Glaucoma – Part II
In part one of our series on glaucoma, we looked at some of the symptoms and causes of the disease. In part two we will review some of the different treatment options, as well important considerations physicians and dentists must take into account when considering filing a disability claim based on a diagnosis of glaucoma, or other vision-related conditions.
The goal of treatment is to slow the progression of the disease by lowering intraocular eye pressure, as there is no cure and no way to reverse damage that has already occurred.
In a majority of cases doctors will start out with conservative treatment, which may include:
- Prescription eye drops that work to improve how fluid drains from the eye or by decreasing the amount of fluid the eye produces
- Oral medications – typically a carbonic anhydrase inhibitor
- Additional lifestyle changes and alternative/home remedies:
- Healthy diet
- Regular exercise
- Limiting caffeine intake
- Moderate amount of fluids throughout the day (too much fluid at once can increase eye pressure)
- Sleeping with an elevated head
- Relaxation techniques
With advanced cases or if conservative treatment doesn’t work or causes side-effects, surgical options include:
- Laser therapy – a small laser beam opens clogged channels in the trabecular meshwork
- Filtering surgery – surgical procedure (trabeculectomy) where an opening is made in the white of the eye and part of the trabecular meshwork is removed
- Drainage tubes – a small tube shunt is inserted into the eye to drain excess fluid and lower the eye pressure
- Minimally invasive glaucoma surgery (MIGS) – procedures that involve microscopic-sized equipment and tiny incisions. While these procedures are considered safer than traditional surgical procedures, they also provide only moderate pressure reduction, and are therefore mainly used for the early to moderate stages of the disease.
Some risks of surgery include:
- Vision loss (either reduced or completely lost)
- Bleeding inside the eye
- Low eye pressure – usually temporary but may require additional surgery to correct
- Scarring – may result in the operation failing
- Cataract formation
The success rate and whether conservative treatments will still be needed, or even whether procedures may need to be repeated, depend on a patient’s age, stage of the disease, and other health factors. Many individuals with glaucoma are able to continue to read, work, and even drive for some time, depending on how far the disease has progressed. However, for dentists and physicians who rely on their central and peripheral vision, depth perception, and visual acuity to practice, a diagnosis of glaucoma could potentially be (or become) totally disabling.
If you have been diagnosed with glaucoma and fear that it may be impeding your ability to continue to safely practice on patients, you should speak with an experienced disability insurance attorney. It is particularly important to speak with an attorney before changing your schedule and/or job duties or beginning to work outside your field, because making changes like these could jeopardize your ability to collect, or continue to collect, benefits under your policy.
These posts are for informative purposes only and should not be used as a substitute for consultation with and diagnosis by a medical professional. If you are experiencing any of the symptoms described above and have yet to consult with a doctor, do not use this resource to self-diagnose. Please contact your doctor immediately and schedule an appointment to be evaluated for your symptoms.
Glaucoma Research Foundation
American Academy of Ophthalmology
National Eye Institute
Glaucoma Service Foundation