Glaucoma is due to elevated pressure in the eye causing loss of vision. It can occur acutely with pain or insidiously without pain. There are many causes for glaucoma. Therefore, a thorough consultation and regular eye checkup is necessary.


There is a fluid called ‘aqueous’ which is secreted by a structure called ‘ciliary body’ located behind the iris. Aqueous passes through the pupil to bring nutrients to the cornea. Aqueous is then drained out of the eye via the trabecular meshwork, situated in front of the iris. You can imagine the iris as a wall separating the ciliary body and trabecular meshwork. The pupil can be imagined as the door where aqueous passed through. Any impediment to the flow of aqueous can cause elevated pressure in the eye. This can damage the nerve and cause the field of vision to constrict. Glaucoma can be classified into open angle and narrow angle.

HOW IS GLAUCOMA DETECTED AND MONITORED?

Check the Angle                             
Check the Pressure
Check Cornea Thickness
Check Nerve Fiber Layer Thickness
Check Visual Field                       
Normal Visual Field
Moderate Glaucoma Damage
Severe Glaucoma Damage

TREATMENT OPTIONS







Eye drops lower the intraocular pressure by decrease aqueous production or drains aqueous out of the eye via a different pathway.




There are different types of lasers used in ophthalmology, two of which are used to treat glaucoma. They lower the intraocular pressure of the eye by different mechanisms depending on the causes of glaucoma.



Selective Laser Trabeculoplasty

This is a laser applied to the trabecular meshwork to help the aqueous to drain better via the trabecular meshwork. This is used in treatment of Open Angle Glaucoma.


Laser Iridotomy

Aqueous flow can be blocked at the pupil such as by a growing cataract. This will cause sudden or gradual rise in intraocular pressure. A small hole is created in the iris to release the pressure. You can imagine this as a valve in a pressure cooker that lets out steam to release the pressure. This is used in treatment of Narrow Angle Glaucoma.

This is shunt inserted into the trabecular meshwork to bypass the resistance in the trabecular meshwork. Usually 2 shunts are needed. Patients do not feel the shunt. It helps to decrease the number of eye drops required in the glaucoma treatment



Trabeculectomy

This is a surgery that creates a fistula that drains aqueous outside the eye.


Seton Procedure

This is a surgery that inserts a tube into the eye to drain the aqueous outside the eye.


Cyclophotocoagulation

This procedure is performed when all of the above treatment fails. It uses laser to damage the ciliary body so that it produces less aqueous.


Dr. Chiu will tailor the treatment plan according to your condition and monitor you with different tests. Dr. Chiu will also work closely with your optometrist to ensure you get the best care.