eye increases when the fluid inside the eye does not drain properly through the drainage system of the eye.

Narrow-angle glaucoma occurs when there is poor drainage because the angle between the iris and the cornea is too narrow. Angle closure glaucoma is a sudden elevation of pressure that can result in severe loss of vision.

What are the symptoms of Glaucoma?

Many patients do not experience any symptoms during the early stages of glaucoma, including no pain and no vision loss. This makes it difficult for many patients to know if they have the disease. But as glaucoma progresses, patients may experience a loss of peripheral or side vision, along with sudden eye pain, headache, blurred vision or the appearance of halos around lights.

Diagnosing Glaucoma

How is Glaucoma diagnosed?

Glaucoma Treatment BaysideWhile some patients experience symptoms from glaucoma as the disease progresses, others learn they have the condition during a complete eye exam. There are several different tests performed to diagnose glaucoma including: visual acuity, measurement of eye pressure (tonometry), angle evaluation (gonioscopy), peripheral vision testing (visual fields), optic nerve evaluation (OCT, ophthalmoscopy), and corneal thickness (pachymetry).

How is Glaucoma treated?

Treatment for Glaucoma

Once glaucoma has been diagnosed, treatment should begin as soon as possible to help minimize the risk of permanent vision loss. There is no cure for glaucoma, but there are treatments that help lower the pressure in the eye to prevent further damage from occurring. Most cases of glaucoma can be treated with eye drops, laser surgery, or microsurgery. The best treatment for your individual case depends on the type and severity of the disease, and can be discussed with your doctor.

  • Eye drops are used to reduce the pressure in the eye either by increasing the amount of fluid that drains from the eye or by reducing the amount of fluid that is produced by the eye. Some medications have side effects that include redness, stinging, irritation or blurred vision.
  • Laser surgery can be used when intraocular pressure cannot be controlled adequately with medication. The goal of laser surgery is to increase the outflow of fluid from the eye or reduce fluid blockage through laser trabeculoplasty, or peripheral iridotomy.
  • Microsurgery involves a surgical procedure called a trabeculectomy, which creates a new channel to drain fluid from the eye and reduce the pressure that causes glaucoma. Surgery is often performed after medication and laser procedures have failed. Recent advancements also include a shunt device called the “Express Shunt”

Glaucoma Prevention

While there is no way to prevent glaucoma from developing, regular screenings and early detection are the best forms of protection against the harmful damage that the disease can cause. While anyone can develop glaucoma, some people are at a higher risk for developing disease. This includes older people, African-Americans over the age of 40, those with a family history of glaucoma, and diabetics. Patients should have a comprehensive eye exam at least once every year, especially if they have a risk factor for developing glaucoma.

To learn more about glaucoma and how you can be tested for this serious condition, please call us today to schedule an appointment with one of our doctors.

Medical Retina

What is the retina?

A healthy retina, optic nerve, and macula.
The retina is a thin sheet of nerve tissue that lines the back of the eye where light rays are focused and transmitted to the brain. Tiny blood vessels supply the retina with oxygen and nutrients. A healthy retina is essential to maintain clear vision and normal eye function. If the retina becomes diseased or injured, significant vision loss can occur. A dilated retinal exam may be recommended to detect retinal abnormalities. During a retinal exam, your doctor may also perform additional diagnostic tests to evaluate the retina for signs of disease. These tests may include a visual field, OCT, fundus photography, or fluorescein angiography.

Age-related macular degeneration (AMD)

AMD is a condition that affects older patients. Symptoms of AMD include problems with reading, visual distortion, and cloudy central vision. There are several types of macular degeneration of varying severity, including dry and wet macular degeneration.

How is AMD diagnosed?

In order to diagnose AMD, your doctor performs a complete dilated retinal examination and tests including OCT and fluorescein angiography.

What are current treatments for AMD?

There is no cure for AMD, but when diagnosed early there are treatments that can prevent progression of disease. Nutritional vitamin supplements that contain high doses of anti-oxidants and zinc have been shown to reduce the risk of developing macular degeneration by 25%. Vitamins are often recommended to patients with macular degeneration. There are also new innovative medications that are being used in the treatment of wet macular degeneration. Lucentis is one such example. Individuals who are at high risk for developing AMD should consult with our doctors for treatment recommendations.

Retinal Detachment Treatment

Retinal detachment is a serious eye condition that occurs when the retina becomes separated from the wall of the eye and its underlying tissue. Permanent vision loss may occur without prompt treatment.

What are symptoms of retinal detachment?

Warning signs of a retinal tear or detachment include: Sudden blurred vision, flashes of light, the development or increase in floaters or cobwebs in the vision, a shadow over the peripheral vision. It is important to see your doctor if these symptoms occur.

