In which specialist field are glaucoma specialists active?
In the world of eye care professionals, optometrists and ophthalmologists have complementary and even overlapping roles. However, it is ophthalmologists who are both medical and surgical specialists, capable of diagnosing, managing and treating a range of eye diseases and conditions, including glaucoma.
Ophthalmology is the branch of medicine that is concerned with the anatomy, physiology and diseases of the eyes. Thus, beyond what other primary eye care providers can offer, an ophthalmologist is a medical and osteopathic doctor who provides comprehensive eye care, including specialist medical, surgical and optical care for eye problems.
As elsewhere in medicine, ophthalmologists develop their own interests and specialisms, and a glaucoma specialist will have completed further advanced training at both theoretical and practical levels in order to become a certified glaucoma practitioner. While many ophthalmologists and perhaps other eye care professionals can, in theory, support glaucoma sufferers, receiving advanced or complex treatments (especially surgery) from a glaucoma specialist could provide a more advantageous outcome.
In many instances, some aspects of your eye care may be managed by both an optometrist and an ophthalmologists working together.
Which illnesses do glaucoma specialists treat?
Glaucoma is an umbrella term for a group of diseases that can cause serious damage to delicate nerve fibres and the optic nerve, which sends visual information to the brain. Some of the main types of glaucoma are as follows:
- chronic open-angle glaucoma – This is generally the most common kind of glaucoma. There are multiple causes, but there are strong suggestions it may be genetic, and though each eye may be affected, the severity may be different. Prevalent from middle age onwards, vision fades gradually, with peripheral (outer edge) vision the first to deteriorate.
- narrow or closed-angle glaucoma – This is a (usually) rarer form, which may develop rapidly and can affect just one eye at first. Common symptoms are blurred vision and redness, plus eye and head pain. The flow of eye liquid is blocked, which may cause a sudden pressure increase. This situation can cause nerve damage and is a medical emergency.
- congenital glaucoma – This is a rare type of glaucoma that threatens newborn infants and toddlers. The front of the eye (cornea) clouds over and the eye then becomes very light sensitive and full of tears. Early diagnosis and treatment is essential.
- secondary glaucoma – This is an extensive list of problems mostly linked to another disorder, such as a cataract, earlier eye damage, diabetes and others.
What treatment methods are used by glaucoma specialists?
Glaucoma damage prior to a diagnosis cannot be repaired, but treatment can preserve your remaining vision, or at least slow the course of the disease. All remedies seek to reduce the pressure in your eye, using one or more of the following methods:
Prescription eye drops
Eye drops seek to ease the pressure on your eye by upgrading the drainage of eye fluid, or else by reducing the volume of fluid produced.
Available eye drop formulas include:
- alpha-adrenergic agonists
- carbonic anhydrase inhibitors
- miotic or cholinergic agents
Surgery and other interventions
The following methods can be employed to lower the intraocular pressure in your eye:
- laser trabeculoplasty is a procedure used for open-angle glaucoma, in which a laser beam opens up blocked channels in the trabecular (drainage) meshwork.
- trabeculectomy, or filtering surgery, is an intervention to create a vent in the sclera (white of the eye) and remove some of the trabecular meshwork.
- drainage (micro) tubes are inserted by an eye surgeon.
- electrocautery is a minimally invasive technique used to remove some tissue from your trabecular meshwork.
Acute angle-closure glaucoma
Acute angle-closure glaucoma needs urgent medical attention to reduce the intraocular pressure in your eye. This may be achieved using a laser peripheral iridotomy procedure, which relieves the serious pressure build-up by creating a tiny hole in your iris.
What additional qualifications do glaucoma specialists require?
A glaucoma specialist must first train as an ophthalmologist.
In the Unites States, this requires four years at medical school, followed by another four years of residency training in ophthalmology in a hospital context. During this residency, the student ophthalmologist will learn the principles of optic medicine and practice the diagnosis and treatment of a whole range of eye problems. Graduation involves passing rigorous medical and surgical exams before certification is finally granted.
Advanced training in ophthalmic specialisms involves a further year or two of academic study and development of practical skills, known as a fellowship. After the successful completion of this additional period of formal training, those who choose glaucoma as their focus will then become certified glaucoma specialists.