By Cheryl L. Dejewski & Carolyn Vescio
Glaucoma is a leading cause of blindness in the U.S., especially for African- Americans. In fact, black Americans have a 6-8 times higher risk of developing glaucoma than whites, and a recent study found that one in five black Americans age 75 and older has glaucoma. If you have diabetes, your risk increases even more. Glaucoma also has strong family ties. If you have a brother or sister with glaucoma, you have a 20% chance of developing the disease by the time you reach 70. And, once you have glaucoma, you’re more likely to suffer falls and car accidents as damage to your optic nerve leads to a “tunneling” of your vision.
How can you protect yourself from this sight-threatening disease? The partners at Eye Care Specialists, one of Wisconsin’s leading ophthalmology practices, advise that you schedule regular, dilated eye exams and follow your doctor’s recommendations, including using medications as prescribed. In this article, they explain how lasers and implants are now being used to treat certain cases of glaucoma.
One Patient’s Story . . .
Judith Nieskes, 65, was diagnosed with glaucoma in 2008. Soon thereafter, her husband’s friend suggested that she make an appointment with Eye Care Specialists, a leading local ophthalmology practice. “At first, my pressures weren’t too bad. There is no history of glaucoma in my family, and I really wasn’t that worried about it,” recalls Nieskes. “But then all of a sudden the pressure in my left eye just went wild. I got really scared when the pressure went up to 50. (Normal pressures range from 12-21 mmHG.) I was upset, because I was doing everything the doctors told me to do and it just didn’t seem to be enough. I love to read anything and everything and I was having trouble doing that and it was really frustrating.”
Ophthalmologist Dr. Robert Sucher explains, “Unfortunately for Mrs. Nieskes, she is one of the small number of patients whose glaucoma cannot be successfully controlled with traditional treatment methods like prescription eyedrops and/or laser therapy. (See the “Fast Facts” section for more information.) That’s when my partner, Dr. Ferguson, and I decided that Mrs. Nieskes was a good candidate for a special advancement in glaucoma treatment—drainage implant surgery.”
Since 1969, researchers have been making improvements in the design of implant devices to decrease glaucoma pressure by increasing the outflow (drainage) of fluid from inside the eye. Also known as “tube shunts,” these devices are typically made of silicone and are positioned so that they are not visible to others. “Glaucoma drainage implants contain a tiny tube that allows fluid inside the eye to drain to a flexible plate behind the eye where the lymphatic system can reabsorb it back into the body. The end result is lower eye pressure. Some drainage implants incorporate a valve to control outflow, others limit outflow in other ways. These devices enable us to protect and preserve vision for patients who have run out of treatment options,” notes Ferguson, who performs the advanced surgical procedure.
“I’m really glad I had the surgery. It wasn’t as easy as my cataract surgery, but it was worth it,” remarks Nieskes. Since her valve procedure, the pressure in her left eye has gone down to a range of about 14-18 mmHg.
“I have thanked my husband’s friend so many times for referring me to Eye Care Specialists,” Nieskes exclaims with a laugh. “I’m very pleased with everything that everyone there has done— they are all so professional and kind. I’ve already recommended a friend who ended up having ECP surgery for her glaucoma, and I just gave another friend who is having eye trouble the doctors’ business card and an article written by them.”
When she isn’t busy educating her friends about the importance of proper eye care or keeping up with her voracious reading habit,” Nieskes enjoys spending time with her husband and her teenage grandchildren.
Fast Facts About Treatment Options
- What is glaucoma?
Dr. Norman Cohen: It is an eye disease that causes progressive damage to the optic nerve and is often related to an increase in fluid pressure in the eye. Left undetected and/or untreated, glaucoma will first cause loss of side vision and later possibly all sight. - How is glaucoma treated?
Dr. Robert Sucher: The most common type is a lifelong condition that requires continual management. To prevent vision loss, we prescribe drops to lower pressure by either decreasing fluid production in or increasing fluid drainage out of the eye. - Is there an alternative to drops?
Dr. Mark Freedman: In some cases, when drops alone cannot control the pressure, or side effects are intolerable, or multiple types of drops are required, laser treatment may be an alternative. The procedures we utilize include LTP & SLT (which increase fluid drainage) and ECP (which decreases fluid production). All take less than 10 minutes at our surgery center and are covered by Medicare & most insurances. - How safe are laser procedures?
Dr. Brett Rhode: LTP, SLT & ECP have very good success rates for controlling glaucoma and reducing the need for drops or surgery. They also have lower complication rates than other glaucoma surgeries and can sometimes be repeated, as needed. - What are the major benefits?
Dr. Daniel Ferguson: If laser treatment achieves the goal of steady normal pressures, it may eliminate two huge burdens—cost and compliance. Patients may no longer have to worry about buying and taking their drops. This is especially important for people who already have other conditions requiring daily medication. - Glaucoma hits 1 in 30 people over age 40. Are you at risk?
Because glaucoma has no symptoms, the American Academy of Ophthalmology encourages everyone over the age of 40 or anyone with any of the following known risk factors to undergo a thorough screening to detect the disease before vision is compromised. Risk factors for glaucoma include:- Age (over 40)
- A family history of glaucoma
- African, Hispanic or Asian heritage
- Diabetes
- Hypertension
- Myopia (nearsightedness)
- A previous eye injury
- Long-term steroid/cortisone medication use
- Pre-existing elevated intraocular pressure
Free educational booklets & information
Eye Care Specialists’ doctors are dedicated to the diagnosis and treatment of glaucoma, diabetic eye disease, AMD and cataracts. They frequently lecture to the public and fellow physicians and have written their own series of booklets on these conditions. Call 414- 321-7035 for FREE copies or to schedule an appointment for a thorough eye screening (usually covered by insurance or Medicare) at their offices on 7th & Wisconsin Avenue, Mayfair Road across from the mall, or 102nd & National. They can also be found at www.eyecarespecialists.net.