How is retinal detachment treated?

Treatment is determined by the extent of the problem. If a retinal tear or hole can be identified, laser surgery can often be performed. Surgical treatment of retinal detachment involves the placement of an encircling scleral buckle on the white part of the eye to close the tear and reduce traction on the retina. These procedures have the potential to preserve vision and may allow some lost vision to return. The sooner a detached retina is reattached, the more effective treatment can be. If you are experiencing signs of retinal detachment, please call your ophthalmologist immediately.

Retinal Vein Occlusion Treatment

Vein Occlusion

The retina contains many veins and arteries. Sometimes these blood vessels can become blocked. This is called retinal vein occlusion (RVO). The blocked circulation can lead to swelling, bleeding, growth of abnormal blood vessels, and partial or total vision loss.

Retinal vein occlusions occur most often in older patients. Risk factors include high blood pressure, cholesterol, diabetes, smoking, glaucoma, and, rarely, blood clotting conditions.

Treatment depends on the severity and location of the blockage. Retinal vein occlusions are detected during a dilated retinal exam. Fluorescein angiography may be performed to confirm the diagnosis and plan treatment. There is no cure for retinal vein occlusion. Emphasis is placed on risk management, treatment of symptoms and prevention of further vision loss. It is critical to control high blood pressure, cholesterol, diabetes and other health conditions that increase the risk of vascular blockage.

To learn more about retina diseases and how you can be tested for this serious condition, please call us today to schedule an appointment with one of our doctors.

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Macular Hole Treatment

Macular Hole Treatment Bayside
Macular Hole: Recovery after
Surgery with a Gas Bubble
A macular hole is exactly what it sounds like: a hole in the macula, the center of the retina responsible for central and reading vision. Specifically, the hole or defect occurs in the fovea, the center of the macula and the most delicate part of the entire retina.

Macular holes almost always develop during the natural aging process, when the vitreous (the gel that fills most of the eye) thins and separates from the macula. This can pull on the macula and cause a hole to form. Less commonly, macular holes are caused by eye injury, intraocular inflammation, retinal detachment and other diseases. Most cases occur in people over the age of 60.

At first, a macular hole may only cause a small blurry or distorted area in the center of vision. As the hole grows over several weeks or months, central vision progressively worsens. Peripheral vision is not affected, and there is no risk of blindness. There are three stages of a macular hole, foveal detachments (stage 1), partial-thickness holes (stage 2) and full-thickness holes (stage 3). Each stage can progress to the next if not treated.

Surgery is over 95% effective for the treatment of macular holes. The procedure is outpatient with local anesthesia. A vitrectomy is performed to remove the vitreous gel, and then a gas bubble is injected into the eye to help the hole close. As the eye heals, the fluid is naturally replaced. There is no non-surgical alternative to treat macular holes.

Macular Degeneration Treatment

Macular Degeneration Treatment Bayside
Dry Macular Degeneration
The macula is a part of the retina in the back of the eye that ensures that our central vision is clear and sharp. Age-related macular degeneration (AMD) occurs when the arteries that nourish the retina harden. Deprived of nutrients, the retinal tissues begin to weaken and die, causing vision loss. Patients may experience anything from a blurry, gray or distorted area to a blind spot in the center of vision.

AMD is the number-one cause of vision loss in the U.S. Macular degeneration doesn't cause total blindness because it doesn't affect the peripheral vision. Possible risk factors include genetics, age, diet, smoking and sunlight exposure. Regular eye exams are highly recommended to detect macular degeneration early and prevent permanent vision loss.

Symptoms of macular degeneration include:

  • A gradual loss of ability to see objects clearly
  • A gradual loss of color vision
  • Distorted or blurry vision
  • A dark or empty area appearing in the center of vision

There are two kinds of AMD: wet (neovascular/exudative) and dry (non-neovascular). About 10-15% of people with AMD have the wet form. "Neovascular" means "new vessels." Accordingly, wet AMD occurs when new blood vessels grow into the retina as the eye attempts to compensate for the blocked arteries. These new vessels are very fragile, and often leak blood and fluid between the layers of the retina. Not only does this leakage distort vision, but when the blood dries, scar tissue forms on the retina as well. This creates a dark spot in the patient's vision.

Dry AMD is much more common than wet AMD. Patients with this type of macular degeneration do not experience new vessel growth. Instead, symptoms include thinning of the retina, loss of retinal pigment and the formation of small, round particles inside the retina called drusen. Vision loss with dry AMD is slower and often less severe than with wet AMD.

Recent developments in ophthalmology allow doctors to treat many patients with early-stage AMD with the help of lasers and medication.

To learn more about macular diseases and how you can be tested for this serious condition, please call us today to schedule an appointment with one of our doctors.


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