Diagnosing Glaucoma and Treatment Options

Featuring Dr. Baseer Khan, MD, FRCS(C), P.CEO, Ophthalmologist

Duration: 3 minutes, 20 seconds

The academic definition of glaucoma is an insult or damage or injury to your peripheral vision associated with typical changes on your optic nerve, which is the nerve that connects your eye to the brain. In the simplest terms, it’s easy to think about glaucoma as being associated with damage to your vision as a result of high pressure, although high pressure isn’t always a requisite for having glaucoma said Dr. Baseer Khan.

Glaucoma should be thought about as the silent blinder. Unfortunately you won’t know if you have glaucoma, without going to an eyecare professional, until it’s too late. It’s really important to go for routine checks with your optometrist to make sure you don’t have any of the early signs of glaucoma before you know there’s a problem said Dr. Baseer Khan.

Your optometrist or your ophthalmologist will check your vision, they will check your pressure, they will check your peripheral vision and they will look at the back of the eye to help put together a profile that will help them figure out whether or not that you have glaucoma said Dr. Baseer Khan.

All treatments for glaucoma are designed to do one thing, and that’s to lower pressure in the eye. We don’t know how to protect the nerve or do other things, so all that we can do is lower the pressure. And there are three ways to lower pressure. One is with drops, number two is laser, which is designed to stimulate the cells responsible for lowering pressure in the eye, and the third is surgery, which is designed to increase the flow of fluid outside of the eye said Dr. Baseer Khan.

At the end of the day glaucoma is a plumbing issue and we’re trying to improve the fluidics inside the eye to lower the pressure and increase the flow of fluid out of the eye. When drops and lasers have failed in glaucoma the next step, and only other option for patients, is to do surgery. What’s important to remember is that surgery is not going to make you see better. It’s there to preserve your vision, to prevent you from losing more vision said Dr. Baseer Khan.

You can think of surgery as being in two buckets, and that’s trabeculectomies, or filtering procedures, where what we’re doing is we’re creating a little flap in the wall of the eye through which fluid percolates through to underneath the skin or the conjunctiva of the eye. Usually we do trabeculectomies first said Dr. Baseer Khan.

In patients in whom the risk of trabeculectomy or failure is high or who have already had one and failed, the next step is to do something called a tube shunt, where we actually put a small tube in the front of the eye which drains into the back of the eye. Those surgeries are reserved for people who are generally more complex or complicated said Dr. Baseer Khan.

More recently, there’s a group of surgeries called MIGS, or minimally-invasive glaucoma surgery, that carry a little bit of a lower risk, although they’re a little less effective in lowering pressure, but they’ve really added to the number of different devices and opportunities that glaucoma surgeons have available to them today said Dr. Baseer Khan .

Glaucoma is a chronic condition that needs constant follow-up, it’s important that you continue to follow up with your eyecare professional, your optometrist, and your ophthalmologist, and certainly if you need surgery, you should talk to your ophthalmologist about the different options that are available to you said Dr. Baseer Khan.

Presenter: Dr. Baseer Khan, Ophthalmologist, Vaughan, ON

Local Practitioners: Ophthalmologist