There are many different types of glaucoma, but all are related
to pressure in the eye, which leads to optic nerve damage. As the
intraocular pressure increases, the patient may begin experiencing
peripheral area blind spots and other vision symptoms. Glaucoma
is a leading cause of blindness in the United States with more
than four million Americans affected.
Common types of Glaucoma include:
- Open angle glaucoma, which happens when the eye’s drainage
system is open, but fluid does not drain adequately for reasons
that are unknown.
- Closed angle glaucoma (acute), which is defined as the acute
closure of the eye’s peripheral drainage system that results
in a sudden increase in the intraocular pressure.
- Closed angle glaucoma (chronic), which is caused when the iris
over time begins to obstruct the drainage system of the eye.
- Pseudoexfoliation glaucoma, which is caused when fibrillary
material is deposited in the eye, impeding fluid from draining.
- Pigmentary glaucoma, which is caused when pigment is dislodged
from the iris of the eye and obstructs fluid from draining.
- Angle recession glaucoma is caused when trauma affects the
structure of the drainage system and causes elevated intraocular
- Neovascular glaucoma, which is caused when abnormal blood vessels
expand and grow on the iris of the eye, blocking the eye’s
drainage channels and structures.
- Congenital glaucoma, which is the abnormal formation of the
eye’s drainage channels during gestation.
In most glaucoma cases, patients have no symptoms in the early
stages. Once the patient experiences decreased vision, they are
already in the later stages of glaucoma. This is why thorough eye
exams are essential to detect this condition.
In all cases of adult glaucoma, any vision loss from glaucoma
is permanent. This irreversible loss of vision is preventable in
the vast majority of cases if the diagnosis is made early. Early
detection is the key to prevent vision loss from glaucoma and is
possible only with regular examinations by an ophthalmologist.
Patients with acute forms of glaucoma may have more severe symptoms due to
the quick increases in ocular pressure. These symptoms may include blurry
vision, especially at night, halos, starbursts or rainbows around lights,
as well as severe eye pain, or headaches and nausea.
Glaucoma treatment starts with efforts to decrease intraocular pressure in
the eye to prevent optic nerve damage. Regimens differ depending on the type
of glaucoma. Often an ophthalmologist will begin with prescribed medications
and eye drops to reduce pressure by increasing the outflow of fluid from
the eye or decreasing the production of fluid in the eyes. Laser treatments
are sometime recommended to increase the opening or open the drainage angle
of the eye to reduce eye pressure. New drainage channels can be created surgically,
but this is only done when medications are not effective.
If surgical intervention becomes necessary, there are many different
procedures that can be performed ranging from standard procedures
that have been performed for decades, to new, cutting edge procedures
that are newly FDA approved, to investigational procedures that
may become the next generation of standard interventions.
The glaucoma surgeons at the Gavin Herbert Eye Institute have
been instrumental in the development and optimization of numerous surgical
innovations that have become the new standard for glaucoma surgery worldwide.
is the standard procedure for glaucoma and has been performed
for over forty years. This procedure involves surgically creating
an alternate drainage pathway for the eye, through the sclera
(the white part of the eye). Recent modifications of this procedure
include implantation of a miniature glaucoma device, (The Ex-PRESS®)
under the sclera to better control fluid flow. The surgeons at
the Gavin Herbert Eye Institute were the first in Orange County
to perform this procedure and are considered national experts
on this technology. They are routinely called upon to train other
surgeons at major national and international meetings.
This procedure was developed at the Gavin Herbert Eye Institute by Dr.George
Baerveldt and his colleagues. This is a minimally invasive approach to restore
the eye’s own natural drainage system and was FDA approved in 2006.
Since then, over 5,000 patients have undergone the procedure in the US, and
it is now widely adopted around the world. The surgeons at the Gavin Herbert
EyeI Institute are considered not only the developers of the technology,
but the foremost authorities in managing complex cases, developing modifications
to improve outcomes, and serve as the instructors for all new surgeons performing
the procedure. They have published dozens of articles describing the procedure
and expected outcomes and have enriched the literature for all glaucoma surgeons
Aqueous shunt devices
are silicone tubes implanted into the eye to facilitate drainage
of the aqueous humor. They are typically used in refractory cases,
and can be used in patients who have had multiple prior surgical
procedures. There are several different models of these shunts,
one of the most frequently used being the Baerveldt Shunt ®.
This shunt was developed by Dr Baerveldt and continues to be
the preferred implant among many glaucoma surgeons. The surgeons
at the Gavin Herbert Eye Institute are widely considered to be
the world’s experts in tube shunt technology. Aside from
writing the major book chapters on this technique, our surgeons
have written the landmark articles on the procedure and are frequent
resources for physicians referring complicated cases from around
Given the surgical expertise of our surgeons, they are frequently called upon
to participate in national clinical trials to evaluate the benefit of newer,
cutting edge technologies. They are actively involved in numerous clinical
trials currently underway to advance our surgical knowledge for the next
generation of surgeons and patients from around the globe.
appointments, please call:
UC Irvine Medical Center
Gavin Herbert Eye Institute Building
Laser Refractive Surgery