Skip to main content
header2
Home » Eye Care Services » Management of Ocular Diseases » Glaucoma Testing & Treatment

Glaucoma Testing & Treatment

Transcript:

Hi there, this is Dr. Bajwa from Buena Vista Optometry in Ventura, California. I wanted to talk to you today a little bit about some new research that’s come out regarding marijuana and eye pressure. It’s been a common question from a lot of my patients as to whether or not marijuana can help with their glaucoma or help manage their glaucoma. We’ve known for years that tetrahydrocannabinol or the THC that’s in marijuana, the psychoactive ingredient does have an effect on the pressure in the eye but the real question was, it ever good enough to be considered an adequate adjunct to our glaucoma therapy.

A recent article in the investigation and journal called the investigative ophthalmology and vision science December issue recently actually reported that a topical form of tetrahydrocannabinol or THC was found to be very effective in dropping the pressure for about eight hours and a lot of patients, but interestingly it was more effective in male patients than it was in female patients. Additionally, one of the other ingredients of marijuana cannabidiol or CBD which is also getting quite popular now with the legalization of marijuana here in California was unfortunately found to be an antagonist to THC and actually prevented the pressure decrease that THC was able to provide.

The reason I mentioned this again is we have a number of patients who are usually inquiring about whether or not marijuana can be used as an adjunct therapy to their glaucoma medication regimen or if it’s going to be preventative for them and unfortunately depending on what method or mode of marijuana consumption you utilize there’s potential that it could be beneficial it could also be detrimental to the beneficial effects of some of the other ingredients.

Lastly when we talk about glaucoma our primary goal of treatment is to lower the pressure in the eye and by lowering the pressure we can help minimize the amount of damage that might be occurring in the back of the eye it is important for you to let your optometrist or ophthalmologist know if you do utilize marijuana for your many aches and pains or what have you because it can affect the pressure readings that we get that can affect the management that we provide for you. If you have a family history of glaucoma, if you are nearsighted, if you are Latino or African-American or if you’re over the age of 50 it is certainly recommended to have your eyes checked because there’s a higher likelihood of developing glaucoma in those specific groups. Again, this is Dr. Ranjeet Bajwa from Buena Vista Optometry. If you have any questions or concerns about your eyes you can always reach me on twitter @DrRajBaj or online at https://www.buenavistaoptometry.com – Take care and talk to you soon.

Glaucoma is a leading cause of preventable vision loss and blindness in adults in the United States and Canada and the second leading cause of blindness in the World.

What is Glaucoma?

Glaucoma is actually a group of eye diseases that cause damage to the optic nerve due to an increase in pressure inside the eye or intraocular pressure (IOP). When detected in the early stages, glaucoma can often be controlled, preventing severe vision loss and blindness. However, symptoms of noticeable vision loss often only occur once the disease has progressed. This is why glaucoma is called “the sneak thief of sight”. Unfortunately, once vision is lost from the disease, it usually can’t be restored.

Treatments include medication or surgery that can regulate the IOP and slow down the progression of the disease to prevent further vision loss. The type of treatment depends on the type and the cause of the glaucoma.

Risk Factors

Prevention is possible only with early detection and treatment. Since symptoms are often absent, regular eye exams which include a glaucoma screening are essential, particularly for individuals at risk of the disease. While anyone can get glaucoma, the following traits put you at a higher risk:

  • Age over 60
  • Hispanic or Latino descent, Asian descent
  • African Americans over the age of 40 (glaucoma is the leading cause of blindness in African Americans, 6-8 times more common than in Caucasians.)
  • Family history of glaucoma
  • Diabetics
  • People with severe nearsightedness
  • Certain medications (e.g. steroids)
  • Significant eye injury (even if it occurred in childhood)

Signs and Symptoms of Glaucoma: Due to a buildup of pressure in the eye, glaucoma causes damage to the optic nerve which is responsible for transmitting visual information from the eye to the brain. How does glaucoma affect your vision?

Types of Glaucoma: There are a number of types of glaucoma, some more acute than others. Learn about the common types of glaucoma and the differences between them.

Diagnosis and Treatment of Glaucoma: Early detection and treatment of glaucoma is essential to stopping or slowing the disease progression and saving vision. Treatment can include medicated eye drops, pills, laser procedures and minor surgical procedures depending on the type and stage of glaucoma.

Signs and Symptoms of Glaucoma

The intraocular pressure caused by glaucoma can slowly damage the optic nerve, causing a gradual loss in vision. Vision loss begins with peripheral (side) vision, resulting in limited tunnel vision. Over time if left untreated, central vision will also be affected which will increase until it eventually causes total blindness. Unfortunately any vision that is lost from the optic nerve damage cannot be restored.

