Glaucoma

Glaucoma refers to a group of eye diseases that damage the optic nerve and cause vision loss. Usually this damage is associated with increased intraocular pressure (IOP). This debilitating condition is one of the leading causes of blindness in Canada.

It is important to maintain routine eye examinations, as most forms of glaucoma often have no symptoms until vision loss occurs. During a routine examination, Dr. Skouras is able to detect any risk factors that may lead to glaucoma and provide any necessary diagnostic testing or treatment.

Causes, Symptoms and Diagnosis

There are several forms of glaucoma, the most common of which are open-angle glaucoma and angle-closure glaucoma.

• Open-angle glaucoma: Open-angle glaucoma is the most common form of glaucoma. While it appears the structure of the eye is normal, fluid does not drain properly and begins to cause damage to the optic nerve. It is unknown what causes open-angle glaucoma, although we do know that genetics play a big role; if someone in your family has had glaucoma, you are at increased risk of developing the disease. Those with open-angle glaucoma are less likely to notice symptoms until the disease has progressed to the point where the optic nerve has been permanently damaged.
• Narrow angle glaucoma: The onset of angle-closure glaucoma occurs quickly when the exit of aqueous humor fluid is obstructed. When this occurs, intraocular pressure spikes, with pain and vision loss soon following. Nausea, vomiting and rainbow-colored halos around lights are other signs of angle-closure glaucoma.

During a routine examination, Dr. Skouras evaluates the risk of glaucoma based on family history, intraocular pressure and assessment of the optic nerve. Based on the findings of the examination, other diagnostic scans may be required.

Dr. Skouras recommends adults maintain routine eye exams every 1-2 years. It is especially essential that patients of African descent and those with a family history of glaucoma maintain regular eye exams to catch problems in their earliest stages. To help diagnose and monitor potential risk of glaucoma, several diagnostic scans will be performed on a regular basis. These include visual field perimetry testing, optical coherence tomography (OCT) and Heidelberg retinal tomography (HRT).

Glaucoma Treatment

There are several types of treatment for open-angle glaucoma, the most common being eye drops. These eye drops will increase the circulation of eye fluid and lower eye pressure, either by decreasing the production of fluid within the eye, or by increasing the flow leaving the drainage channel. Eye drops may have contradictions with other medications, so it is important to notify Dr. Skouras of all medications you are taking, and update him on any new medications while using glaucoma eye drops.

When eye drops alone are not sufficient in lowering intraocular pressure, or when a patient has intolerance to the eye drops or is not compliant in using them correctly, Dr. Skouras will perform selective laser trabeculoplasty (SLT). SLT is a therapeutic laser treatment that has become very successful in lowering intraocular pressure and can be used in conjunction with eye drops, often eliminating them altogether for some patients. SLT uses short pulses of low energy light to target cells in the drainage system within the eye. This laser treatment induces an inflammatory response from the body, increasing the drainage of fluid and reducing intraocular pressure.

In patients that are not properly controlled with eye drops and SLT treatment, surgery may be required.

Those diagnosed with narrow angles are advised to seek immediate treatment to prevent the potential onset of glaucoma. Dr. Skouras performs YAG peripheral iridotomy, a laser treatment that creates a new passageway in the iris to relieve pressure. This passageway allows the eye fluid to move about freely within the eye, thereby reducing the risk of increased intraocular pressure. The procedure lasts only a few minutes per eye, and is performed in the clinic. Dr. Skouras uses anesthetic eye drops so that the procedure is not painful. Additional medications are often prescribed to prevent post-treatment inflammation.

If you would like to schedule a check-up for glaucoma, please contact Skouras Eye & Cosmetic Centre immediately by calling (416) 590-0445 or sending us an email.