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Dr. Williams discusses glaucoma and walks us through a typical eye examination.
Glaucoma is a disease that has no symptoms and can cause blindness. It is totally asymptomatic in its early, and into its late stages. That’s the reason examinations for glaucoma need to be performed. Glaucoma is a plumbing problem in the eye caused by high eye pressure. Largely, patients adjust to the high eye pressure so they can’t tell that it’s high. Pressures have to be checked, but it can occur even if pressures are normal. Normal pressure glaucoma can also cause the same serious sight loss as pressures that are high. Your optic nerve needs to be checked carefully.
First we’ll check the vision in the right eye. Stephanie, can you read the letters for me that you see there? [Stephanie: V, L, N, R, E]. Very good, that’s excellent. [Stephanie: O, F, C, O,T]. Very good, thank you. Now I’m going to put some drops in your eye so that we can measure your pressure for glaucoma. Look up for me.
I’m looking at the front of Stephanie’s eye with a microscope, looking for any abnormalities. And now I’m going to check her intraocular pressure with this device. This actually touches the surface of her eye but is not painful. The eye has been made numb with the eye drops I just placed it. This measures the pressure in millimeters of mercury. (Look straight ahead).
The optic nerve condition is paramount for making the diagnosis; it’s of paramount importance because pressures can be normal and you can still have glaucoma. The appearance of the optic nerve has to be carefully looked at. And we have new diagnostic machines available that can check the condition of the optic nerve in addition.
Stephanie has been diagnosed with glaucoma. I have recommended a series of eye drops to treat her intraocular pressure. Her initial pressures were very high and they have now been brought under control. It’s important to realize that vision lost from glaucoma is irreversible. Not even with surgery can vision be brought back.
The treatment of glaucoma is carried out initially by using eye drops. Later on, if eye drops are not successful, laser can be used. Laser can be used as an initial treatment in some patients and is a safe, simple treatment for glaucoma for the right selected group of patients.
Most patients throughout the United States are treated with eye drops for glaucoma exclusively, and it protects their vision throughout their life. It’s important to know as well, glaucoma is a treatable condition. So if you have questions about glaucoma or your eye health, please ask your doctor.
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A. Sydney Williams, MD is a Board-certified ophthalmologist, glaucoma specialist and surgeon in private practice at the San Francisco Eye institute in San Francisco and San Mateo, CA. He is an Associate Clinical Professor at the University of California in San Francisco in the Department of Ophthalmology and past director of glaucoma service at Stanford University Hospital.
Last reviewed on September 14, 2015