Glaucoma

Glaucoma is the second leading cause of blindness in patients over the age of 65. It is another ophthalmologic disease process that occurs with increasing frequency as we age. The most important step in the treatment of glaucoma is early recognition and treatment. Unfortunately, damage to the optic nerve that occurs in the case of glaucoma is not reversible in adults. Although the majority of patients respond very well to medications and laser surgery, some patients will require traditional surgery in order to lower their intraocular pressure to prevent disease progression. In that case, your operating surgeon may choose to perform cataract surgery in conjunction with a glaucoma procedure. If your ophthalmologist does not perform glaucoma surgery, he or she may consult a glaucoma subspecialist, either to perform your surgery or to determine whether a glaucoma procedure is required at the time of cataract surgery.

As a cataract grows, or progresses, the crystalline lens in the eye increases in size. This may cause crowding in the front of the eye, because the iris is pushed forward, which directly inhibits the eye’s ability to remove fluid. This can lead to an increase in eye pressure. Therefore, by removing the cataract and replacing it with a smaller prosthetic intraocular lens, the eye pressure may decrease. This is particularly helpful in patients with some forms of glaucoma, as the simple removal of a cataract may help prevent disease progression.

It is important to communicate with your operating surgeon in order to determine what medications you should take postoperatively to control your glaucoma. These may need to be adjusted as you recover from your cataract surgery, but it is important that you do not discontinue any glaucoma medications without first discussing it with your doctor.

As in the case of diabetes and macular degeneration, a clear view to the optic nerve is important to determine the appropriate care for your glaucoma. So, if your cataract is limiting your eye doctor’s view to the optic nerve, cataract surgery may be recommended to improve visualization of the nerve in order to make appropriate treatment recommendations for the glaucoma to prevent further loss of vision.

As in the case of macular degeneration or diabetes, because patients with glaucoma may already be visually debilitated, maximizing best-corrected vision and visual function is extremely important for improving visual performance. Maximizing vision where it can be improved not only helps maintain independence and lifestyle satisfaction, but also may help prevent falls that can cause fractures.

© Vision Information Services, LLC, Mooresville, NC 2012