Vision Care

The Food and Drug Administration has approved two new drugs for the management of glaucoma. Glaucoma is the second leading cause of blindness in the United States and the leading cause of irreversible blindness in the world. Glaucoma is characterized by an increase in the pressure within the eyeball from a fluid within the eye called the aqueous humor. This increase in eye pressure, if left untreated, damages the optic nerve and leads to blindness. Lumigan (bimatoprost ophthalmic solution) and Travatan... more

Early detection of glaucoma. InSite Vision Inc., Alameda, CA, has launched a new test for the early prognosis and diagnosis of glaucoma. The test, ISV-900, is named the OcuGene glaucoma genetic test. Early detection is important because glaucoma usually has no signs or symptoms until serious loss of vision has occurred. Those who are considered to be at risk for developing glaucoma include relatives of glaucoma patients and ocular hypertensives. The OccuGene glaucoma genetic test will be available... more

Different forms of glaucoma are based on the configuration of this angle. Open-angle glaucoma is the most common form in the USA. In angle-closure glaucoma, the iris, or colored part of the eye, blocks fluid drainage and causes elevated eye pressure. Having narrow angles does increase the risk of developing angle closure glaucoma. This can happen abruptly in an acute angle-closure attack, or it can occur more insidiously in chronic angle-closure glaucoma. In either condition, damage to the vision... more

Because glaucoma may not initially cause symptoms, the best form of prevention is to have regular eye exams. Patients with narrow angles should avoid certain medications (including some over-the-counter medications, such as some cold or allergy medications). Patients who are glaucoma-susceptible (i.e. have narrow angles and borderline IOPs) should be advised to read the warning labels on over-the-counter medicines and inform physicians of products they are considering taking. Steroids may also raise... more

The first line of glaucoma treatment is the use of prescription eyedrops. Several classes of medications are effective at lowering IOP and thus preventing optic nerve damage in chronic and neonatal glaucoma. Beta blockers (e.g. timolol), carbonic anhydrase inhibitors (e.g. acetazolamide), and alpha-2 agonists (e.g. brimonidine tartrate) inhibit aqueous humor production. Miotics (e.g. pilocarpine) and prostaglandin analogues (e.g. latanoprost) increase the outflow of aqueous humor. It is important... more

The initial glaucoma diagnosis is made through an eye examination by an optometrist (O.D.) or ophthalmologist (M.D.). The examination begins with an ophthalmic assistant, technician, or scribe gathering patient information, including any family history of glaucoma. Then the ophthalmic assistant takes a reading of the patient’s intraocular pressure (IOP). IOP is measured with an instrument called a tonometer, using a technique called applanation tonometry. The test is performed after anesthetic... more

The cause of vision loss in all forms of glaucoma is optic nerve damage. There are many underlying causes and forms of glaucoma. Most causes are not known, but it is evident that different processes are involved, and a malfunction in any one of them could cause glaucoma. For example, eye trauma may result in the angle becoming blocked, or, as a person ages, the lens may become larger and push the iris forward. The cause of optic nerve damage in normal-tension glaucoma is also unknown, but there is... more

Glaucoma is a condition where the optic nerve is subject to damage-usually, but not always, because of excessively high intraocular pressure (pressure within the eye, also called IOP). If untreated, the optic nerve damage results in progressive, permanent vision loss, starting with unnoticeable blind spots in the field of vision, progressing to tunnel vision, and then to blindness. More than 2 million people in the United States have glaucoma, and 80,000 of them are legally blind as a result. It... more

Age-related cataract (ARC) is the leading cause of blindness in the world, particularly in developing countries. In contrast, cataract surgery has become the most frequent surgical procedure in people aged 65 years or older in the Western world, causing a considerable financial burden to the health care system. The development of cataracts is mainly an age-related phenomenon, although socioeconomic and lifestyle factors appear to influence their development, e.g. smoking has been found to directly... more

Generally, cataract surgery is more prone to complications if the cataract is more advanced. The cataract becomes harder or denser as it matures, and more difficult to remove. However, the critical issue is whether the benefit of the surgery is worth the risk. The decision to proceed with cataract surgery should be based on the person’s visual needs. When the cataract is still mild, it is certainly easier and safer to remove. However, the benefit may be low because the vision is not significantly... more