What Are The Treatment Options For Glaucoma?

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In general, glaucoma is treated with a combination of prescription eye drops, laser treatment, and/or surgery. Below is a brief overview of some of the safest and most effective laser and surgical procedures.

SLT (Selective Laser Trabeculoplasty): A very focused beam of light is used to treat the drainage area of the eye. This surgery makes it easier for fluid to flow out of the front part of the eye, thereby decreasing intraocular pressure. Patients generally do extremely well after just one laser session. Canaloplasty: In an advanced, nonpenetrating procedure, a microcatheter is used to enhance and restore the eye’s natural drainage system. The microcatheter is then removed and a suture is placed and tightened, effectively alleviating the eye pressure. It is minimally invasive and highly effective in reducing intraocular pressure.

Tube-shunt surgery: A flexible plastic tube with an attached silicone drainage pouch is placed in the eye to help drain fluid from the eye and reduce intraocular pressure.

Trabeculectomy: A small piece of tissue in the drainage area of the eye is removed, creating an opening. The opening is partially covered with the outer tissue of the eye. This new opening effectively allows fluid to drain out of the eye, bypassing the clogged drainage channels that resulted in increased intraocular pressure. In addition, there are several promising studies ushering in a new era of glaucoma treatment and care. Such ongoing, innovative research and clinical trials continue to bring new hope to patients with glaucoma. In an effort to provide the best possible care, Texan Eye’s glaucoma specialists are involved in various studies. By participating in FDA trials, such as the Glaukos iStent® trial, our Doctors have worked with various technology since its inception, making themselves the most qualified and familiar with specific glaucoma treatments. Following the FDA approval of the Glaukos iStent® Texan Eye became involved in the Glaukos iStent Supra® study. Currently awaiting FDA approval, the iStent Supra® is a small tube measuring 4mm. The tube allows fluid to flow through it in order to reduce eye pressure and the use of some glaucoma medications. Since the iStent Supra® has gained approval in Europe, glaucoma patients have seen already seen a 50% decrease in their eye pressure. Our Doctors are also currently participating in a new FDA trial called the Glaukos iDose®. The Glaukos iDose® is a product that is injected through a corneal incision that then elutes medication, from within the eye, over time. The product has the potential to eliminate routine eye drops in glaucoma patients while still reducing eye pressure in a low risk manor. With a myriad of possible treatment options that Texan Eye offers, your glaucoma will be treated based on your current condition and vision needs.

General

It is important to undergo regular eye examinations in order to prevent and detect eye disease. Certain conditions, including glaucoma, do not manifest any symptoms until permanent damage has been done. Detecting these diseases early allows for more flexible treatment options and reduces the risk of further harm.
Texan Eye is open during regular business hours, Monday through Friday, 8 am to 5 pm. All after hours emergencies are handled through our on-call service 24 hours a day.
The nature of your appointment will determine the length of your visit. The initial visit is usually quite extensive so be prepared to spend 1 to 3 hours at Texan Eye. If your condition requires additional testing or immediate treatment, your stay could be longer. As we respect your time, be assured that our doctors and staff will do our best to attend to your needs within a reasonable timeframe.
Texan Eye accepts most types of health insurance. Whether you have Medicare, managed care, or private insurance, it is likely that your insurance will cover all or some of the services you receive. As insurance policies vary greatly, we recommend that you check with your insurance carrier regarding the details of your coverage. If you are a member of a Health Maintenance Organization (HMO), you will need prior authorization from your insurance company or carrier before making an appointment at Texan Eye in order to receive any insurance coverage.
Texan Eye offers a full range of eye and vision care services to patients of all ages. Our broad scope of expertise makes us an excellent choice for those who have complex eye conditions or seek a second opinion. Texan Eye provides the latest cataract and refractive surgery procedures, in addition to providing complete eye exams, and contact lenses and glasses prescriptions. For more information about eye care services available at Texan Eye, contact us today.

Glaucoma

Glaucoma is the second leading cause of blindness in the United States and throughout the world. Currently, there are 70 million people worldwide with glaucoma and that number continues to grow as the population ages.

In the United States, there are 4-5 million Americans with glaucoma but only half of them are aware of their condition and seek treatment. As untreated glaucoma leads to permanent damage of the optic nerve with resultant vision loss, it is imperative to be screened for glaucoma as part of the annual eye exam.

