Glaucoma Risks, Types & Testing

At Ridgewood Eye Associates, our ophthalmologists and eye surgeons provide examination, diagnosis and treatment of glaucoma. Glaucoma is an eye problem that can damage the optic nerve and cause loss of vision. Most serious eye problems typically produce some symptoms that make patients uncomfortable or disturb their vision. However, the most common type of glaucoma, called Primary Open Angle Glaucoma, begins without any symptoms or obvious loss of vision. It is critical to diagnose and treat glaucoma as early as possible through regular eye examinations in order to prevent vision loss as with early detection and diagnosis, in the vast majority of cases, glaucoma can be treated and controlled.

Glaucoma Testing & Diagnosis

During your examination, we may perform a number of tests in order to make the most accurate diagnosis of glaucoma. These include Tonometry, to measure eye pressure, Ophthalmoscopy, to carefully examine the inside of the eye – especially the optic nerve, Visual Field testing, using a computer bowl-like instrument to evaluate your “side” or peripheral vision to see how sensitive your side vision is in various directions, Gonioscopy, to directly observe the health and condition of the angle of your eye where the iris meets the cornea, OCT or “optical coherence tomography,” digital imaging of the optic nerve and retina, and Pachymetry, or corneal thickness measurement, as corneal thickness can alter the accuracy of the measurement of intraocular pressure (IOP), and it appears that patients with thin corneas may be inherently more likely to develop glaucoma.

Glaucoma Risks & Types

Depending on your general health, eye health and family history, a number of factors may increase your likelihood of developing glaucoma. An increased risk of glaucoma occurs when you have higher than normal intraocular pressure (IOP), being above 40 and especially above 60 years of age, being of African-American descent or Hispanic and above 60 years of age, being extremely nearsighted, having high blood pressure or diabetes, and especially, anyone who has a family history of glaucoma is at considerably greater risk. Prolonged use of oral contraceptive birth control pills, as well as the early onset of menopause, may increase glaucoma risk in women. In addition, anyone suffering from sleep apnea needs to be carefully examined, as this condition significantly increases glaucoma risk. If you have had trauma to your eyes, such as from a sports injury or car accident, or if you have been treated for asthma or other conditions for long periods of time with steroid inhalers, or have a corneal thickness less than 0.5mm, you too might be at greater risk of developing glaucoma. The two main types of glaucoma are Primary Open Angle Glaucoma (POAG), and Angle Closure Glaucoma.

Patients with Primary Open Angle Glaucoma usually have an increase in Intraocular Pressure (IOP) upon routine measurement, called Tonometry. Acute Angle Closure Glaucoma is one of the only types of glaucoma that causes obvious symptoms that may include pain, light sensitivity, redness, blurred vision, colored haloes around lights and nausea or vomiting and is a medical emergency. If you have these symptoms, please call Ridgewood Eye Associates at 201-857-4999 for an immediate appointment.


Medical, Laser & Surgical Glaucoma Treatment

The goal of glaucoma treatment is to stabilize and control your eye pressure in order to provide the best chance of preserving your vision. The three main glaucoma treatments are medical-using eye drops, glaucoma laser treatment & glaucoma surgery, most often minimally invasive glaucoma surgery (MIGS).

Medical Treatment of Glaucoma

Primary Open Angle Glaucoma can initially been treated with eye drops and/or an in office laser treatment called Selective Laser Trabeculoplasty (SLT). By using one or two types of glaucoma eye drops most patients are able to achieve a stable and lowered eye pressure. Some patients are unable to achieve adequate control with eye drops alone, or may experience intolerable side effects from the eye drops, and do better with an the office glaucoma laser treatment to maintain control as a first choice of treatment.

Laser Treatment of Glaucoma

Selective Laser Trabeculoplasty (SLT) is a type of glaucoma laser treatment for Primary Open Angle Glaucoma that helps to reduce the Intraocular Pressure (IOP) by creating more effective drainage of fluid through the trabecular meshwork. We perform this painless procedure in the comfort of our office and often patients are able to obtain good stability and also reduce the number or frequency of eye drops they need to use. Laser Peripheral Iridotomy (LPI) is a type of glaucoma laser treatment for Angle Closure Glaucoma that creates a hole on the outer edge, or rim, of the iris, the colored part of the eye which allows the aqueous humor fluid to easily flow between the anterior chamber, the front part of the eye, and the area behind the iris, the posterior chamber. This is performed for patients with narrow chamber angles or those patients experiencing angle closure to prevent sudden buildup of pressure within the eye, which occurs during an episode of acute closed-angle glaucoma.

Surgical Treatment of Glaucoma

Even with the maximum eye drop medical therapy and glaucoma laser treatment, for some patients it is still not possible to achieve good stable control of their disease and stop the progression of vision loss. Glaucoma specialists are able to perform Minimally Invasive Glaucoma Surgery (MIGS) for most patients. Sometimes traditional glaucoma surgery may be an option and may include removing a tiny piece of the trabecular meshwork-called Trabeculectomy or a MIGS procedure to implant microscopic tubes, shunts, valves or stents may be recommended.