Glaucoma can be separated into two broad categories, Open Angle and Angle Closure (narrow angle) Glaucoma. Open Angle Glaucoma, the more common condition, occurs when the glaucoma drain of the eye (trabecular meshwork) does not function properly and the fluid pressure builds up within the eye. Open Angle Glaucoma tends to develop slowly and may have no symptoms until some vision has been permanently lost.

In Angle Closure or Narrow Angle Glaucoma, the iris physically obstructs the drain of the eye. The glaucoma drainage inlet becomes so narrow due to the position of the iris that the trabecular meshwork is not visible upon examination. This type of glaucoma can develop suddenly with an abrupt closure of the drainage inlet. Emergency treatment may be required for this acute and often painful condition.

Open Angle Glaucoma is usually first treated with eye drops. If eye drops are insufficient to achieve satisfactory control, laser therapy (trabeculoplasty) may be added. For patients requiring additional intervention, glaucoma surgery may be performed.

Treatment of Angle Closure (narrow angle) Glaucoma
Course of Treatment: Laser Therapy » Medical Therapy » Surgical Therapy

Angle Closure (narrow angle glaucoma) therapy initially involves making a small opening (iridectomy) in the iris to relieve the blockage of fluid that causes angle closure. The procedure is performed painlessly with use of a laser on an outpatient basis. Depending on the extent of irreversible angle closure, medicines and surgery are sometimes added to treatment to satisfactorily control intraocular pressure.

For further details, see glaucoma laser surgery. Please click here to request additional information.

Gonioscopy allows Dr. D'Antonio to directly visualize the glaucoma drainage inlet in the eye with the use of a special lens. It is quick, painless, and performed after the use of a topical anesthetic drop. The test helps differentiate between open angle and angle closure glaucoma.

Visual field tests assess your peripheral vision. Early damage from glaucoma can often be detected by this important test. Dr. D'Antonio uses the latest computerized technology to assess peripheral vision. Both eyes are easily tested in 10 to 20 minutes and the visual field examination is repeated at varying intervals to monitor progression of glaucoma damage.

Optic nerve photography documents the configuration of the optic nerve. Changes that develop in the shape or pattern of the optic nerve help us to monitor glaucoma. Color photography of the optic nerve serves as a permanent record for future comparisons and evaluations.

Nerve fiber analysis is another computerized assessment of the optic nerve that measures the thickness of the nerve fiber layer, which is damaged from glaucoma.

• Please complete and bring the patient registration and medical history forms that are mailed to you prior to your appointment.
• Bring your glasses, contacts, and all glaucoma medications used currently.
• Bring any old records of previous glaucoma care and names of any medications used in the past.
• Your eyes will be dilated during the examination; therefore, you should bring sunglasses or someone to drive you home after the examination.

• Vision test
• Slit lamp biomicroscopic examination
• Applanation tonometry
• Gonioscopy
• Optic nerve assessment—ophthalmoscopy, color photography, nerve fiber layer analysis
• Visual fields