Glaucoma refers to a group of eye diseases with the common feature of optic nerve damage. Though it is often associated with increased eye pressure, it is not always the case, leading some patients with normal eye pressures to have glaucoma while others with increased eye pressures never develop glaucoma. As such, glaucoma can be elusive in nature and therefore requires specialty training to diagnose and manage properly.

While there is no established cause of glaucoma, certain individuals are at a higher risk for developing the condition -- including those with a family history of the disease; those with diabetes or a past eye injury; people within certain ethnic groups, including African-Americans, Hispanics, Asians, and Scandinavians; those taking corticosteroids; and anyone over the age of 40.

In most cases, glaucoma develops without warning. For that reason, glaucoma has been called "the silent thief of sight". In general, glaucoma can be divided into two main groups: closed angle and open angle. Closed angle glaucoma can appear suddenly and is often painful. Vision loss can progress quickly but the discomfort often leads patients to seek medical care before significant damage occurs. The more common open angle glaucoma develops without pain or warning and tends to progress at a slower rate. Patients are therefore often unaware of losing their vision until the disease has progressed. By the time these patients seek medical care, their vision is permanently lost.
Although there is currently no cure for glaucoma, treatment is highly effective and safe. The key is early intervention. With timely detection, it is possible to arrest the development or slow the progression of optic nerve damage. Once glaucoma is diagnosed, eye pressure can be successfully decreased and controlled with a combination of prescription eye drops, laser treatment, and/or surgery. Many factors are considered in deciding the best treatment plan for each patient. Then, as glaucoma requires long term management and care, patients are monitored on a regular basis using the most advanced technologies and instrumentation, including optical coherence tomography (OCT) and Heidelberg retinal tomography (HRT). Regular checkups are required to monitor and ensure proper management and care.
In general, glaucoma is treated with a combination of prescription eye drops, laser treatment, and/or surgery. Below is a brief overview of some of the safest and most effective laser and surgical procedures. SLT (Selective Laser Trabeculoplasty): A very focused beam of light is used to treat the drainage area of the eye. This surgery makes it easier for fluid to flow out of the front part of the eye, thereby decreasing intraocular pressure. Patients generally do extremely well after just one laser session. Canaloplasty: In an advanced, nonpenetrating procedure, a microcatheter is used to enhance and restore the eye's natural drainage system. The microcatheter is then removed and a suture is placed and tightened, effectively alleviating the eye pressure. It is minimally invasive and highly effective in reducing intraocular pressure. Tube-shunt surgery: A flexible plastic tube with an attached silicone drainage pouch is placed in the eye to help drain fluid from the eye and reduce intraocular pressure. Trabeculectomy: A small piece of tissue in the drainage area of the eye is removed, creating an opening. The opening is partially covered with the outer tissue of the eye. This new opening effectively allows fluid to drain out of the eye, bypassing the clogged drainage channels that resulted in increased intraocular pressure. In addition, there are several promising studies ushering in a new era of glaucoma treatment and care. Such ongoing, innovative research and clinical trials continue to bring new hope to patients with glaucoma. In an effort to provide the best possible care, Texan Eye's glaucoma specialists are involved in various studies. By participating in FDA trials, such as the Glaukos iStent® trial, our Doctors have worked with various technology since its inception, making themselves the most qualified and familiar with specific glaucoma treatments. Following the FDA approval of the Glaukos iStent® Texan Eye became involved in the Glaukos iStent Supra® study. Currently awaiting FDA approval, the iStent Supra® is a small tube measuring 4mm. The tube allows fluid to flow through it in order to reduce eye pressure and the use of some glaucoma medications. Since the iStent Supra® has gained approval in Europe, glaucoma patients have seen already seen a 50% decrease in their eye pressure. Our Doctors are also currently participating in a new FDA trial called the Glaukos iDose®. The Glaukos iDose® is a product that is injected through a corneal incision that then elutes medication, from within the eye, over time. The product has the potential to eliminate routine eye drops in glaucoma patients while still reducing eye pressure in a low risk manor. With a myriad of possible treatment options that Texan Eye offers, your glaucoma will be treated based on your current condition and vision needs.

