According to the American Academy of Ophthalmology, the term glaucoma describes a group of diseases that are characterized by optic neuropathy and are typically associated with visual field loss and elevated intraocular pressure.

This elevated pressure can be due to the production of too much aqueous fluid in the eye or inadequate drainage of fluid in the eye causing the increased pressure. It should be noted that even eyes with normal pressure (10-22 mm Hg) can develop glaucoma.

In general terms, the different types of glaucoma can be thought of as open angle, narrow angle, or secondary glaucoma. Each type of glaucoma entails a different type of treatment.

Not all risk factors for glaucoma are known. However, depending on the glaucoma type, risk factors include increased age, family history of glaucoma, racial background, increased intraocular pressure (eye pressure), and corneal thickness.

Daniel Hill, DDEAMC Ophthalmic Technician, is about to have his intraocular pressure checked with Applanation Tonometry. Courtesy photo Some of these risk factors, such as eye pressure and corneal thickness, can only be evaluated in the eye clinic.

Other possible risk factors include gender, diabetes, uncontrolled blood pressure, and myopia (nearsightedness).

The problem with the visual loss in glaucoma is that peripheral vision is lost much earlier than central vision. If a patient waits to see the ophthalmologist when central vision loss is noticed, up to 90 percent of the optic nerve may already be damaged.

However, if a patient who is a glaucoma suspect based on an eye exam, maintains regular visits to the ophthalmologist, then glaucoma can be detected up to five years earlier.

With early identification and treatment, a patient’s central vision can be spared for a much longer time. Early detection of peripheral vision loss can be discovered in the ophthalmology clinic by a visual field test.

Patients should consider an eye exam for glaucoma if they have family members with glaucoma, have had a high eye pressure before, or have been told that their optic nerves look enlarged or like they may one day develop glaucoma.

If glaucoma is diagnosed, there are many treatment options available. The vast majority of patients with open angle glaucoma and secondary glaucoma due to excess pigment are controlled with eye drops and/or a laser procedure performed in the office called a Selective Laser Trabeculoplasty (SLT).

Pressure lowering drops do so by decreasing the production of aqueous fluid or by increasing the drainage rate of the fluid out of the eye. The SLT laser helps the drainage system to work better and increases the drainage rate of fluid out of the eye.

Patients with narrow angle glaucoma may need an office procedure called a laser peripheral iridectomy and/or a laser peripheral iridoplasty.

Surgery to lower eye pressure may be necessary if maximum drop therapy and laser treatments fail to control glaucoma. The basic idea is to surgically create a shunt in the eye to cause fluid to flow out at a higher rate.

Many devices have been developed to aid the filtration process and the best procedure is determined by the patient and the physician on a case by case basis.

The Ophthalmology Clinic is on the 2nd floor of Eisenhower Army Medical Center and is fully staffed with Ophthalmologists who provide the full spectrum of eye and vision care from screening exams to medication and surgery.

The Ophthalmology Clinic can also treat a broad spectrum of other eye conditions. Stay tuned for future updates in the Signal Newspaper on other medical, laser, and surgical treatments we can provide for a variety of eye conditions caused by cataracts, diabetes, droopy eyelids, strabismus (lazy eye), lesions on the eyelid surface or surface of the eye itself (pterygia).

Eligible beneficiaries can make appointments with Ophthalmology by calling the Specialty Care Coordination Office at (706) 787-0297 or toll free (877) 667-5828.

The Specialty Care Coordination Office at Eisenhower coordinates referrals for the Ophthalmology Clinic and 28 other specialty clinics for all Department of Defense beneficiaries, regardless of age. This includes retirees and dependents. Even if those with an external primary care physician are eligible to use the specialty clinics at Eisenhower with no co-pay.