The Glaucoma Service

The doctors and staff of the Queens Eye Center are especially devoted to the diagnosis and treatment of glaucoma. This group of illnesses permanently steals the sight of multitudes, making early diagnosis and proper management essential.

The center uses gold-standard visual field machines, pachymeters and the Heidelberg Retinal Tomography machine to detect and help patients with glaucoma. Many patients' glaucoma can be managed with medication alone, while some will need surgery.

For individuals who are appropriate candidates, we offer on-premises argon and YAG laser treatments. Patients requiring more involved surgical treatment are treated at New York Hospital Queens where our ophthalmologists regularly operate.

The Queens Eye Center is a major center providing support for the work of the Congressional Glaucoma Caucus. With grant support from Friends of the Congressional Glaucoma Caucus Foundation, we perform free, community screenings and bring those found to be at risk to our Center for further evaluation and treatment.

What is Glaucoma?

Glaucoma is a actually a group of eye diseases that can gradually steal sight without producing symptoms. Vision loss is caused by damage to the optic nerve which is the "electric cable" responsible for carrying images to the brain.

Although high intraocular pressure (IOP) is clearly a risk factor, other factors can also be involved because even people with "normal" IOP can experience vision loss from glaucoma.

Three Types of Glaucoma

The two main types of glaucoma are primary "open angle glaucoma," (POAG), and "angle closure glaucoma." Normal tension glaucoma is not as common.

Primary Open Angle Glaucoma is the most common form, affecting about three million Americans. It is caused by the eye's drainage canals become clogged over time. The inner eye pressure (also called intraocular pressure or IOP) rises because the correct amount of fluid can't drain out of the eye. In this form of the illness, the entrances to the drainage canals are clear but the clogging problem occurs inside the drainage canals themselves, (like clogging that can happen inside a pipe below the drain in a sink).

Most people have no symptoms and no warning signs. If not diagnosed and treated, POAG can cause a gradual loss of vision. It can develop slowly and may not produce sight loss for years. Happily, it usually responds well to medication, especially if caught early.

Angle Closure glaucoma is also called "acute glaucoma" or "narrow angle glaucoma." It is less common than POAG and is very different in that eye pressure usually goes up very fast. This happens when the drainage canals get blocked or covered over. With angle closure glaucoma, the outer edge of the iris bunches up over the drainage canals, when the pupil enlarges too much or too quickly, as when entering a dark room.

A simple test can be used to see if your angle is normal and wide or abnormal and narrow. If you have a narrow angle, treatment usually involves surgery to remove a small portion of the outer edge of the iris. This helps unblock the drainage canals. Surgery is usually successful and its effects long-lasting. Symptoms of angle closure glaucoma can include blurred vision, headaches, eye pain, nausea and rainbows around lights at night.

Normal tension glaucoma is also called "normal pressure glaucoma." In this type the optic nerve is damaged even though intraocular pressure (IOP) is not very high. It is not known why some optic nerves are damaged even though the IOP is considered to be "normal." Those at risk for this form of glaucoma are people with a family history, people of Japanese ancestry, and people with a history of systemic heart disease such as irregular rhythm. Normal tension glaucoma is usually detected by an examination of the optic nerve.

Research studies have concluded that eye drops that lower IOP were effective even in cases of normal tension glaucoma. Therefore, most doctors treat normal tension glaucoma by keeping normal eye pressures as low as possible with medicines, laser surgery or filtering surgery.

Secondary Glaucoma

Glaucoma can occur as the result of an eye injury, inflammation, tumor or in advanced cases of diabetes. It can also be caused by certain drugs including steroids. Secondary glaucoma may be mild or severe and its treatment will depend on whether it is open angle or angle closure glaucoma.

 
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