Glaucoma (Open-Angle, Closed-Angle & Normal-Tension Glaucoma) – Billings, MT

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About Glaucoma

Sometimes referred to as the "silent thief," glaucoma is an extremely common eye condition that can lead to significant vision impairment and even blindness, often without any symptoms or noticeable vision problems until the condition is fairly advanced.

Glaucoma is an umbrella term for conditions that damage the eye's optic nerve. This damage is nearly always caused by elevated internal eye pressure, and the elevated eye pressure is nearly always due to intraocular fluid buildup. The optical nerve is responsible for sending image information to the brain, so when it becomes damaged, its signals to the brain are affected. This typically starts causing blind spots or impairment in a person's peripheral vision, but it can eventually block the entire visual field. Glaucoma develops very slowly over time and rarely has any early symptoms. That's why it is so important to schedule regular comprehensive eye exams, so your eye care professional can detect any blind spots and begin treatment to slow or stop the damage to the optic nerve.

Types of Glaucoma

There are many different types of glaucoma. Each type is categorized according to the cause of the patient's elevated internal eye pressure — typically either the narrowing of the drainage space or a blockage of the trabecular meshwork — and has different methods and techniques for treatment. When talking about glaucoma, the term "angle" refers to the drainage space between the iris and cornea.

Open-angle glaucoma - The most common form of the condition, open-angle glaucoma is when the space between the iris and cornea is open, but the trabecular meshwork is blocked or draining less efficiently. This causes a more gradual buildup of pressure within the eye and a slower loss of peripheral vision. 

Angle-closure glaucoma - Angle-closure glaucoma is when the space between the iris and cornea is totally obstructed or closed. If this space is too narrow, blocked, or closed, no fluid can drain, and intraocular pressure can rise quite suddenly. This quick rise in pressure causes hazy vision, halo and glare problems, headaches, and sore and aching eyes.

Chronic angle-closure glaucoma - This type of glaucoma is most commonly found in patients with Asian ancestry. It develops more gradually than acute angle-closure glaucoma and typically does not cause any pain or noticeable early symptoms. 

Secondary glaucoma - Secondary glaucoma refers to glaucoma that is caused by a separate, primary underlying condition, such as diabetes, injury, or infection. Depending on the primary condition, secondary glaucoma can be open- or closed-angled glaucoma. Often, the first symptom is a loss of peripheral vision. 

Congenital glaucoma - Present at birth, congenital glaucoma will lead to blindness if not treated right away. It is a very uncommon birth defect involving a narrow or closed drainage angle. Abnormally large eyes, clouded corneas, sensitivity to light, and excessive tearing are some of the symptoms of congenital glaucoma. 

At Vance Thompson Vision, board-certified ophthalmologist surgeon Dr. Russell Swan and his award-winning team are dedicated to helping patients slow or stop the progression of damage to the optic nerve. 

Glaucoma FAQs

WHO IS AT RISK FOR GLAUCOMA?

Glaucoma is a very common condition that often does not have any symptoms or warning signs in its earlier stages. Therefore, it is very important to have your eyes checked regularly by an experienced ophthalmologist to be sure to detect glaucoma before permanent damage is done to the optic nerve. Glaucoma can affect anyone; however, there are a few factors that may put you at higher risk:

  • Glaucoma runs in your family
  • You are 45 years old or more
  • You have African-American, Hispanic, or Asian ancestry
  • You've had a previous eye injury that caused intraocular bleeding 
  • You are severely nearsighted

It is important to remember that a diagnosis of glaucoma does not mean that your lifestyle will have to change or be restricted. With proper management of the condition, most patients are able to maintain their normal daily routines without any problems.

Treatment Options

An estimated 2.5 million people have glaucoma, though about half of these people don't know they have the condition because it doesn't typically have symptoms. Glaucoma is the second most common cause of blindness in this country; however, with proper treatment, patients with glaucoma are able to continue living full, independent lives.

At Vance Thompson Vision, we are proud to provide our patients the full range of glaucoma treatments, from prescription eye drops to MIGS to advanced surgical procedures.

