Open angle glaucoma is the most common form of glaucoma, a leading cause of blindness in the United States and second leading cause worldwide. It has earned the nickname “the sneak thief of sight" because the loss of vision normally occurs gradually over time and is often only recognized when the disease is quite advanced. Once lost however, the damaged visual field can never be recovered. It affects one in two hundred people aged fifty and younger, and one in ten over the age of eighty. People of African descent are three times more likely to develop primary open angle glaucoma.
In a normal eye, aqueous humor--a clear, nutrient-rich fluid--passes continuously through the pupil and into a small space at the front of the eye, called the anterior chamber. In an eye with open-angle glaucoma, the aqueous humor drains too slowly through the channel system, creating a chronic rise in fluid pressure inside the eye. As intra-ocular pressure (IOP) increases, it pushes against the nerve fibers of the optic nerve, which transmits images to the brain. The increased pressure causes a reduction in the blood supply to the optic nerve, which is deprived of essential oxygen and nutrients. Over time, high IOP can cause irreversible optic nerve damage and vision loss.
There is no cure for glaucoma, but there are treatments to stem its progress. Treatment is directed toward lowering the intra-ocular pressure. Laser trabeculoplasty is aimed at opening up the meshwork in the eye through which the aqeous fluid flows to allow more outflow of the fluid. Traditional laser trabeculoplasty works by causing thermal damage to the trabecular meshwork, and therefore can be utilized only once. Selective laser trabeculoplasty (SLT), an enhancement developed at Wellman, uses a “cold” laser which does not cause thermal damage to the meshwork, and yet is just as effective as the traditional laser therapy. It provides the additional advantage of being repeatable three to four times over the course of a patient’s lifetime.