Cataracts

A cataract refers to a clouding of the normally clear lens of the eye. There are many types and causes of cataracts, and some progress more rapidly than others. But the end result is the same, one of blurry or hazy vision, believed to be caused ultimately by a chemical change in the eye.
Risk factors for cataract development include the following:
  • Advanced age
  • A past eye injury
  • A family history of cataracts
  • A history of smoking
  • A history of taking certain prescription medications (e.g., corticosteroids)
  • A history of certain medical conditions (e.g., diabetes)
  • Long term exposure to ultraviolet light or exposure to radiation.
Symptoms of cataracts may include the following:
  • Blurry vision
  • Double vision
  • A feeling of "film" over the eyes
  • Temporary improvement in near vision ("second sight")
  • Sensitivity to bright lights and glare which may make driving difficult
  • Less vivid perception of color
  • Frequent changes in eyeglass prescriptions
As cataracts progress, vision can be corrected with frequent changes in eyeglass prescriptions. When significant visual impairment has occurred, the lenses clouded by cataracts can be replaced through lens implant surgery. Cataract removal is the most frequently performed surgery in the United States, with more than 3 million Americans undergoing the procedure each year.

Other Conditions

Floaters refer to the circles, spots, squiggly lines, and cobwebs that drift through our vision. They may be of embryonic origin or acquired through degenerative processes of the vitreous gel or retina. These deposits result in shadows across the retina, the portion of the eye responsible for seeing clear, sharp images. It is imperative to distinguish normal and naturally occurring floaters and flashes from those associated with retinal problems. Floaters, with or without flashes of light, can be symptomatic of serious eye damage, such as a torn or detached retina. If you have noticed floaters or flashes in your vision, contact our eye doctors to schedule a dilated eye exam as soon as possible.
Diabetic retinopathy is a known complication of diabetes that affects the retina, causing blurry vision, double vision, blind spots, and floaters. The retina is the inner lining of the eye. When the blood vessels that supply nourishment to the retina are weakened, they tend to leak, swell or bleed, causing vision loss, and eventually, blindness. Ninety-five percent of those with significant diabetic retinopathy can avoid substantial vision loss if they are treated in time. With early intervention and treatment, diabetic retinopathy can be controlled; however, any damage to the retina is irreversible. Therefore it is important for patients with diabetes to have a dilated eye exam at least once a year.
If detected early, the more aggressive and vision-threatening "wet" form of Age-Related Macular Degeneration can be treated with laser and injectable drug therapies. The more common and less severe "dry" form of Age-Related Macular Degeneration has no existing treatment and is generally managed by observation and nutritional supplements. The growing use of pharmaceuticals (vitamins, minerals, and nutraceuticals) can be beneficial for patients with Age-Related Macular Degeneration. To learn more, contact a Texan Eye doctor today.
  • Loss of color vision
  • Difficulty seeing objects clearly
  • Distorted, blurry vision
  • Darkened, or empty spots near the center of the visual field
The macula is the part of the retina near the back of the eye that is responsible for the clearest and sharpest images. Macular Degeneration refers to a progressive loss of vision caused by deterioration of the macula. There are several types of Macular Degeneration. Age-Related Macular Degeneration refers to the type associated with advanced age and is one of the leading causes of vision loss in the United States.

