Center For Eye Care: On The Cutting Edge of Advanced Specialty Eye Care


Glaucoma is a disease that damages the optic nerve and causes vision loss – often without warning and symptoms. Like a cable wire, the optic nerve is responsible for carrying 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. However, damage may occur without elevation of the intra-ocular pressure. Conversely, the pressure may at times be elevated without damaging the optic nerve. This is a condition known as Ocular Hypertension. Blind spots in the field of vision usually go undetected by the individual until the optic nerve is significantly damaged and a great loss of peripheral or central vision has occurred. A Visual Field evaluation can detect glaucomatous damage in its very early stages. If the disease is untreated the optic nerve may be damaged to a point that irreversible blindness will result.

Glaucoma, often called the “sneak thief of sight” because it usually has no symptoms, affects about 3 million Americans and 67 million people worldwide. It is a leading cause of blindness in the United States, particularly among the elderly population.

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Types of Glaucoma:

Not every type of glaucoma is the same or will have the same impact on your life. If you have been diagnosed with Glaucoma please make sure to familiarize yourself with the different types of glaucoma listed below.  Dr. Raymond M. Girgis, M.D. will be happy to provide additional information regarding your specific type of glaucoma and what this will mean to your life.

1. Chronic open-angle glaucoma:

This is the most common type of glaucoma. The drainage angle, where the fluids in the eye drain, is open, but working less efficiently. The inability to drain causes pressure within the eye to rise, which results in a gradual loss of side-vision. This can be likened to an air filter, which gathers dust over time & eventually becomes too laden with dust to work properly.

2. Angle-closure glaucoma:

This type of glaucoma occurs when the drainage angle is completely blocked, often by the iris. This prevents any fluid to drain from the eye & causes the pressure within the eye to suddenly rise. This extreme rise in pressure causes blurred vision, headaches, severe eye pain as well as the appearance of halos around lights.

3. Chronic angle-closure glaucoma:

This is painless and more gradual closing of the drainage angle, which occurs most frequently in people of African or Asian descent.

4. Secondary Glaucoma:

This type of glaucoma progresses very much like chronic open-angle glaucoma. It occurs when scar tissue blocks the drainage angle. The first symptom is loss of side-vision.

5. Congenital Glaucoma:

This is a birth defect, which affects the drainage angle. To prevent blindness, this condition must be treated shortly after birth. Symptoms include enlarged eyes, a cloudy cornea, light sensitivity and excessive tearing.

Treatment Options:


Medical technology can often times bring miracles. Glaucoma is usually treated with daily eye drops that decrease eye pressure either by slowing the amount of fluid produced within the eye or by improving the flow through the drainage angle. Glaucoma medications may produce side effects, so be sure to talk to your doctor if you experience any unusual symptoms.


Laser Surgery

Laser surgery treatments may be recommended for certain types of glaucoma. In open-angle glaucoma, a laser can be used to modify the drain to help control eye pressure.

In angle-closure glaucoma, the laser can be used to create a hole in the iris to improve the flow of aqueous to the drainage angle.

SLT – Selective Laser Trabeculoplasty

Selective Laser Trabeculoplasty is quickly becoming a widely accepted treatment option in glaucoma treatment. SLT offers a new glimpse of hope for glaucoma patients. By engaging in this NEW laser technology the ophthalmologists can now lower pressure that can possibly help a patient avoid a more invasive surgery. The surgery might even reduce the dependence on medications or drops.

What does the procedure do?

SLT actually lowers (IOP) intraocular pressure by creating relatively small pulsing low-energy laser light to target cells in the trabecular mesh system of the eye.



In a standard, operating room procedure, your doctor can also use fine, microsurgical instruments to create a new drainage channel for outflow of aqueous fluid. Though serious complications of modern glaucoma surgery are uncommon, they can occur. Surgery is recommended if your ophthalmologist feels that it is necessary to prevent further damage to the optic nerve.


Who is at risk?

Glaucoma can impact anyone or any family. All people should be concerned about the glaucoma disease and the potential harm it could cause someone’s life. Because this disease is also known as the sneak thief of sight we must remind each other, especially our elders to get regular eye examinations. Early detection could save your vision.

Glaucoma: Those At Risk?

People at greater risk for glaucoma:

1) People of African-American descent

2) Adults over the age of 50 years

3) Those with a significant family history of glaucoma

4) People who have diabetes

5) Nearsighted patients

6) People with high intraocular pressure


African-Americans have a greater than average chances for developing glaucoma than do people of other racial backgrounds.

The American Academy of Ophthalmology (AAO) now recommends that people with other risk factors for glaucoma have their eyes examined.

Corticosteroids that are inhaled are most often used to treat asthma and have been reported to raise intraocular pressure (IOP)

The Center for Eyecare Glaucoma Services

Like diabetes, open angle glaucoma is a disease which can be controlled but not cured. Early diagnosis, close followup care, and lifetime monitoring are key in maintaining good vision. Using eyedrops becomes as normal a habit as brushing one’s teeth, and people continue to lead normal active lives with glaucoma.

Dr. Raymond M. Girgis is trained to treat glaucoma. In many cases, the treatment can be successfully achieved with eyedrops and or laser. In more advanced cases, surgical operations must be performed.