Glaucoma

{altimg}

Catch it Early, and Get the Best Care

Glaucoma is a disease that causes damage to the nerve in the back of the eye, which is called the optic nerve. It is frequently, but not always, associated with increased intraocular pressures and if not caught and treated early it may lead to irreversible vision loss. 

 

Glaucoma can cause blindness if left untreated. When glaucoma develops, usually you don’t have any early symptoms and the disease progresses slowly, destroying vision gradually. Fortunately, early detection and treatment (with glaucoma eye drops, surgery or both) can help preserve your vision. We do it every day at Sabates Eye Centers.

 

Symptoms of Glaucoma

Glaucoma usually presents without any symptoms. At first, you may lose your side, or peripheral, vision. Because this happens gradually over time, it’s hard to notice. Later in the disease, after much of the optic nerve has been destroyed, you may lose your central vision, which then becomes noticeable. The majority of glaucoma is asymptomatic.

 

Click here for more information about - treatment and glaucoma surgery.

  • Glaucoma eye disease effects an estimated 3 million Americans.

    It Sneaks Up on You

    Only half of the estimated 3 million Americans who have glaucoma are aware they have the disease.

  • Did you know the optic nerve is actually a bundle of fibers similar to an electric cable.

    Glaucoma: Introduction

  • Glaucoma eye specialist Dr. Rohit Krishna - Sabates Eye Centers.

    Glaucoma Eye Specialist

    Dr. Rohit Krishna, M.D.  – Dr. Krishna sees patients at the Leawood and Plaza Eye Centers, plus at Truman Medical Center – University Health and Lakewood.

For emergency or time sensitive appointments, call 913-261-2020
or 1-800-742-0020 (toll free).

Schedule Appointment

Are you a new or returning patient?

Returning Patient

Have you enrolled in Patient Portal and do you have a password?


Returning Patient

As of the beginning of 2015, we are asking all returning patients to enroll in Patient Portal. This online portal contains a wealth of general health information, along with patient-specific communications from our practice.

To sign up, please call our scheduling department at 913-261-2020. They will provide you with a PIN number to use when enrolling.

New Patient Information

The scheduling department is open Monday to Friday from 7 a.m. to 5 p.m. We will contact you by 5 p.m. the next business day to confirm appointment details.

Type of Appointment

A Medical Eye Exam -

  • Thorough dilated exam to address eye medical conditions.
  • Examples: cataract, glaucoma, diabetic retinopathy, macular degeneration.
  • This type of exam is a detailed medical exam to determine, assess, and recommend any treatment necessary and may include additional testing.
  • Filed to your insurance under medical coverage.

A Routine Eye Exam -

  • This type of exam will assess the basic general health of your eyes and may include dilation.
  • Schedule a new glasses or contact lens prescription.
  • Filed as a routine eye exam with your insurance or vision service plan.
  • No medical eye conditions will be evaluated at this exam.

The scheduling department is open Monday to Friday from 7 a.m. to 5 p.m. We will contact you by 5 p.m. the next business day to confirm appointment details.

Type of Appointment


The scheduling department is open Monday to Friday from 7 a.m. to 5 p.m. We will contact you by 5 p.m. the next business day to confirm appointment details.

Are you a contact lens wearer?


The scheduling department is open Monday to Friday from 7 a.m. to 5 p.m. We will contact you by 5 p.m. the next business day to confirm appointment details.

Physician



The scheduling department is open Monday to Friday from 7 a.m. to 5 p.m. We will contact you by 5 p.m. the next business day to confirm appointment details.

Insurance Information

Please contact your insurance to confirm network eligibility.

Are you the primary insurance holder

Yes No

The scheduling department is open Monday to Friday from 7 a.m. to 5 p.m. We will contact you by 5 p.m. the next business day to confirm appointment details.

Preferred Time of Appointment

The scheduling department is open Monday to Friday from 7 a.m. to 5 p.m. We will contact you by 5 p.m. the next business day to confirm appointment details.

