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What is Glaucoma?

Glaucoma is a group of diseases that damage the eye’s optic nerve and can result in vision loss and blindness. With early detection and treatment, you can often protect your eyes against serious vision loss.
The optic nerve
The optic nerve is a bundle of more than 1 million nerve fibers. A healthy optic nerve is necessary for good vision.


How does the optic nerve get damaged by open-angle glaucoma?

Studies have shown that high eye pressure is a major risk factor for optic nerve damage.
In open-angle glaucoma, even though the drainage angle is “open”, the fluid passes too slowly through the meshwork drain. The fluid builds up, and the pressure inside the eye rises to a level that may damage the optic nerve.


Who is at risk for open-angle glaucoma?

Anyone can develop glaucoma. Some people, listed below, are at higher risk than others:

  • African Americans over age 40
  • Everyone over age 60, especially Mexican Americans
  • People with a family history of glaucoma

Glaucoma Symptoms

At first, open-angle glaucoma has no symptoms. It causes no pain. Vision stays normal. Glaucoma can develop in one or both eyes.

Without treatment, people with glaucoma will slowly lose their peripheral (side) vision. They seem to be looking through a tunnel. Over time, straight-ahead (central) vision may decrease until no vision remains.

How is glaucoma detected?

Glaucoma is detected through a comprehensive dilated eye exam that includes the following.

Glaucoma Treatments

There is no cure for glaucoma. Vision lost from the disease cannot be restored.

Immediate treatment for early-stage, open-angle glaucoma can delay progression of the disease. That’s why early diagnosis is very important.

Medicines: Eyedrops are the most common early treatment for glaucoma. Taken regularly, these eyedrops lower eye pressure. Many medicines are available to treat glaucoma. If you have problems with one medicine, tell us because treatment with a different dose or a new medicine may be possible.

Laser trabeculoplasty: Laser trabeculoplasty helps fluid drain out of the eye. We may suggest this step at any time. Laser trabeculoplasty is performed routinely in our eye clinic. This allows the fluid to drain better, and is known to work very well.

Conventional surgery: Conventional surgery makes a new opening for the fluid to leave the eye. We may suggest this treatment if medicines and laser surgery have failed to control pressure.

iStent Trabecular Micro-Bypass: The iStent is a small stent placed inside the eye during cataract surgery. It has been proven to lower the pressure, and can be done if you are planning on having cataract surgery.


Some information about iStent®:
The world’s tiniest medical device—iStent—is 20,000 times smaller than the intraocular lenses (IOL) used in your cataract surgery. But the size of iStent is only part of its story. By increasing the eye’s ability to drain fluid, this technology is designed to reduce the pressure in your eye.

In a U.S. clinical study, 68% of glaucoma patients who received iStent remained medication free at 12 months while sustaining a target IOP of ≤ 21 mm Hg vs. only 50% of patients who underwent cataract surgery alone.

iStent works like the stents used to prevent heart attacks and strokes. When blood vessels get clogged, a stent creates access to the vessel flow. While a highly innovative technology, how iStent works is elegantly simple:

  • If you have glaucoma, over time the eye’s natural drainage system becomes clogged
  • iStent creates a permanent opening through the blockage to improve the eye’s natural outflow
  • Restoring this mechanism lowers and controls pressure within the eye

iStent is implanted during your cataract surgery procedure. Once implanted, iStent will begin working to safely and effectively manage pressure. What’s more, patients who receive iStent may experience a reduction in glaucoma medications; but this will be at the discretion of your physician.


Dr. Heeral Shah is the only surgeon in the area that is currently offering iStent with cataract surgery. Call 417-781-2616 for more information and to schedule an appointment today.


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