Glaucoma Management and Treatment

We can help improve your vision

Glaucoma

Glaucoma is a disorder that occurs when fluid pressure increases within the eye. Over time, this pressure may cause irreversible damage to the optic nerve and result in vision loss. While there is no cure for glaucoma, prevention involving early detection and thorough comprehensive testing may help prevent future vision loss. Collins Vision provides state-of-the-art technology to test for glaucoma, including OCT (optical coherence tomography) that takes an image of the nerve to look for damage from glaucoma. Our physicians may recommend medications, usually in the form of eye drops, or suggest glaucoma surgical treatment to be performed by Dr. Collins.

Glaucoma Treatments

Micro Treatment for Glaucoma – iStent

 The iStent Trabecular Micro-Bypass for Those With Cataracts and Glaucoma

If you have both cataracts and open-angle glaucoma, Dr. Collins may suggest the iStent Trabecular Micro-Bypass to treat your open-angle glaucoma. Dr. Collins is one of the first and most experienced surgeon’s in the Southwest Florida area to offer the iStent. With the implantable iStent, you may be able to forgo or greatly reduce the daily use of medicated eye drops while still lowering excess intraocular eye pressure.

The iStent is the smallest medical implant device in the world — it is 20,000 times smaller than the intraocular lens implant (IOL) used in cataract surgery! It is implanted in the eye during cataract surgery.

iStent provides a permanent opening through the blocked drainage channel, causing fluid to drain more easily and thus lowering intraocular eye pressure.


Dr. Collins discussing the iStent technology.

Endocyclophotocoagulation (ECP)

ECP is a laser treatment done at the time of cataract surgery that delivers a gentle type of light energy through a fine fiber optic probe. During the cataract operation, Dr. Collins is able to use the same tiny incisions to remove the cataract, implant an intraocular lens, and perform the ECP procedure.

Selective Laser Trabeculoplasty (SLT)

This procedure involves short bursts of energy to reduce pressure on the optic nerve in patients with primary open angle glaucoma. It may reduce dependence on drops and can be safely repeated many times.

Macular Degeneration

Age-related macular degeneration (AMD) affects the area of the retina called the macula. This small area is responsible for producing sharp, central vision required for “straight ahead” activities such as driving, reading, recognizing faces, and performing close-up work. AMD destroys cells in the area of the macula in two different forms, “dry” and “wet.”
Dry AMD can advance so slowly that people hardly notice the change on a day-to-day basis, but over the long term, dry AMD may result in significant vision loss. Dry AMD can rapidly progress to the wet AMD with extreme vision loss in one or both eyes. If you have a family history of AMD, are over 59, or have been diagnosed with AMD, you should schedule an examination with Dr. Collins. There is no cure for macular degeneration, but Dr. Collins can recommend treatment that may be able to delay its progression or even improve your vision.

Diabetic Retinopathy

Diabetic retinopathy is the most common cause of vision loss among people with diabetes and is a leading cause of blindness in the US today. Diabetes causes weakening of the tiny blood vessels that nourish the retina. Left untreated, these weakened blood vessels can leak, leading to vision loss.

Diabetic retinopathy typically develops without any warning signs. Damage to the eye can occur slowly and may go unnoticed until there is significant damage. For this reason, anyone with diabetes should receive regular monitoring by an experienced eye doctor.

Diabetic Retinopathy Treatment

Treatment for diabetic retinopathy is highly individualized and will be based on your age, medical history and degree of damage to your retina. In its earliest stages, diabetic retinopathy may not require treatment beyond regular monitoring by your Collins Vision doctor.

If treatment is required, one of our trained physicians will explain all your options, including risks, benefits and alternatives before recommending the most appropriate treatment course for you. Treatment can include referral to a specialist for:

Intravitreal injections. This is the injection of medication into the back of the eye to help reduce fluid leakage associated with diabetic retinopathy.

Photocoagulation. This procedure involves a laser that is used to finely cauterize and seal or shrink the weakened blood vessels.

In severe cases, the retina can become detached due to diabetic retinopathy and may require surgery.

Fuch’s Dystrophy

Fuchs’ Dystrophy is a condition where the inner lining of the cornea (endothelium) contains abnormal cells. Fuch’s Dystrophy causes fluid to build up in the cornea, causing it to swell and thicken. This can lead to glare, blurry or cloudy vision and discomfort. Fuchs’ Dystrophy often affects both eyes and can cause vision to gradually worsen over time.

Fuch’s Dystrophy Treatment

Nonsurgical treatments, such as eye drops, might help relieve the symptoms of Fuchs’ Dystrophy. But for those with advanced stages of the disease, corneal transplant surgery offers the best chance of restored vision and improvement of symptoms. Dr. Collins has fellowship training in corneal conditions, and is versed in the latest procedures for treating advanced Fuchs’ Dystrophy, including:

Ultra-thin descemet-stripping endothelial keratoplasty (DSEK). This is a partial-thickness cornea transplant, where only the affected layers of corneal tissue are replaced with donor tissue and the patient’s own healthy, properly functioning corneal layers are left in place.

Pterygium

A pterygium is a non-cancerous growth that covers the white part of the eye over the cornea. This condition is more common in people who spend a lot of time in the sun. Although benign, a pterygium can affect your vision and cause irritation.

Pterygium Treatment

Pterygiums cannot be treated with glasses, contacts or medication, but corticosteroid drops may help with discomfort. More severe cases must be treated surgically to alleviate pain and restore vision. Dr. Collins can perform sutureless pterygium surgery with a conjunctival sliding graft. This advanced technique uses a patient’s own mucus membrane graft and does not require sutures, making the recovery easier, in most cases.

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