Medications

Many patients with open-angle glaucoma and the earliest stages of other types of glaucoma can manage their condition with daily eye drops. These prescription drops can reduce eye pressure either by decreasing the amount of fluid the eye produces or by enhancing the flow through the drainage angle. Glaucoma medications can cause side effects for some patients, so always contact your doctor if you notice any unusual symptoms.

Laser Treatments

Selective Laser Trabeculoplasty (SLT), an in-office treatment performed at our Bozeman, MT facility, is a wonderful treatment option for glaucoma that is totally painless. Using this laser technology, our highly experienced ophthalmologists can reduce intraocular pressure and potentially allow a patient avoid a more invasive surgery. In some cases, SLT could even reduce a patient's need for medications or drops.

Surgery

For surgical glaucoma treatments, our doctors utilize specialized, microsurgical instruments to improve the function of your natural drainage paths or create new channels for outflow if necessary. Your ophthalmologist may recommend surgery if medications and other less-invasive treatments have not slowed the damage to your optic nerve. If this is the case for you, it is important that you seek out a team of highly experienced ophthalmologist surgeons who can help you understand all of your surgical options. At Vance Thompson Vision, we have a team of surgeons who specialize in glaucoma treatments and can help you determine the ideal approach to managing your glaucoma.

Trabeculectomy & Tube Shunts

Glaucoma surgeries like the trabeculectomy and tube shunt procedure are performed in order to prevent further damage to the optic nerve by lowering intraocular pressure. When glaucoma is caught early enough, these surgeries have the potential to save patients' sight. However, any vision loss that has already occurred cannot be reversed.

Trabeculectomies and tube shunts are two different methods by which your surgeon can create or improve drainage pathways in your eye. These surgeries are usually reserved for patients who have not had satisfactory results from medications, laser therapy, or other minimally invasive procedures. 

MIGS

Minimally Invasive Glaucoma Surgery (MIGS) is a revolutionary advancement in glaucoma management. Until very recently, the only treatment options were medications, laser therapy, and major glaucoma surgery. MIGS procedures utilize innovative devices and techniques to provide a much less invasive alternative to glaucoma surgery. MIGS is typically performed at the same time as cataract surgery in patients with mild to moderate glaucoma; however, cataract surgery is not always required. Some of the MIGS procedures we perform at Vance Thompson Vision include:

  • KDB: The Kahook Dual Blade (KDB) is an advanced, single-use ophthalmic blade that can be used to either excise a tiny area of the trabecular meshwork or simply create an incision for easier natural drainage. The KDB procedure can be performed on its own for patients with mild to moderate glaucoma, as well as in combination with cataract surgery.
  • ABiC: Ab Interno Canaloplasty (ABiC) is a procedure designed to widen the Schlemm's Canal, part of the natural drainage system of the eye. In the ABiC procedure, a microcatheter is carefully and precisely wound through the canal, where it then injects a specialized gel that will enlarge the drainage area. 
  • Visco360: The Visco360 is a specialized device used to perform ab interno canaloplasty. It enables the surgeon to perform the procedure single-handedly using only one tiny incision that is self healing. ABiC with the Visco360 can be a standalone procedure or can be combined with cataract removal.
  • iStent: The iStent Trabecular Micro-Bypass Stent is the smallest medical device ever implanted into humans, measuring only 1mm by .3mm. The iStent is generally implanted during cataract surgery and helps to reduce eye pressure by bypassing the trabecular meshwork. FDA approved in 2012, the iStent is the most comprehensively studied glaucoma device available.
  • ECP: Endoscopic cyclophotocoagulation (ECP) is a laser procedure used to "shrink" the vascular tissue of the ciliary body, which produces intraocular fluid, in order to reduce eye pressure. Studies of ECP indicate it has more promising results than earlier ciliary body treatments. This modern advancement allows more precise treatment areas, shorter surgery duration, quicker recovery, and a decrease in post-operative complications.
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Relieve Your Glaucoma 

The team at Vance Thompson Vision invites you to schedule a consultation at our Billings or Bozeman, MT locations to learn everything we offer for your glaucoma care and management. We are dedicated to ongoing glaucoma research initiatives to ensure we are always at the forefront of state-of-the-art advancements in technologies and treatments. Reach out today to plan your visit with Dr. Russell Swan or another experienced member of his team.

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