Gene Wyll, M.D.
Ophthalmologist, Surgeon and Contact Lens Specialist

What is Glaucoma?

Glaucoma is a disease of the optic nerve.  The optic nerve connects the eye to the visual centers of the brain.

Normal Optic Nerve

In glaucoma, the optic nerve cells are damaged or injured, resulting in loss of nerve fibers in the central portion of the optic nerve and ultimately loss in vision.

Abnormal Optic Nerve

What causes Glaucoma?

A clear fluid, the aqueous humor circulates inside the eye.  Fluid is constantly produced and, in normal circumstances, an equal amount flows out of the eye through a microscopic drainage system located in what is termed the angle of the eye.  This fluid balance results in a normal pressure in the eye.  If this drainage angle is partially obstructed, fluid backs up in the eye, resulting in a increase in the pressure within the eye. This increase in the pressure within the eye is believed to be the leading cause of loss of vision due to glaucoma.  This is why the goal of treatment of glaucoma is to lower the intraocular pressure (IOP).

What are the types of Glaucoma?

1.    Primary Open Angle Glaucoma (POAG)

Primary Open Angle Glaucoma is by far the most common form of glaucoma.  In this disease, the drainage angle becomes less efficient over time without any known specific cause, resulting in increased IOP.  This typically occurs so gradually and painlessly that the patient is not aware of the loss of vision in the early stages.  However, Dr. Wyll can frequently detect objective evidence of glaucoma in the early phases of the disease, and can begin treatment to prevent loss of vision.

2.    Secondary Glaucoma

Damage to the drainage area can result from numerous eye diseases and problems, such as injury, bleeding, inflammation or tumor.

3.    Angle Closure Glaucoma (ACG)

Certain eyes, because of their small size or unusual shape, are susceptible to develop near-total or total blockage of the fluid drainage area.  This can occur suddenly, and result in very high eye pressure.  Symptoms include blurred vision, severe eye pain, redness, headaches, seeing halos around lights, nausea and vomiting.  This is a medical emergency requiring immediate treatment, as the sustained elevation of pressure can result in major loss of vision if the attack is not relieved quickly.

Who is at risk of developing Glaucoma?

According to the American Academy of Ophthalmology, glaucoma is the second most common cause of blindness in the United States.  The number one risk factor for developing glaucoma is increased intraocular pressure.  But there are other significant risk factors, including increasing age, family history of glaucoma, near-sightedness, and certain ethnicities.

How is Glaucoma detected and diagnosed?

Having a comprehensive dilated eye examination by Dr. Wyll is the best way to detect glaucoma.  There are several important parts of a glaucoma exam that he performs.

Because glaucoma is a disease which can result in significant permanent loss of vision before a person notes any symptoms, it is especially important that every adult have regular eye exams and glaucoma testing.  Vision lost due to glaucoma generally cannot be regained, buy early detection and treatment can often prevent subsequent vision loss. 

How is Glaucoma Treated?

Several methods of treatment are utilized by Dr. Wyll to treat glaucoma.  The goal of treatment is to lower the pressure within the eye.

1.    Eye Drops to reduce IOP are generally the first line of treatment for open angle glaucoma.  As with any medication, there are potential side effects with the use of these drops.

2.    Laser Surgery - Laser treatment can be utilized to treat the various types of glaucoma and will be tailored to obtain the best possible therapeutic outcome for each individual patient.

Dr. Wyll performs selective laser trabeculoplasty (SLT), which utilizes a "cool" laser beam to open the fluid outflow channels in order to decrease the eye pressure.  This is a painless outpatient procedure.

3.    Operative Surgery - Surgery is typically utilized in patients for whom medications and laser treatment have not been adequate to control their glaucoma.

What is your role in treatment?

Treatment for glaucoma requires teamwork between you and Dr. Wyll.  He can prescribe treatment, but only you, the patient, can make sure you take your medications on the prescribed schedule, and that you return for regular follow-up exams.

610 North Coit, Suite 2115 Richardson, Texas 75080    Telephone 214-575-4455    Fax  972-918-0480

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