Glaucoma and What Vision Source Specialists Can Do

*Blog Written By Dr.Dawn Wattenhofer
Why is Prevention and Detection of Glaucoma so vital?
Early detection and treatment  of glaucoma gives patients a chance to maintain vision and avoid more invasive treatments, like surgery, in the future.  So, early detection allows for the best outcome and the least vision loss.
Treatment
Initial glaucoma treatment involves instilling medicated eye drops in the eye(s) every day.  We may be able to control glaucoma with one drop, but some patients require more.  Laser treatments can reduce eye pressure for a temporary time, possibly up to two years.  Patients can have tiny drainage tubes (to lower eye fluid pressure) placed in their eyes during routine cataract procedures.   More aggressive forms of surgery are sometimes needed if the glaucoma cannot be controlled.
Many people confuse glaucoma as being high eye pressure.  The most important test we use to detect glaucoma is the health of the optic nerve.  Patients can have glaucoma with low eye pressure.  Some patients even have high eye pressure and do not develop glaucoma.
Detection 
Detecting glaucoma early is like detective work.  Patients typically do not have symptoms with the most common types of glaucoma.  When a patient shows early signs or risk factors of glaucoma, multiple tests need to be performed.  Sometimes, we have to wait 6-12 months and repeat the tests.  The most common form of glaucoma progresses gradually and we diagnose it by finding change over time.  If your doctor thinks you are a glaucoma suspect, continue performing tests over time: that is how you are most likely to diagnose glaucoma early when vision loss is minimal.
At Vision Source Specialists, Dr. Pearson and Dr. Wattenhofer use two new technologies, in addition to traditional testing, to diagnose glaucoma earlier.  One screening we use is called the Ganglion Cell Complex Analysis, and it is performed on every patient at every comprehensive exam.  This is done with a simple, non-invasive retinal scan called the iWellness scan.  The Ganglion Cell Complex is the specific layer of cells that are damaged in glaucoma, so isolating and analyzing this layer can detect glaucoma before other traditional testing.

When a patient is showing possible signs of glaucoma, the doctors use traditional testing along with another test called Pattern Electroretinography (pERG) to detect early glaucoma.  Traditional tests for glaucoma measure cell death over time (or the vision loss associated with cell death).  The pERG test is different because it measures stress on the living cells, which highly correlates with glaucoma.  If this stress is detected early, we may be able to treat glaucoma before there is any vision loss at all.
Research suggests that 1/3 to 1/2 of our Retinal Ganglion Cells are dead before vision loss can be detected on a traditional Visual Field test.  Glaucoma is not treatable, but it is manageable.  Once vision loss is present, we can never gain it back, so it is very important to detect and treat glaucoma early.  If we can detect and treat glaucoma earlier, another possible benefit will be less need for invasive surgeries later in life.
We don’t have a cure for glaucoma, but vision loss can be slowed.  Our treatment goal is to help patients maintain functional vision throughout their lives.  The earlier we detect and treat glaucoma, the more likely we are to reach this goal.