Additional information

The scheduling department is open Monday to Friday from 7 a.m. to 5 p.m. We will contact you by 5 p.m. the next business day to confirm appointment details.

Confirm Your information

Type of Appointment

Medical Routine



Are you the primary insurance holder

Yes No

The scheduling department is open Monday to Friday from 7 a.m. to 5 p.m. We will contact you by 5 p.m. the next business day to confirm appointment details.

Thank You

You're ready to see the best.

You've successfully requested an appointment with Sabates Eye Centers, the most trusted name in eye care.

The scheduling department is open Monday to Friday from 7 a.m. to 5 p.m. We'll be in touch by phone by 5 p.m. the next business day (Monday-Friday) to confirm your appointment.

Thank you for choosing Sabates Eye Centers.

Sabates EYE Centers Glaucoma Specialty Group

In order to understand how glaucoma works, you need to think like a plumber.

 

If you visualize your kitchen sink, there is a faucet and a drain. In the eye, the faucet is always on, producing fluid that helps to maintain the normal shape of the eye as well as carry oxygen and nutrition to the anterior segment of the eye (this is not the tearing system; rather, it is a separate plumbing system inside the eye). Moreover, in our analogy, the drain is always open. The balance between the amount of fluid produced by the eye and the amount that can be drained by the drainage system determines the pressure.

 

Glaucoma is a multifactorial disease. Current theories include mechanical compression from increased pressure within the eye, decreased blood flow to the eye and genetics. While the majority of glaucoma cases in North America and Europe are associated with an elevation of intraocular pressure (IOP), approximately 40 percent of cases are associated with normal pressure. In either situation, the intraocular pressure is involved in the deterioration of optic nerve function, though this can be accelerated when the IOP is significantly elevated. In almost all cases of glaucoma, this elevation of eye pressure arises from blockage of fluid outflow.

Glaucoma Treatments and Types

There are five types of glaucoma:

  1. Primary Open-Angle Glaucoma (the most common type of glaucoma) is a mismatch of fluid being pumped into your eye and the amount of fluid exiting the drain (called the angle). By placing a special mirrored contact lens on your eye, the drain may be visualized. In POAG, the drain appears to be open. However, on a microscopic level, the drain may be filled with debris, which may cause the fluid to build up in your eye (like your kitchen sink filling up with water).

Alternatively, your faucet may be working too well and overwhelming the ability of the drain to get rid of the fluid fast enough. Unlike your kitchen sink, which can spill over on the floor, the eye is contained and the fluid just builds up in the eye. The result of this is that the fluid starts to compress the other parts of the eye.

  1. Pigment Dispersion Glaucoma – In pigment dispersion, the lens of    your eye is rubbing against the back surface of the colored part of  your eye. This releases pigments, which float around your eye.  This process may be exacerbated by exercise. We believe there is a mismatch of fluid being pumped into your eye and the amount of fluid exiting the drain (called the angle). By placing a special mirrored contact lens on your eye, the drain may be visualized. 

In pigment dispersion, the drain appears to be clogged up with the pigment floating in your eye. This may cause the fluid to build up in your eye (like your kitchen sink filling up with water). Also, your faucet may be working too well and overwhelming the ability of the drain to get rid of the fluid and pigment fast enough. Unlike your kitchen sink, which can spill over on the floor, the eye is contained and the fluid just builds up in the eye. The result is that the fluid starts to compress the other parts of the eye.

  1. Pseudoexfoliation Glaucoma – In pseudoexfoliation, the support system (zonule) for the lens of your eye is disintegrating. Why this happens is unknown. There are undoubtedly genetic factors at work. This white flaky material floats around your eye. We believe there is a mismatch of fluid being pumped into your eye and the amount of fluid exiting the drain (called the angle). By placing a special mirrored contact lens on your eye, the drain may be visualized.

In pseudoexfoliation, the drain appears to be clogged up with the white flaky material floating in your eye. This may cause the fluid to build up in your eye (like your kitchen sink filling up with water). Also, your faucet may be working too well and overwhelming the ability of the drain to get rid of the fluid and pseudoexfoliation material fast enough. Unlike your kitchen sink, which can spill over on the floor, the eye is contained and the fluid just builds up in the eye. The result is that the fluid starts to compress the other parts of the eye.

