The Silent Thief of Sight

Glaucoma DiagramIf your doctor has told you that you have high intraocular pressure, or if you might have the beginning stages of glaucoma, then you will want to read the information below. Many people think that glaucoma is an eye disease that affects only seniors. This is not true. Glaucoma can strike even those in their early thirties. Many of you may remember a famous Minnesota Twins baseball player named Kirby Puckett.

In 1995 Kirby Puckett was the MVP of the World Series, and the next year he was blind in one eye. At the age of 35, his baseball career was over. This was absolutely catastrophic for the Minnesota Twins, their fans, Kirby Puckett, and his friends and family. Let the story of this baseball legend be a lesson regarding regular eye exams. Regular eye exams can save your vision because glaucoma is the leading cause of preventable blindness in the United States.

Many eye care patients are surprised when they learn that, according to the American Academy of Ophthalmology, almost 2.5 million Americans have glaucoma. More than half of these people do not even realize they have the disease, because glaucoma is asymptomatic in the early stages. As previously mentioned, glaucoma is known as the “silent thief of sight”, because it silently steals your vision.

Glaucoma often goes undiagnosed because there is no pain associated with this high intraocular pressure. Patients are urged to have routine eye exams to check the status of their general eye health. In a general eye exam, glaucoma tests can be performed, and the health of the retina can also be checked. Glaucoma is the second leading cause of blindness in the U.S., but it is the leading cause of preventable blindness. According to the American Academy of Ophthalmology, approximately 2.2 million Americans age 40 and older have glaucoma.

About Glaucoma

Glaucoma is an eye disease where the intraocular pressure in the eye increases and can eventually cause damage to the optic nerve, ultimately leading to vision loss if untreated. As previously mentioned, vision loss will occur with absolutely no warning signs or symptoms. The optic nerve is like a fine wire that connects the retina and the images we see to the brain. Damage to the optic nerve can occur when the pressure within the eye increases, usually due to a build-up of aqueous fluid inside the eye. This leads to the development of blind spots in our field of vision. As you probably realize glaucoma is a very serious disease that requires medical eye care attention.

The good news for Ft. Worth area glaucoma patients is that the doctors at the Texas Eye and Laser Center can help diagnose and treat this disease.

Diagnosing & Treating Glaucoma

Elderly man receiving Glaucoma TreatmentPatients who have glaucoma or glaucoma-like symptoms will benefit from the HRT II test, an instrument that uses a scanning laser to create an image of the optic nerve. It helps your eye doctor monitor the optic nerve for changes, thereby aiding diagnosis and assisting follow-up of the disease.

Before consulting you about glaucoma, the doctors at Texas Eye and Laser Center will require you to come in for an eye exam. The doctors will design a treatment plan based on your specific situation. Typically a medical approach using eye drops is the first line of treatment. For these eye drops to work, you must take them regularly and continuously. Many patients have difficulty taking eye drops on a regular basis. Glaucoma eye drop medications can have side effects. You should notify your eye doctor immediately if you think you experience side effects.

Side Effects May Include:

  • Red eyes
  • Change(s) in your heartbeat
  • Stinging eyes
  • Blurry vision
  • Frequent headaches

Argon Laser Trabeculoplasty (ALT)

When glaucoma medicine fails, laser treatment may be necessary. A modern laser glaucoma treatment called argon laser trabeculoplasty (ALT) is now available at the Texas Eye and Laser Center. This procedure works well, lowering eye pressure and decreasing the need for eye medication in some cases.

Argon Laser Trabeculoplasty (ALT) is a widely used treatment option for glaucoma management. By engaging in this laser technology, our doctors can now lower intraocular pressure and help patients avoid more invasive procedures. The surgical process begins with numbing the eye with topical eye drops so that you will not feel the laser treatment. A contact lens is applied, which will help the surgeon when applying the laser spots on the trabecular meshwork. After the procedure, anti-inflammatory drops are applied liberally to the eye.

What Does the Procedure Do?

ALT lowers intraocular pressure (IOP) by using small, low-energy laser pulses to target cells in the trabecular mesh system of the eye.


Glaucoma treatment combined with your cataract surgery procedure.

iStent Glaucoma Treatment ExampleTechnology has always played an important role at Texas Eye and Laser Center. Today, almost every aspect of vision is connected to a product or procedure that wasn’t available even 10 short years ago. If you have glaucoma and also require cataract surgery there is a new glaucoma eye care procedure that can help. By utilizing the iStent® our doctors can better help cataract patients with glaucoma. The iStent® enables patients to better control their glaucoma treatment and possibly reduce the need to use prescription eye drops at all.

