Glaucoma | Ophthalmology | Loyola Medicine

Glaucoma

Comprehensive Eye Care Services for Patients with Glaucoma

Loyola Medicine provides comprehensive, multidisciplinary care for glaucoma. Our dedicated team of doctors, surgeons and nurses will provide expert care and address any questions and concerns that you may have.

Glaucoma is one of the leading causes of blindness in the United States. It is a common eye disease characterized by increased fluid pressure in the eye that causes damage to the optic nerve. This condition interferes with the delivery of visual impulses to the brain. Most forms of glaucoma do not produce symptoms until vision is already severely damaged. But if diagnosed early, the disease can be controlled and permanent vision loss can be prevented.

Loyola’s ophthalmology team offers a wide range of comprehensive eye care services. Our board-certified ophthalmologists and licensed optometrists provide diagnostic services and personalized treatment for adults and children in all ophthalmic subspecialties. Our ophthalmology department uses the most current, state-of-the-art equipment and procedures.

What Conditions Does Loyola Treat?

Acute Angle Closure Glaucoma

Acute angle closure glaucoma occurs when there is a sudden rise in intraocular pressure, the pressure inside the eye. This is caused by a buildup of fluid in the eye. Normally, fluid drains out of the eye through a channel called the angle that runs between the cornea and the iris. In cases of acute angle closure glaucoma, the iris presses against the angle, closing it off and preventing fluid from being released.

Learn more about acute angle closure glaucoma.

Chronic Angle Closure Glaucoma

Chronic angle closure glaucoma develops slowly over time as the iris, or colored part of the eye, blocks the eye’s drainage angle. Once it becomes fully blocked, the pressure in your eye increases, leading to a range of symptoms and, sometimes, permanent eye damage.

Learn more about chronic angle closure glaucoma.

Primary Open Angle Glaucoma

Primary open angle glaucoma is the most common of the glaucoma conditions. As the condition progresses, your eye pressure increases; however, your cornea doesn’t swell and you remain symptom free. This often results in the condition going undetected, until permanent damage occurs. Once the optic nerve becomes damaged, you may notice blind spots or loss of vision, especially in your peripheral or side vision.

Learn more about primary open angle glaucoma.

Pseudoexfoliation Glaucoma

Pseudoexfoliation glaucoma is an eye disease that is characterized by the presence of an exfoliative material in the anterior portion of the eye. Over time, this exfoliative material, which is largely comprised of abnormal and thin fibers that overlap each other, builds up in the anterior portion of the eye, and causes eye pressure to rise leading to optic nerve damage. Damage to the optic nerve results in impaired or loss of vision, or glaucoma.

Learn more about pseudoexfoliation glaucoma.

Pigmentary Glaucoma

Pigmentary glaucoma is an eye condition that occurs when the layer of the eye containing pigment, the iris, rubs against the lens, causing the release of pigment particles. These particles accumulate in the eye, preventing the fluid produced by the eye from draining. Fluid buildup can cause increased eye pressure and the development of glaucoma conditions. Eventually, damage to the optic nerve, the structure responsible for sending visual stimuli to your brain, leads to vision loss.

Learn more about pigmentary glaucoma.

Angle Recession Glaucoma

Angle recession glaucoma is a condition that develops from blunt trauma to the eye. Injury can cause the fluid inside your eye to be displaced, which may cause damage that includes torn eye tissues. As a result, scarring and degenerative changes can occur, which blocks the channel that drains the fluids produced by your eye. Fluid buildup can further cause elevated intraocular pressure (pressure inside the eye), leading to angle recession glaucoma.

Learn more about angle recession glaucoma.

Neovascular Glaucoma

Neovascular glaucoma is a condition that affects your eyes’ blood vessels and is frequently associated with diabetes. In neovascular glaucoma, the vessels that supply oxygen-rich blood to your eyes are constricted, thereby cutting off the oxygen necessary to function. Consequently, your body will signal new blood vessels to grow. This process eventually causes new growth to plug the channel that drains the fluids produced by your eye. Blockage can cause fluids to build up and create pressure on the optic nerve; damage to the nerve will eventually lead to vision loss.

Learn more about neovascular glaucoma.

Congenital Glaucoma

Congenital glaucoma occurs when high fluid pressure in the eye puts too much strain on the optical nerve, damaging it. Normally, this fluid is drained away from the optical nerve, but people with this disease are born with a problem that affects the eye’s drainage channel. Because this disease is present at birth, this problem is either due to an issue with development or inherited malformation.

Learn more about congenital glaucoma.

How Is Glaucoma Diagnosed?

Assessment of the optic nerve

Indications: A slit lamp microscope is used to determine whether or not there are changes in the optic nerve’s size and shape.

Procedure: The patient is positioned in front of the slit lamp and the ophthalmologist focuses a narrow, high-intensity beam towards the eye to examine the optic nerve.

Evaluation of your visual field

Indications: Glaucomatous damage produces characteristic defects in the central and peripheral visual fields. Vision tests can be used to assess any abnormalities that may indicate the presence of glaucoma.

Procedure: The patient is asked to look straight ahead and indicate when a moving light passes into the peripheral visual field.

Measurement of intraocular eye pressure (IOP)

Indications: Normal IOP is between 12-22 mm Hg (millimeters of mercury). Elevated IOP is a major risk factor for the development of glaucoma. Optic nerve damage becomes more likely as the IOP increases.

Procedure: The patient’s eyes are numbed with eye drops and the inner pressure of the eye is measured with a device called a tonometer or a warm puff of air. ​

How Is Glaucoma Treated?

Treatment for glaucoma involves decreasing intraocular pressure and preventing damage to the optic nerve. Options include medicated eye drops and surgery to create a route for aqueous fluid to drain out of the eye.

Eye Drops

Eye drops are often effective in reducing intraocular pressure. Several different classes of glaucoma medications are available, including beta-blockers, prostaglandin analogues, alpha adrenergic agonists, miotics and carbonic anhydrase inhibitors. These medications work by either reducing the rate at which fluid in the eye is produced or increasing the outflow of fluid from the eye.

Surgeries to create a new passage for fluid drainage

  • Canaloplasty — For patients with open angle glaucoma, especially those at risk for infection and bleeding. This procedure uses a small tube to enlarge the eye’s drainage canal, relieving pressure in the eye.
     
  • Drainage implants — For more severe cases of glaucoma and in children. In this procedure, a small tube is inserted into the eye to allow the aqueous fluid to drain. This is also called tube shunt surgery.
     
  • Endocyclophotocoagulation (ECP) — For patients with both glaucoma and a cataract. During this procedure, a tiny probe and a fiber optic camera are used to locate and treat some of the fluid-producing cells in the eye, causing a reduction in fluid.
     
  • Trabectome - For patients with both glaucoma and a cataract, this procedure removes the eye’s natural filtering system, allowing fluid to drain from the eye more easily.
     
  • Trabeculectomy — An opening, surgically created under a trap-door incision in the sclera, allows the aqueous fluid to drain. Anti-scarring medications such as mitomycin or fluorouracil are commonly applied at the surgical site to reduce scarring that could close the trap door. As a result of this procedure, eye pressure will be relieved.

Exceptional Research to Advance Ophthalmology Care

Loyola’s expert ophthalmology program is actively pursuing new research with a focus on patient-centered outcomes. As an academic medical center, Loyola is dedicated to improving future treatments by conducting research on new diagnostics and treatments. Loyola’s patients benefit from research discoveries made here; read about Loyola’s current clinical trials.