Glaucoma
Ophthalmology located in San Francisco, CA
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Glaucoma Services Offered In San Francisco, CA
Half of all Americans who have glaucoma do not know they have it, do not get treatment, and suffer permanent vision loss. Regular eye exams are vital for diagnosing glaucoma. For glaucoma screening and care, see experienced ophthalmologist Dilys Bart, MD. Dr. Bart has the expertise and advanced equipment to provide exceptional glaucoma treatment. Call her office to schedule an eye exam, or use the online booking feature to request one today.
What is glaucoma?
Glaucoma is a group of eye diseases that damage the nerve in the back of the eye, called the optic nerve. This nerve carries visual information from the eye to the brain so you can see. Glaucoma can cause permanent vision loss and blindness.
Over 3 million Americans have glaucoma but only half are aware they have it. Early on, glaucoma typically has no symptoms. Slowly one loses vision, usually beginning with side vision. Because the change is so gradual, people typically don’t know that their eyesight is changing until late in the disease when their vision is irreversibly poor. When someone is diagnosed with glaucoma, treatment usually prevents additional vision loss from glaucoma. The only way to know if one has glaucoma is to have a comprehensive eye exam. A screening exam for eye disease is recommended by age 40. While glaucoma can develop at any age, the risk of glaucoma rises over age 40 and increases dramatically after age 60.
Even if you are not experiencing any vision changes, it is very important to have regular eye exams so that silent eye conditions are identified and treated before you lose vision.
What are risk factors for glaucoma?
Glaucoma can happen to anyone, and there is no known single cause. Some people have a higher than normal risk of getting glaucoma. Risk factors include:
• Age over 40, and especially over 60
• Family members with glaucoma
• African, Hispanic, or Asian heritage
• High eye pressures
• Nearsighted or farsighted
• An eye injury
• Long-term steroid medications
• Corneas that are thin in the center
• Thinning of the optic nerves
• Diabetes, migraines, high blood pressure, obstructive sleep apnea, poor blood circulation
• Smoking
How does glaucoma cause vision loss?
The front part of the eye is filled with aqueous fluid. New fluid is constantly being produced while old fluid is drained out of the eye through the drainage angle. The amount of fluid going into and out of the eye should be the same, keeping the pressure in the eye stable. This pressure is called intraocular pressure or IOP. But if too much fluid is produced or the drainage angle is not working properly, fluid builds up. Pressure inside the eye rises, damaging the optic nerve.
The optic nerve consists of more than a million nerve fibers, like an electric cable made up of many small wires. As these nerve fibers die, blind spots develop in one’s vision. Often these blind spots are not noticed until most of the optic nerve fibers have died. If all of the fibers die, blindness results.
What are the types of glaucoma?
Open-angle glaucoma
This is the most common type of glaucoma. Gradually eye pressure builds, damaging the optic nerve. It is painless and causes no vision changes until later in the disease. Some people have optic nerves that are damaged even by normal eye pressure. Glaucoma treatment can prevent injury to the optic nerves. Regular eye exams are important to find early signs of optic nerve damage.
Angle-closure glaucoma (also called narrow angle glaucoma)
This type happens when the drainage angle is completely blocked. Fluid builds up and eye pressure rises very quickly. This is called an acute attack. It is a true eye emergency, and you should call your ophthalmologist right away or you might go blind.
Symptoms of an acute angle-closure glaucoma attack include:
• Severe pain in the eye or forehead
• Redness of the eye
• Decreased or blurred vision
• Seeing rainbows or halos
• Headache
• Nausea, sometimes with vomiting
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How is glaucoma diagnosed?
A glaucoma screening that only checks eye pressure will miss a large proportion of glaucoma.
During a glaucoma exam, Dr. Bart will:
• Measure your eye pressure, called tonometry
• Examine your optic nerve, called ophthalmoscopy
• Measure the thickness of your cornea, called pachymetry
• Observe your eye's drainage angle, called gonioscopy
• Test your peripheral (side) vision, called a Humphrey Visual Field test
• Take a computer measurement of your optic nerve, called Optical Coherence Tomography (OCT) or take a photo of the optic nerve, called fundus photography
What are treatments for glaucoma?
Although there is no cure for glaucoma, several treatment options prevent or slow down vision loss by decreasing eye pressure.
Medications
Prescription eye drops can be taken each day for glaucoma. This is the most common form of glaucoma treatment in the US.
Laser Treatments
Selective Laser Trabeculoplasty (SLT) is a short procedure that uses a low-power laser to improve the drainage of aqueous fluid and reduces eye pressure. Laser Peripheral Iridotomy (LPI) treats angle-closure glaucoma by creating a microscopic opening in the iris.
Minimally Invasive Glaucoma Surgery (MIGS)
Specialized micro-implants improve fluid drainage and are commonly inserted during cataract surgery.
Trabeculectomy
This is considered conventional glaucoma surgery. A very small opening with a flap over it is made in the white part of the eye (sclera), increasing fluid drainage from the eye.
Tube-Shunt Surgery
A flexible tube with an attached drainage pouch is connected to the drainage area of the eye. This is performed relatively rarely and is typically done after other types of treatment have been explored.
Can I prevent glaucoma?
Glaucoma cannot be prevented. Regular eye exams are vital to diagnosing glaucoma early enough to prevent any permanent vision loss.
From one of our patients:“Thank you, Dr. Bart, for catching my glaucoma early. I am so grateful that it is under control.”
We are here to preserve your vision. For glaucoma screening and care, call the Bart Eye Center or use the online booking feature to request an eye exam today.
TESTIMONIALS
Dr Bart is extremely professional and very helpful in caring for my eyes. She has been treating me for Glaucoma for many years with very efficient follow up.
Joan G.
Dr. Bart is just great, polite, punctual and I really feel she is interested in the health of my eyes. There is familial glaucoma, so between her and her predecessor they have kept me on the road to health, for this I am truly grateful.
John R.
First in importance: excellent ophthalmology care. Second: pleasant office with courteous reception and timely attention to appointment schedule. Third: Dr. Bart affords her patient time and attention at each appointment including providing answers to patient questions and explanation of diagnoses, treatment and prescribed medications.
Herman P.
After almost 17 years of care, I find Dr. Bart's care to be as attentive as early on. I recommend her without reservation.
Kymus G.
I love Dr. Bart! She is very reassuring and extremely knowledgeable. I cannot recommend her enough.
Jennifer P.