LASIK/ASA

To find out more about the LASIK and ASA payment plans, contact one of our Central Texas or Austin eye centers or visit our LASIK financing page.
LASIK and ASA are elective procedures and therefore are not generally covered by insurance. However, many employers offer plans with flexible spending that allow patients to put pre-tax funds toward their surgery.
Patients over the age of 40 who require reading glasses have a condition called presbyopia which makes it difficult to change focus for reading. When those patients undergo LASIK or ASA to correct their myopia, hyperopia, and astigmatism, they will likely continue to require reading glasses, unless they elect monovision LASIK or ASA. One of the recent trends in ophthalmology is for patients to undergo LASIK or ASA to eliminate their refractive error and then later, follow the procedure with Crystalens(R), ReSTOR(R), or Tecnis(R) Multifocal lens implants when their near vision becomes affected by presbyopia. These accommodating or multifocal intraocular lenses are designed to replace the natural lens, granting patients with presbyopia vision at distance, near, and intermediate. Lens implant surgery has the additional benefit of circumventing the eventual development of cataracts as the natural lenses are removed in the process of implanting the intraocular lenses.
Our LASIK patients can expect to return to work or school in a couple of days. As ASA recovery time is longer than LASIK, our ASA patients can expect steady improvements in their vision each day over the course of several weeks. This difference in recovery time is due to the healing of the epithelium following ASA.
Our patients may undergo LASIK or ASA on both eyes during a single appointment, or they may choose to have one eye done at a time on different days. Most choose to have both eyes done on the same day.
From entering our facility to departing after the procedure, patients can expect to spend between one to two hours at the surgery center. For LASIK and ASA, time spent in the treatment room is approximately 15-30 minutes. Actual laser activity is brief. Our patients are usually on their way after a final check with the doctor.
The best way to find out if laser eye surgery is right for you is to visit one of our laser eye centers in Austin for a Refractive Surgery Consultation. Your exam will take about one hour. During the appointment, one of our premier eye surgeons will examine your eyes to determine the best treatment for your vision needs. A complimentary LASIK / ASA Screening is also available to address preliminary questions, take initial measurements, and prepare you for your Refractive Surgery Consultation.
Complications following laser eye surgery are rare. Most side effects will subside over time, and the risk of permanent vision problems is less than 1%. During the Refractive Surgery Consultation, patients are thoroughly educated regarding the risks of surgery and have the opportunity to discuss any concerns they may have with their surgeon. At Texan Eye, we feel that all patients should have a thorough understanding of the inherent risks of surgery before electing to undergo LASIK or ASA. Please contact us at our eye centers in Austin today to find out more about LASIK and ASA.
No. At our eye centers in Austin or Cedar Park, LASIK and ASA patients have their eyes numbed with eye drops prior to laser eye surgery. There are no needles or shots to prepare for treatment and during the surgery, there is no pain. Any mild discomfort can be managed with eye drops or medication.
Yes. During laser eye surgery, the shape of the cornea is permanently changed to correct refractive error. However, aside from refractive error, there are several age-related conditions, including cataracts and presbyopia that may affect vision over time. Fortunately,Crystalens®,Tecnis® Multifocal, ReSTOR®, and AcrySOF® Toric lens implants are available for the correction of cataracts and/or presbyopia.
As with any medical procedure, there are a variety of factors that influence the outcome of laser eye surgery. Results are different for each individual, and healing rates will also vary. However, with a success rate of more than 95%, LASIK and ASA rank among the best and most successful elective surgeries in the United States, with the vast majority of patients achieving 20/20 vision or better following LASIK and ASA. Therefore, for patients with myopia, hyperopia, and astigmatism, this translates into the ability to drive and enjoy life's daily activities without glasses or contact lenses. Following treatment at one of our Texan Eye centers in Austin and Cedar Park, LASIK and ASA patients can generally expect their vision to stabilize within a few weeks. During the healing process, minor fluctuations in vision may occur.
With the advent of new refractive surgery technology, laser eye surgery has become infinitely more safe and effective. At Texan Eye in Austin and Cedar Park, recovery from laser eye surgery is brief and the procedure is more comfortable than ever before. The laser eye surgery techniques used by our refractive surgeons have also been refined over the years to minimize the risks of side effects. Laser eye surgery was invented in the 1980s. Worldwide, more than 16 million laser eye surgeries have been performed since that time. In the United States, laser eye surgery was FDA approved in 1995 and is considered a safe and successful treatment for patients with myopia, hyperopia and astigmatism who meet laser eye surgery eligibility requirements.
The main differences between LASIK and ASA are times of recovery, and the presence or absence of a flap. Following LASIK, there is minimal to no discomfort and patients can generally return to work or school within a couple of days. LASIK patients also recover their vision more quickly than patients who undergo ASA. In contrast to ASA, LASIK involves the creation of a flap. And finally, LASIK patients generally use prescription eye drops for a shorter period of time than their ASA counterparts. Your surgeon will carefully determine which procedure is best suited for you based on the results of your Refactive Surgery Consultation. Ultimately, the excellence in visual results are equivalent for LASIK and ASA.


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