What are the Symptoms?

Typically, glaucoma sets in without any symptoms. At the early onset of the most common type of glaucoma “open angle” glaucoma, vision remains normal and there is no pain or discomfort. This is why the disease is nicknamed the “sneak thief of sight”.

An acute type of glaucoma, called angle-closure glaucoma, can present sudden symptoms such as foggy, blurred vision, halos around lights, eye pain, headache and even nausea. This is a medical emergency and should be assessed immediately as the intraocular pressure can become extremely high and cause permanent damage within hours.

Types of Glaucoma

The primary forms of glaucoma are open-angle and narrow-angle, with open-angle being the most common type.

Primary open-angle glaucoma (POAG) gradually progresses without pain or noticeable vision loss initially affecting peripheral vision. By the time visual symptoms appear, irreparable damage has usually occurred, however the sooner treatment starts the more further vision loss can be prevented. When untreated, vision loss will eventually result in total loss of side vision (or tunnel vision) and eventually total vision loss.

Normal-tension glaucoma or low-tension glaucoma is another form of open-angle glaucoma in which the intraocular pressure remains within the normal level. The cause of this form of glaucoma is not known, but it is believed to have something to do with insufficient blood flow to the optic nerve, causing damage. Individuals of Japanese descent, women and those with a history of vascular disease or low blood pressure are at higher risk.

Angle-closure glaucoma can be a sudden increase in eye pressure causing severe pain, blurred vision, halos, nausea and headaches. The pressure is caused by a blockage in fluid at the front of the eye which is a medical emergency and should be treated immediately. Without prompt treatment to clear the blockage vision can be permanently lost.

Congenital glaucoma is an inherited form of the disease that is present at birth. The babies are born with a defect that slows the normal drainage of fluid out of the eye and are usually diagnosed by the time they turn one. In these cases there are typically some noticeable symptoms such as excessive tearing, cloudiness or haziness of the eyes, large or protruding eyes or light sensitivity. Surgery is usually performed with a very high success rate of restoring full vision.

Secondary glaucomas are complications that develop from eye surgeries, injuries or other medical conditions such as cataracts, tumors, or a condition called uveitis which causes inflammation. Uncontrolled high blood pressure or diabetes can result of another serious form called neovascular glaucoma.

Pigmentary glaucoma is a rare form in which pigment from the iris sheds and clogs the drainage of fluid from the eye resulting in inflammation and damage to the eye and drainage system. .

Treatment of glaucoma is dependant upon the severity and type of glaucoma present.

Glaucoma Diagnosis and Treatment

Detecting Glaucoma

During a routine comprehensive eye exam to check for glaucoma, your eye doctor will dilate your eye to examine the optic nerve for signs of glaucoma and will also measure the intraocular pressure (IOP) with an instrument called a tonometer. Tonometry involves numbing the eye with drops and then gently pressing on the surface of the eye to measure the pressure. Since your IOP can fluctuate throughout the day and glaucoma can exist without elevated IOP this is not enough to rule out the disease. If there are signs of the disease, further testing will be performed.

Visual Field Test

A visual field test is designed to detect any blind spots in your peripheral or side field of vision. You will be asked to place your head in front of a machine while looking ahead and indicate when you see a signal in your peripheral field of view.

Your doctor may also measure the thickness of the cornea with an ultrasonic wave instrument in a test called pachymetry or use imaging techniques such as digital retina scanning or optical coherence tomography (OCT) to create an image of your optic nerve to look for glaucoma damage.

Treating Glaucoma

Treatment for glaucoma depends on the type and severity of the disease and can include medication such as eye drops or pills or laser or traditional surgery.

Medication and drops to lower IOP are often the first resort for controlling pressure-related glaucoma. These drops may have some uncomfortable side effects, but compliance with the treatment plan is essential for preserving vision and halting the progression of the disease.

Surgical procedures are designed to control the flow of fluids through the eye by either decreasing the amount of fluid produced or improving the drainage. Your doctor may decide that a combination of surgery and medication will be the most effective in many cases.

It cannot be stressed enough that the most effective treatment for glaucoma happens when the disease is detected and treated early before significant vision loss occurs. Any vision that is lost can not be restored. This is why the best prevention is awareness by knowing your risks and taking responsibility by having your eyes examined on a regular basis.

Learn about how we Treat Macular Degeneration in Ventura, CA.

Request An Appointment

or Call Us At:  (805)  620-3115