Glaucoma Treatment and Surgery in Kauai
Glaucoma is a painless optic nerve disease sometimes associated with high eye pressure that causes peripheral vision damage. The optic nerve connects the eye to the brain, so it is vitally important for sight. One may not necessarily notice any symptoms of glaucoma, but it can be an irreversible blinding condition, which is why regular screening for glaucoma is of utmost importance. Glaucoma is one of the leading causes for blindness in those more than 60 years old.
Glaucoma can be caused by aging, hereditary disposition, trauma, steroid use, abnormal eye pathology causing an increase in intraocular pressure (IOP). An elevated IOP is a result of an excessive build up of fluid within the eye which does not drain appropriately through the trabecular meshwork.
Risk Factors for Glaucoma
- High IOP
- Over 60 years old
- Black, Asian, or Hispanic background
- Family history of glaucoma
- Underlying medical conditions – diabetes, heart disease, high blood pressure, and sickle cell anemia
- Thin central corneal thickness
- Eye injury/trauma, or eye surgery
- History of steroid use (systemic, injection, or eyedrops).
- Intermittent headache or eye soreness/pain
- Blurred vision
- Haloes around lights
- Patchy blind spots in peripheral vision
- In more advanced stages, tunnel vision will develop.
In early stages of glaucoma, eye drop medications or laser therapy are used to help lower the intraocular pressure.
If medications and/or laser do not work well enough, or if eye drops are troublesome due to cost, side effects, or other difficulties, then glaucoma surgery is required.
In mild to moderate open angle glaucoma, MIGS, or minimally invasive glaucoma surgery, becomes a viable surgical option. A stand-alone surgery or in conjunction with cataract surgery, this is a relatively safe procedure done to “open up” the drainage of the eye and reduce dependence on topical therapy. MIGS surgery is a same-day, outpatient surgical procedure done at either Kauai Veterans Memorial Hospital (KVMH) or Wilcox Memorial Hospital (WMH).
At Kauai Eye Institute, we offer three kinds of MIGS procedures for our patients.
- OMNI canaloplasty and trabeculotomy: a non-toxic jelly is used to inflate and stretch parts of your eye’s drainage system (the trabecular meshwork, Schlemm’s Canal, and collector channels) to allow fluid to leave your eye. Then the trabecular meshwork is partially opened to allow fluid to leave your eye. No device is implanted.
- iStent inject Trabecular Microbypass: Two tiny iStent devices are implanted in an area of the eye called Schlemm’s Canal to allow fluid to leave your eye. The stents are made out of inactive titanium. You can safely have an MRI with these stents.
- Goniotomy (using Kahook Dual Blade): An incision is made in the trabecular meshwork to allow fluid to leave your eye. No jelly is injected into the Schlemm’s canal, and no device is implanted.
Moderate to severe cases of glaucoma may require the more invasive, traditional glaucoma surgeries, like tube shunt or trabeculecomy.
Glaucoma is condition that can cause painless loss of sight or even blindness. Any individuals who have high risk factors should be monitored regularly by an ophthalmologist to detect and monitor glaucoma in its early stages. If surgery is required, MIGS can be performed at the time of cataract surgery or as a standalone procedure to help lower intraocular pressure in mild to moderate glaucoma.
If you are interested in surgical intervention with your glaucoma at the time of cataract surgery, please schedule an evaluation with Dr. Yoo to discuss your current ocular condition and to answer any questions you may have. Call our office at (808) 378-9927