Glaucoma
Glaucoma is a very complex group of conditions which cause progressive damage to the optic nerve. The result is lost vision, first in the peripheral visual field and ultimately in the central vision in severe cases. It is thought that in most glaucoma conditions the injury to the optic nerve is caused by high eye pressure.
Each patient that is suspicious for glaucoma needs to be evaluated individually. The components of this evaluation are consideration of the patient’s age, race and family history as well as a comprehensive medical history. Next, a comprehensive eye examination needs to be performed which include measurement of vision, visual field, corneal thickness, eye pressure and a complete evaluation of the optic nerve including special scanning testing. There is not one measurement that determines the presence or absence of glaucoma.
A common misconception is that the eye pressure is measured and that determines whether one has or doesn’t have glaucoma. This has led to many patients unnecessarily losing vision. Some of the worst cases of glaucoma are in individuals with normal eye pressure. Also, many individuals with elevated eye pressure do not have glaucoma at all. That is why a comprehensive evaluation of each patient is required in the assessment of glaucoma. Hirshfield Eye Associates in Queens has all of the latest state of the art testing equipment but even more importantly Dr. Hirshfield will personally supervise and evaluate the work up of each patient.
Whether one has high eye pressure or normal eye pressure, the mainstay of treatment of glaucoma is to lower the pressure from the baseline pressure. This is done in a stepwise fashion. The first choice is either drops or a painless in office laser procedure. There are many choices of medication that may be used and this choice is individualized for each patient. In some cases, surgery becomes necessary. The choices of specific surgical method are also very complex and individualized. Here in Queens, Dr. Hirshfield will personally advise the patient about and perform all necessary procedures and options to give the patient the best chance of maintaining useful vision and the best quality of life.
