Sunday, June 26, 2016

Looking into Glaucoma

Glaucoma, Open-angle | National Eye Institute

The Pressure is On -What is Glaucoma?

What is eye pressure? - American Academy of Ophthalmology
The eye is a closed ball filled with clear jelly (vitreous humor) in the back behind the lens and clear fluid (aqueous humor) in the front, between the iris and the cornea. Aqueous humor is created just behind the iris and is in continuous circulation throughout the front part of the eye before it drains out just in front of the iris where it meets the cornea. This fluid helps keep the eye "inflated" just like air inside a balloon.
We can measure pressure of the eye just like you can gauge how full a balloon is by poking the balloon with your finger. The less air or pressure in the balloon, the easier it will be to poke and conversely, the more air or pressure in the balloon, the stiffer the balloon will be and the harder it will be to poke it. We measure pressure in the eye the same way; by gently touching the cornea with special instruments to see how hard it is to "poke." The unit of measurement is millimeters of mercury, or mmHg.
Pressure in the human eye, known as intraocular pressure, varies throughout the day with "normal" pressure being anywhere between 10 and 21 mmHg. Glaucoma is an eye disease in which the optic nerve is damaged by the pressure inside the eye. In most cases, the damaging pressure is greater than 21 mmHg, but there are some patients who can have damage at lower pressures (known as normotensive glaucoma). Conversely, there are some people who can tolerate higher-than-normal pressures without having optic nerve damage. These people are said to have "ocular hypertension." Eye pressure can vary with the thickness of the cornea—this is also measured when trying to interpret the significance of an eye pressure—reading in any one patient.
In addition to high pressure, risk factors for glaucoma include African or Hispanic ancestry, having diabetes and having a family member with glaucoma. Glaucoma does not typically cause pain and many cases of glaucoma go undiagnosed. Checking eye pressure is an important part of a comprehensive eye exam and one good reason to get regular check-ups by your ophthalmologist or eye care provider.



Presentation "GLAUCOMA: PREVALENCE IN USA 3 million individuals with glaucoma 1 million unaware they have glaucoma 80,000 blind from glaucoma Introduction."



Glaucoma Facts and Stats | Glaucoma Research Foundation

Some Statistics About Glaucoma

  • It is estimated that over 3 million Americans have glaucoma but only half of those know they have it. (1)
  • In the U.S., more than 120,000 are blind from glaucoma, accounting for 9% to 12% of all cases of blindness. (2)
  • Glaucoma is the second leading cause of blindness in the world, according to the World Health Organization.
  • After cataracts, glaucoma is the leading cause of blindness among African Americans. (1)
  • Blindness from glaucoma is 6 to 8 times more common in African Americans than Caucasians. (3)
  • African Americans are 15 times more likely to be visually impaired from glaucoma than Caucasians. (4)
  • The most common form, open-angle glaucoma, accounts for 19% of all blindness among African Americans compared to 6% in Caucasians. (5)
  • Other high-risk groups include: people over 60, family members of those already diagnosed, diabetics, and people who are severely nearsighted.
  • Estimates put the total number of suspected cases of glaucoma at over 60 million worldwide. (6)

Facts About Glaucoma | National Eye Institute

How Glaucoma is Treated

Eye Drops, Medication, Laser Treatment, and Surgery

Two flavors of Lasers - Argon ALT, and YAG SLT



SLT (Selective Laser Trabeculoplasty) Demonstration



Andrew G Iwach, MD Briefing on SLT @UCSF



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