July 2024
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GLAUCOMA-CATARACTS work, which is the natural drain in the eye. The goal of Q: What is Glaucoma? A: Glaucoma is a chronic eye disease that affects the optic nerve, causing perma- these surgeries is to improve the function of the trabecnent and progressive vision loss and blindness. Glaucoma is the 2nd leading cause of blindness worldwide with a prevalence of about 2% in the U.S. population. As of 2023, there are 3 million people in the United States living with glaucoma and that number is expected to increase to 6.3 million by 2050 due to the aging population (1). There are a number of risk factors for glaucoma, one of which is high eye pressure. Lowering the eye pressure is currently the only known method of treating glaucoma in order to stabilize the disease. Other risk factors include age (age >40), race (African Americans, Hispanics and Asians are at higher risk), thin corneas, and family history. Some health conditions such as diabetes and medications may also increase your risk of developing glaucoma. Glaucoma is typically painless, and symptoms develop very slowly over years. Patients may not detect any symptoms or vision loss for many years, and by the time symptoms are noted, the disease may be in a more advanced stage.
Q: How is Glaucoma treated? A: There is no cure for glaucoma. Glaucoma treatment aims to lower eye pressure to stabilize the disease and prevent further vision loss and damage to the optic nerve. We can typically lower eye pressure in three ways: medication, laser treatment, or surgery. Medication usually includes prescription eye drops that help to either decrease the amount of fluid production in the eye and/or improve the outflow of fluid from the eye. There are several different classes of these medications, and they can be used alone or in combination. The most common laser procedure that is used to treat open angle glaucoma is Selective Laser Trabeculoplasty (SLT). This laser helps to improve the outflow of fluid from the eye, therefore, lowering the eye pressure. This procedure is safe, works well for most people, and may be repeated if the effect of the procedure wears off over time. In recent years, this procedure has become the preferred first line treatment for glaucoma in eligible patients. There are two categories of glaucoma surgeries. MIGS (Minimally Invasive Glaucoma Surgery) targets the trabecular mesh-
ular meshwork by either opening it, dilating it, or stenting it, in order to increase the outflow of fluid from the eye. These procedures are typically recommended for patients with mild to moderate glaucoma and can often be performed at the time of cataract surgery. Filtration surgery is usually reserved for more advanced glaucoma. These surgeries bypass the trabecular meshwork by creating a new drainage pathway in order to lower the eye pressure.
by Julia K. Polat, MD Glaucoma and Cataract Surgeon Board certified in Ophthalmology Glaucoma-Cataracts Consultants, Inc
Q: What is a common misconception about Glaucoma? And what can I do if I am concerned about Glaucoma?
A: The most common misconception about Glaucoma is that a patient with glaucoma must have a high eye pressure. However, glaucoma can develop at any eye pressure. Therefore, it is important to have routine comprehensive dilated eye exams with an optic nerve assessment, since eye pressure alone is not a good screening parameter. Furthermore, early diagnosis and treatment of glaucoma lead to better outcomes with more preservation of vision. If you are concerned about Glaucoma, I would recommend scheduling a visit for a comprehensive eye exam with your local eye provider or with a subspecialist, such as myself. As a Glaucoma and Cataract subspecialist, I can provide a comprehensive evaluation and identify those patients who are at risk for glaucoma. I am also able to provide a wide range of treatment options for glaucoma, including SLT (laser treatment) and surgical options including MIGS, which I am often able to combine with cataract surgery. Undergraduate Degree: Carnegie Mellon University Medical School: Boston University School of Medicine Ophthalmology Residency: West Virginia University Eye Center Glaucoma Fellowship: UPMC Eye Center Prior Employment: UPMC Eye Center 2015-2022 as a glaucoma and cataract surgeon, VA of Pittsburgh 2015- present as a glaucoma and cataract surgeon and as a residency program site director 2018-2022 References: 1. Davuluru, et al. “Identifying, Understanding and Addressing Disparities in Glaucoma care in the United States”. Transl Vis Sci Technol. 2023 Oct; 12(10):18.
S U R G I C E N T E R Glaucoma and Cataract Consultants: Charleroi Office: 17 Arentzen Blvd, Suite 201, Charleroi, PA 15022, 724-483-3688 Mt. Pleasant Office: 220 Bessemer Rd, Suite 101, Mt. Pleasant, PA 15666, 724-547-5733 Mt. Lebanon Office: 1000 Bower Hill Rd, Suite 7200, Pittsburgh, PA 15243, 412-572-6121
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