Glaucoma and LASIK Surgery

Glaucoma Lasik

Glaucoma affects around 3 million people in the United States, and is the second leading cause of blindness worldwide. Nicknamed "the silent thief," it affects vision gradually. Often people notice no symptoms until the disease is quite advanced, and unfortunately its effects are irreversible.

What is glaucoma?
The human eye is filled with a clear watery fluid called aqueous humor. Normally this fluid flows through the eye and then drains out. It is believed that in a person with glaucoma, this fluid does not drain properly, so it builds up within the eye, increasing the pressure inside. This increased intraocular pressure (IOP) can damage the optic nerve, causing a permanent decrease in vision and eventually blindness.

The disease is still not fully understood. It was once believed that IOP was the primary cause of the nerve damage, but research has indicated that other factors are likely involved. There is no specific threshold for IOP causing nerve damage. Some people can live for years with "high" IOP and show no signs of glaucoma, while someone else with "normal" IOP experiences vision loss from the disease. However, high IOP is definitely a risk factor, and should be treated accordingly.

Who is at risk?
Risk factors for glaucoma include:

  • Family history of the disease
  • African, Hispanic, or Asian ancestry
  • Advanced age (over 60 years old)
  • Steroid use
  • Previous eye injury
  • Smoking
  • Diabetes
  • Severe nearsightedness
  • High blood pressure
  • Central corneal thickness less than .5 mm

Testing and Treatment
Your eye doctor can test for glaucoma as part of your regular eye exam. The most common way to measure intraocular pressure is with a machine that blows a small puff of air into the eye. This test is very brief (only a few seconds) and painless. The doctor will also examine your optic nerve visually for signs of damage, and test your visual field for blind spots.

There is no cure for glaucoma, but medicated eye drops or surgery can slow or stop the progress of the disease.

If I have glaucoma, can I still have LASIK surgery?
If your glaucoma is being treated, and your condition is stable, you are probably eligible for some, but not all, types of laser surgery.

Glaucoma patients are not good candidates for some refractive surgeries, such as traditional LASIK, Wavefront LASIK, and Epi-LASIK. These procedures involve the use of a microkeratome, which attaches to the eye with a vacuum suction ring. This suction significantly increases the IOP of the eye for a brief period of time, which is insignificant for most people, but is not recommended for those who already have elevated IOP.

However, there is no shortage of alternatives for glaucoma patients wanting surgical vision correction. Possibilities include photorefractive keratotomy (PRK), LASEK, conductive Keratoplasty (CK), and implantable intraocular lenses.

To find out more about these and other options for glaucoma patients, speak with your eye doctor.

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