Dr. Ballitch has the most technologically advanced equipment and surgery available for the diagnosis, evaluation, and treatment of glaucoma. With an onsite surgery center, and well equipped medical office, he is able to evaluate and treat mild to severe cases.
Glaucoma is the leading cause of blindness and visual impairment in the United States, and can affect patients of any age or ethnicity. The term glaucoma refers to a group of diseases that cause damage to the optic nerve (the pathway from the eye to the brain). This damage causes irreversible loss of vision, and left untreated results in severe visual impairment or blindness.
Tests for Glaucoma
(measures the intraocular pressure (IOP))
This is done with the use of topical anesthesia (eye drops) to measure IOP to evaluate readings over time, and to evaluate the effectiveness of treatment.
(the doctor views the optic nerve with magnification)
The doctor can objectively view the appearance of the optic nerve and judge whether it has a normal or abnormal appearance, and if it has changed over time.
Perimetry/Visual Field Testing:
(measures the field of vision)
This test checks the field of vision for changes before they become noticeable to patients. It helps determine if your therapy is effective or if changes are indicated. This is normally done once a year.
(reveals whether the “angle” is open or closed)
A mirrored lens is placed near the eye, and the doctor views the drainage angle with a microscope to evaluate if it is open, partially closed, or closed.
(measures the corneal thickness)
The thickness of the cornea can influence IOP readings, and should be considered when treating glaucoma. Eye drops are used to numb the eye and a gentle probe is placed on the center of the corneal to obtain the measurement.
(optical coherence tomography, “maps” the optic nerve)
This is computerized equipment that uses special beams of light to create a contoured map of the nerve, the optic cup, and the retinal fiber layer.
Treatment for Glaucoma
- Laser surgery
- Micro-Invasive Glaucoma Surgery (MIGS)
Types of Glaucoma
Open angle glaucoma is the most common type of glaucoma. This type occurs slowly over time as the natural drainage system becomes clogged preventing the drainage of fluid (aqueous humor) from the eye resulting in increased intraocular pressure (IOP). Most people have no early warning signs or symptoms of this type of glaucoma. The development of vision loss is slow and progressive; visual loss may not be noticed for years. Early detection and treatment is important to prevent vision loss and/or blindness.
Normal Tension Glaucoma
Normal tension glaucoma occurs when there is optic nerve damage in the absence of elevated IOP. The cause of damage to the optic nerve when IOP is normal is not known. Those with a family history of NTG and some systemic diseases (i.e. heart arrhythmia) are at higher risk.
Narrow Angle Glaucoma
Narrow angle glaucoma can be acute (sudden) or intermittent. This form of glaucoma is less common, but can be more severe. Symptoms of acute angle closure (AACG) are severe painful red eye, nausea, vomiting, and blurry vision. AACG is a medical emergency, and treatment must be sought immediately. Intermittent angle closure glaucoma is when there are periods of time that the angle is open and periods of time when the angle is closed. People with this type of NAG are at risk for an acute attack, and should undergo an iridotomy (removal of a small section of the iris edge) to prevent AACG. Symptoms may include headache, intermittent eye pain (especially at night or in darkness when the pupil dilates), rainbows around lights, and/or nausea. This form of glaucoma is also a contraindication to antihistamine medications that carry a glaucoma warning on the package.
Secondary glaucoma is elevated IOP and optic nerve damage resulting because of another condition such as inflammatory eye disease, tumor, long term steroid use, or injury to the eye (may happen years later).
Pediatric glaucoma consists of congenital, infantile, and juvenile cases. Congenital glaucoma is present at birth, and is usually diagnosed within the first year of life. Infantile glaucoma is diagnosed up to the age of three years. Pediatric glaucoma represents cases between ages of three years through teenage/young adulthood. Signs and symptoms may be eyes that are unusually large, excessive tearing, and a cloudy appearance to the eyes.