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VISION ONE
TOTAL EYECARE CENTER
Port Orange, Daytona Beach, Deland
386-671-2020
UNDERSTANDING GLAUCOMA

Glaucoma is a condition of the eye in which the pressure in the is to high for the health of the optic nerve. The elevated pressure causes slow, irreversible damage to the optic nerve in the back of the eye, in turn causing the peripheral vision to be decreased. The portion of the peripheral vision initially effected is not noticeable to the patient. Visual acuity may be measured as 20/20, even though significant damage can be present. The patient experiences no pain bu may suffer further irreversible damage until she is tested, a diagnosis is made and treatment is implemented. While there are several methods of treatment, if untreated, glaucoma can lead to blindness.

The pressure may fluctuate throughout the day. “Normal” pressure readings are between 13 and 21. Some people’s optic nerve appear to have a higher tolerance to pressure that others. Some people with normal pressure may show signs of damage, conclusive of glaucoma, while another people who’s pressures are above normal, shows no sign of damage, making that patient a “glaucome suspect.” It is important for the doctor to order tests to diagnose glaucoma. Treatment for glaucoma may involve observation, eye drops, laser treatment, pills, or surgery. These forms of treatment reduce the eye pressure, relieving the threat of further visual loss. While treatment may control pressure for a varied period of time, there is no cure for glaucoma. Close observation is required for the doctor to make timely adjustments to a patients medicating schedule.

Treatment for glaucoma may span over many, many years. Some of the tests used to follow glaucoma are:

  1. Gonioscopy- for viewing the structure where the fluid drains from the eye.
  2. Visual Fields- for assessment of the peripheral vision and the health of the optic nerve.
  3. Photographs of the optic nerve- for comparison and future reference.
  4. Eye pressure checks throughout the whole day.

98% of all glaucoma involves a painless, gradual loss of vision (primary open-angle). 2% involves an attack of glaucoma where the patient experiences pain and/or nausea and should seek care immediately (angle-closure glaucoma). Laser treatment may lessen the risk of angle-closure. Lasers can be used to treat either form of glaucoma.

While findings are not conclusive, CAFFEINE may raise pressure. DIABETES MELITIS may raise pressure. STRESS may raise pressure. EXERCISE and ALCOHOL may lower pressure. CIGARETTES appear to have little or no effect.

DIABETIC RETINOPATHY

People who are diabetic have many concerns including meal plans, glucose levels and insulin or medication schedules. In addition to these concerns, the diabetic faces a far greater risk from eye diseases as a result of their condition. A diabetic is nearly twice as likely to develop cataracts and glaucoma than a person who does not have diabetes. The most common diabetic eye condition however, is called diabetic retinopathy.

A diabetic may have diabetic retinopathy and not even know it. This condition can start without symptoms and worsen over time, leading to partial vision loss or even blindness. Factors such as high glucose levels, high blood pressure, how long you’ve been a diabetic, and genetics may contribute to the development and progression of diabetic retinopathy. It is strongly advised that a diabetic be established with a board certified optometric physician who is trained to detect and follow this and other diabetic eye conditions.

The eye is a small, yet detailed and complex organ. The portion of the eye effected by diabetic retinopathy is the retina. The delicate tissues of the retina convert light into impulses, which travel to the brain and are converted into the images we perceive. Diabetes weakens other blood vessels in the body, the tiny delicate blood vessels in the retina are especially vulnerable. These small blood vessels (capillaries) may leak fluid or close-up from lack of oxygen. Growth of new, weak capillaries may occur after capillary closure. A clear gel in the eye (vitreous) may pull on these weak capillaries, causing bleeding in the eye. Damage to the retina often results in irreversible vision loss. To date, there is no transplant or implant to replace the retina. This is why routine eye exams and possibly treatments are important factors in preserving a diabetic’s eyesight.

At Vision One, Total Vision, and the Neumann Eye Institute we are trained to detect and follow eye conditions that result from diabetes. If needed, our patients can be referred for possible laser treatment. The laser may be used to reduce swelling, destroy weak or closed blood vessels or reduce the growth of new blood vessels. In addition to routine eye exams, we offer the following advice to our diabetic patients.

  1. Control your blood sugar (test you blood regularly and take medication accordingly)
  2. Control your blood pressure (doing so may stop retinopathy from becoming worse)
  3. Eat Healthy (eat foods high in complex carbohydrates like starches, cereals, fruits, and vegetables.., while avoiding sugary foods)
  4. Exercise often (for the maximum benefit, elevate your heart rate for twenty minutes straight, daily, by swimming, cycling, or walking briskly)
MACULAR DEGENERATION

Do you feel print is becoming too small, or you never have enough light. Is there a blurry or blankspot in the middle of your visual field, as if a flash bulb has just gone off in your face? Do not assume that you need new glasses or can wait weeks for a convenient appointment. See an eye care professional immediately. Any of these visual distortions may be an early symptom of macular degeneration, a loss of central vision that is the leading cause of legal blindness in the united states.

The macula is a tiny, highly sensitive region in the center of the retina that allows you to see fine details when you look directly at something. Without a properly functioning macula, your central vision becomes increasingly impaired, though you will retain peripheral vision in shades of black and white. There is no cure for macular degeneration but if blood vessels are leaking under the macula, they can be sealed off using laser surgery. This treatment can slow the loss of vision.

Macular degeneration is rare in people under 50, but its incidence rises with age. Some ways to lessen your chances for this condition are to keep any conditions of high blood pressure, heart disease, and diabetes managed correctly, avoid tobacco smoke, eat a diet rich in fruits and vegetables, reduce saturated fats, and wear sunglasses that block ultraviolet rays. We have special amsler grids that can help detect or monitor macular degeneration in our patients.

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