Eyecare Specialties – Glaucoma By Dr Jason Lake

Hi! One of the questions we get frequently here
in the office is “What is Glaucoma and how do I get it?” “What do I do to prevent it?”. One of the things that we’re gonna talk
about today is I’m gonna use my eye model here because it really helps understand what’s
going on. In this area behind the cornea in the front
part of the eye, there is a fluid called aqueous. As that fluid, if the pressure gets a little
bit too high, it pushes backwards. And as it pushes backwards it compresses this
area. This entire area is filled with a gelatinous
substance called vitreous. Kinda has the consistency of a clear cooking
gelatin. As the pressure builds it pushes backwards. Back here in the back of the eye is the photoreceptors. Those photoreceptors are what collect light
information and they take it through the optic nerve into the brain, and that’s how we
see. If the pressure gets big enough, it slowly
destroys those photoreceptors. The way those photoreceptors die, is they
die peripherally first. That’s why the average patient doesn’t
know if they have Glaucoma. What happens is as we start losing the peripheral
vision, I’m gonna put my eye model here. As we start losing the peripheral vison, what
happens is you wouldn’t notice it if you we’re missing 5 or 10 degrees of peripherally. That’s why we have to run tests called Visual
Field. If anyone has ever had a Glaucoma test they
have to had a little button and they see a little sensor that goes off in the peripheral. We’re trying to check for the sensitivity
of the peripheral retina. One of the things we can do even earlier than
that with today’s technology is Ocular Coherence Tomography. What that does is it actually measures the
thickness of that retina and it compares you to what’s called a normative database. When we’re looking at that information,
we can tell if we do series of those tests if there’s any changes. Sometimes if you’re genetically born with
a thinner retina, you may get some abnormal results that’s why we check it multiple
times. We know if it’s changing it is a disease
process, if it’s abnormal once and stays the same, that’s probably just the way God
made you. So, what are some of the symptoms if you have
advanced as an in-stage Glaucoma, you’re going to lose a lot of your peripheral vision. We’re really playing catch up. The problem with Glaucoma and it’s why they
call it the Thief in the night is it generally speaking you don’t see those symptoms until
it’s too late. You wouldn’t notice it if you were missing
5-10 degrees of your peripheral retina. Can Glaucoma be prevented? Generally, not, what it generally is, a lot
of it is hereditary genetic and can be caused by injury and other things but we can slow
it down. You don’t cure Glaucoma if you have it but
you take medication that lowers the pressure in the front of the eye which in turn takes
pressure off the photoreceptors in the back of the eye. Once you do that, you get a slowing of the
loss and slowing of the death of the photoreceptors. What we hope for with our patients is with
find a go target pressure and we take medication, if we keep it under that and we continue to
monitor those tests we know that we’re not losing any tissue. We’ve already covered how Glaucoma can affect
your vision in-stage but if we treat it properly and do our jobs and catch it early enough,
it shouldn’t affect your vision at all. Who’s at the highest risk? There is a higher risk in the African American
community and there is certain shapes and prescriptions in the eye that actually lend
themselves to be an atomically more susceptible to Glaucoma. The thing to remember is generally, you’re
not gonna know it if you have it or if you’re susceptible unless there’s a family member
whose had it. So, you need to make sure you’re going and
getting your pressure tested and having your optometrist look at the back of your eye,
to make sure the nerve head looks healthy. The treatments that we use are generally eye
drops, or generally topical, some as few as one times a day. I have been in practice for over 20 years. There are patients I’ve had during that
20 years they have used the same drop, one drop at night before bed in the entire 20
years and have got excellent results overtime. The special testing and things that we do
on there are usually every 3 to 6 months. That monitors how the drops are working and
determines whether we need to add further medication to lower the pressure or if we’re
doing a good job with it. Remember the key of thing is come and to see
us at Eye Care Specialties and let us look at the back of your retina and examine the
optic nerve to make sure you have a healthy optic nerve head and we can monitor that for
you, maintain your perfect vision. Thanks

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