The iStent® is FDA-approved for use in conjunction with cataract surgery to reduce eye pressure in adult patients with mild-to-moderate open-angle glaucoma currently being treated with glaucoma medicine. In clinical trials, iStent® has been shown to safely reduce eye pressure, which is the primary cause of open-angle glaucoma.


High levels of intraocular pressure “IOP” (fluid within the eye) is the only controllable factor when treating glaucoma and is the number one risk factor for glaucoma. The main cause of elevated eye pressure in patients with primary open-angle glaucoma is a reduction of the aqueous outflow in an area called the trabecular meshwork. For patients with combined cataract and open-angle glaucoma, iStent reduces intraocular pressure (IOP) by improving aqueous humor outflow.

Inserted through a 1.5-mm corneal incision, iStent is the only FDA-approved device for the treatment of mild to moderate open-angle glaucoma. The iStent allows the aqueous fluid to bypass the trabecular meshwork and flow into Schlemm’s canal, which allows the aqueous fluid to leave the eye so that when new aqueous is produced within the eye there will not be such a pressure elevation. The iStent increases aqueous outflow through its normal pathway through Schlemm’s Canal. The iStent® is placed in your eye during cataract surgery by our surgeons at Texas Eye and Laser Center and is so small that you won’t be able to see or feel it in your eye.


A multicenter study in Germany, Switzerland, and Spain revealed an intraocular pressure reduction that ranged from 3.4 to 5.9 mm Hg when combined with cataract surgery. One year after the surgery patients were still able to eliminate 1 to 1.3 glaucoma medicines from their previous eye drop treatment plan.

iStent® has been proven safe and effective, the iStent Trabecular Micro-Bypass is a surgical therapy that:

  • Does not limit treatment options that could help maintain your vision in the future
  • Can be safely implanted during cataract surgery
  • Saves very important eye tissue that is often damaged by other types of glaucoma surgery


The iStent Trabecular Micro-Bypass Stent (Models GTS100R and GTS100L) is indicated for use in conjunction with cataract surgery for the reduction of intraocular pressure (IOP) in adult patients with mild to moderate open-angle glaucoma currently treated with ocular hypotensive medication.


The iStent is contraindicated in eyes with primary or secondary angle-closure glaucoma, including neovascular glaucoma, as well as in patients with retrobulbar tumor, thyroid eye disease, Sturge-Weber Syndrome or any other type of condition that may cause elevated episcleral venous pressure.


The patient should be monitored postoperatively for proper maintenance of intraocular pressure. The safety and effectiveness of the iStent has not been established as an alternative to the primary treatment of glaucoma with medications, in children, in eyes with significant prior trauma, chronic inflammation, or an abnormal anterior segment, in pseudophakic patients with glaucoma, in patients with pseudoexfoliative glaucoma, pigmentary, and uveitic glaucoma, in patients with unmedicated IOP less than 22 mmHg or greater than 36 mmHg after washout of medications, or in patients with prior glaucoma surgery of any type including argon laser trabeculoplasty, for implantation of more than a single stent, after complications during cataract surgery, and when implantation has been without concomitant cataract surgery with IOL implantation for visually significant cataract.


The most common postoperative adverse events reported in the randomized pivotal trial included early post-operative corneal edema (8%), BCVA loss of = 1 line at or after the 3 month visit (7%), posterior capsular opacification (6%), stent obstruction (4%) early post-operative anterior chamber cells (3%), and early postoperative corneal abrasion (3%).


Hurst & Ft. Worth Glaucoma Specialists Incorporate the New iStent for the Treatment of Open-Angle Glaucoma During Cataract Surgery.

Texas Eye & Laser Center continues to stay at the forefront of glaucoma technology by offering this new glaucoma procedure. Brian D. Ranelle, D.O., Jerry G. Hu, M.D.Stacey Webb, O.D. M. Keith Head, O.D.Gregg Duistermars, O.D., D’Laine Pulliam O.D., and Cary Labbe, O.D. make up the core of the Texas Eye & Laser Centers glaucoma diagnosis and treatment protocol team. If you are a patient with glaucoma nearing cataract surgery now would be a great time to learn about what the iStent could do for you. We provide glaucoma second opinions to determine if your current treatment is as effective as possible. In addition to iStent, we offer a wide range of glaucoma treatment options.

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