Glaucoma Specialist

What is glaucoma?

Glaucoma is a disease that damages your eye's optic nerve. It usually happens when fluid builds up in the front part of your eye. That extra fluid increases the pressure (called intraocular pressure or IOP) in your eye above normal levels, damaging the optic nerve. It is estimated that three million Americans have glaucoma, but only about half of them know that they have glaucoma. Glaucoma is a leading cause of blindness for people over 60 years of age. But blindness from glaucoma can often be prevented with early treatment. When glaucoma develops, usually you don’t have any early symptoms and the disease progresses slowly. In this way, glaucoma can steal your sight very gradually. Fortunately, early detection and treatment is vital and can help preserve your vision. Having regular dilated eye exams is so very important to detect glaucoma.

What symptoms does glaucoma cause?

Glaucoma has earned the nickname “Silent thief of sight” because it usually causes no symptoms until vision loss has occurred. Patients with undiagnosed glaucoma that has progressed may begin to notice a decrease in the ability see out of the side of their affected eye (peripheral vision), resulting in a narrower field of vision.

What methods are used to diagnose glaucoma?

As part of a comprehensive glaucoma evaluation, Dr. Nadji will initially measure your eye pressure using tonometry. Testing your eye pressure is an important part of a glaucoma evaluation. A high-pressure reading is often the first sign that you have glaucoma. Next, gonioscopy may be indicated to allow Dr. Nadji to get a clear look at the drainage angle to determine the type of glaucoma you may have. Using a mirrored lens, he can examine the drainage angle to determine if you have open-angle glaucoma (where the drainage angle is not working efficiently enough) or closed-angle glaucoma (where the drainage angle is at least partially blocked). Dr. Nadji will also inspect your optic nerve for signs of damage using ophthalmoscopy. Your pupils will be dilated (enlarged) with eye drops to allow your doctor a better view of your optic nerve.

The visual field test will check for blank spots in your vision. The results of the test show your ophthalmologist if and where blank spots appear in your field of vision — including spots you may not even notice. Because the thickness of the cornea can affect eye pressure readings, pachymetry is used to measure corneal thickness. Fortunately, technology continues to evolve and retinal nerve fiber layer analysis by optical coherence tomography is now available to directly measure the health of the optic nerve. This technology allows the doctor to determine if the disease is present and in confirmed glaucoma patients if it is stable or progressing.

How is glaucoma treated?

Eye drops along with precise lasers are the first line treatment for glaucoma. Dr. Nadji has one of the few in office selective glaucoma lasers in Santa Monica to offer patients an alternative to daily eye drops. If your intraocular pressure cannot be managed with eye drops and/or laser alone, surgery may be recommended to improve drainage of the eye and prevent the fluid buildup that causes the rise in pressure. Recent advances in glaucoma treatments include the iStent, indicated at the time of cataract surgery.