GLAUCOMA

WHAT IS GLAUCOMA?

Glaucoma is defined as increased pressure within the eye that causes degenerative changes in the optic nerve and retina with subsequent blindness.

WHAT CAUSES GLAUCOMA?

Cells inside the eye behind the iris, called the ciliary epithelium, continuously make the fluid (“aqueous humor”) that fills the front portion of the eye. Glaucoma develops when the normal flow of this fluid out of the eye is impaired. In most cases, this is caused by a hereditary defect where the filtering mechanism (“filtration angle”) around the periphery of the iris is blocked off. This is referred to as “primary glaucoma” and is most commonly seen in pure bred dogs such as the Cocker Spaniel, Basset Hound, Bouvier, Springer Spaniel, Beagle, Shar Pei, Chow Chow, as well as many others. “Secondary glaucoma” refers to increased pressure in the eye due to other diseased such as anterior uveitis (inflammation inside the eye), lens luxation (dislocation of the lens from its normal position), and hyphema (bleeding inside the eye).

WHAT ARE THE SIGNS OF GLAUCOMA?

· Red eye

· Cornea may turn blue

· Pain

· The pupil may be dilated

· Watery discharge from the eye

· Blindness

· Enlargement of the eye

HOW IS GLAUCOMA TREATED?

Rapid diagnosis and treatment are necessary to save vision once glaucoma has developed. Before referring you to the ophthalmologist, your veterinarian may have given your pet some medications and/or eye drops; these help to start treating the glaucoma, however, they cannot control the pressure on their own. To effectively decrease the pressure in the eye, your pet will be placed under anesthesia and the ophthalmologist will use a laser to partially destroy the ciliary epithelium inside the eye. Destroying these cells reduces the eye’s ability to produce fluid, thereby decreasing the pressure. The laser will also be used to create a small hole in the sclera which is covered over with a flap of conjunctiva, creating a filtering bleb, which allows fluid to slowly leak out. This hole will gradually close up in about a week. In some cases, a small length of tubing is inserted into this hole and sutured to the outside of the sclera under the conjunctiva. This tube will remain permanently to allow fluid to constantly drain.

WHAT HAPPENS AFTER TREATMENT?

Once the pressure has been stabilized, it is very important that the pressure in both eyes be monitored on a 3-month basis for the first year, then every 6 months after that. This may be performed at our office or at your regular veterinarian’s, depending on the situation. Due to the genetic nature of primary glaucoma in the pure bred dog, the other eye has a very high chance of developing glaucoma as well. The ophthalmologist will likely start preventive eye drops in the good eye. In some instances, it may even be necessary to perform laser therapy on the good eye.

WHAT WILL I NEED TO DO AT HOME?

· Your pet’s eye will remain slightly red and inflamed for about 2 weeks after glaucoma surgery. If redness or pain begins to increase or if vision deteriorates, call us immediately.

· Keep the head collar on at all times (even at night). It only takes a second for a rubbing paw to do serious damage to the surgery site.

· Your pet will go home on several eye drops and oral medications after surgery; these meds will be slowly decreased by the doctor. Some animals have to remain on medications for a long period of time. Be sure to give all meds at the appropriate times.

· When using eye drops, be sure to hold the lids open so the medication is placed onto the eyeball. Wait 5 minutes between different drops so as not to flush out the previous medication before it has been absorbed. Often dogs with glaucoma do not blink properly, therefore the eye needs to be lubricated with an ointment – always apply this ointment AFTER all the drops have been given.

· Wipe away any discharge from the eye with a clean, moist Kleenex or face cloth.

Keep your pet quiet until directed otherwise by the doctor.