  1. Narrow (or Closed) Angle Glaucoma – If there is a mismatch of fluid being pumped into your eye and the amount of fluid exiting the drain (called the angle), fluid will accumulate and cause the pressure in your eye to increase. By placing a special mirrored contact lens on your eye, the drain may be visualized.
    • Narrow-Angle Glaucoma

In Narrow-Angle Glaucoma, the entrance to the drain appears to be narrow or covered by the colored part of your eye (the iris). In other words, it is like a drain plug popping in and out of the drain.

 

    • Closed-Angle Glaucoma

In Closed-Angle Glaucoma, the colored part of your eye has scarred closed part of the drain from being in contact with it for a long time. It is like a drain plug stuck into part of the drain.

  1. Acute Angle Closure Glaucoma – If the colored part of your eye (the drain plug) suddenly creeps into the entire drainage system of your eye and gets stuck in there and doesn’t come out on its own, the fluid in your eye will have nowhere to go. The fluid in the eye will accumulate very rapidly. Typically one will experience pain, a red eye, colored haloes, headache, blurry vision, and even nausea. Most of the vision can be lost in a matter of hours or few days. The ability to see colors and shades of black and white rarely returns to normal.

The treatment of this type of glaucoma is to place a hole through the colored part of the eye as an emergency. Most of the time this can be accomplished with the aforementioned laser. However, due to the swelling to the eye, it can be very difficult to accomplish. Rarely, surgery may need to be performed urgently to create a new drainage system for the eye.

 

If any of the five types of glaucoma are detected, the goal of treatment will be to lower pressure in your eye. If fluid balance cannot be restored to the level where no further optic nerve damage is occurring, laser treatment can be attempted or a new drain may be made for the eye surgically.

 

As you recall, high pressure in the eye is not the only contributing factor to glaucoma. The amount of oxygen that reaches the optic nerve is also important, as are genetics. Currently, nothing can be done to alter your genetics.

 

To reestablish a sufficient oxygen level in the eye, there are no direct treatments. We believe that exercise; control of high blood pressure, diabetes, and high cholesterol; and stopping smoking may be beneficial to this end.

 

FAQs About Glaucoma

Q. Are certain people at greater risk of developing glaucoma?

A. Yes. Known risk factors include family history, African or Hispanic ancestry, near or farsightedness, previous eye injury, and advancing age. Others include elevated eye pressure, a central cornea that’s too thin, low blood pressure and any condition that affects blood flow, such as diabetes and migraines.

 

Q. Will glaucoma make me go blind?

A. Glaucoma is a very complicated eye disease that can cause vision loss if not caught early. This is another reason annual eye exams are recommended. Early detection is key to protecting your vision.

 

Q. How can I tell I have glaucoma if there are no early symptoms?

A. The only way to catch glaucoma early is through an eye pressure and visual field test, part of a comprehensive eye exam. Since glaucoma typically occurs after age 40, we recommend seeing an ophthalmologist at least every two years after your 40th birthday.

 

Q. What should my eye pressure be?

A. Safe pressures depend on the amount of damage to the optic nerve – the more damage there is, the lower the pressure should be.

 

Q. Why do I have to do testing when I come for my appointment?

A. The Visual Field will detect any vision loss that may be caused by glaucoma. The Ocular Coherence Tomography is a scan of the optic nerve that measures the tissue around the optic nerve and will detect damage even earlier than the Visual Field will. Glaucoma is a disease that takes away side vision gradually. Vision loss from glaucoma is usually not noticeable until it becomes severe; this is yet another reason regular eye exams are important.

 

Q. Is the cost of a glaucoma exam covered by Medicare?

A. Yes, Medicare does cover an annual comprehensive dilated eye exam for some people at high risk for glaucoma, including those with diabetes or a family history of glaucoma, and African-Americans age 50 and older.