Glaucoma

Glaucoma is a condition where high eye pressure damages the optic nerve inside the eye

Below is a series of images showing normal (left side) to slightly thin (center) to absent (right) optic nerve rim tissue

Many people come in for their first eye exam and we see an optic nerve which looks like the middle picture below

In these cases we do not know if it used to look like the normal optic nerve and glaucoma has caused it to change

Or if it has always looked like that and there is no problem with glaucoma

For this reason we need to monitor for changes over time in mild or borderline cases of glaucoma

Optic nerve damage from glaucoma cannot be reversed (there is no cure for glaucoma) but we can lower the eye pressure and prevent further damage

When there is damage to the optic nerve, the eye will progressively and often very slowly lose its side (peripheral) vision

If left untreated, glaucoma can lead to complete blindness of the eye

Treatments include eye drops that you take each night, forever

The eye drops do not cure glaucoma, but they prevent glaucoma from worsening

If you stop taking the drops for glaucoma, your glaucoma will worsen

Other treatments include laser treatments, minimally invasive glaucoma surgery (performed during cataract surgery) or other glaucoma surgeries (for more advanced cases)

Glaucoma tends to move slowly; most cases are not emergencies, but this is something that you do not want to ignore

My office does not have the advanced technology to manage glaucoma

Your medical insurance will pay to manage your glaucoma

https://www.glaucoma.org/glaucoma/ 

https://www.aao.org/education/interactive-tool/risk-calculators-primary-open-angle-glaucoma

Narrow Angles

The angle of the eye is the intersection of the inner curve of the cornea and the colored iris inside your eye

If there is not enough space in the angle, fluids in the eye can be blocked from flowing out through the angle, which can cause eye pressure to increase

In some cases the eye pressure can increase to very dangerous levels

This can lead to peripheral vision loss from glaucoma

This can be prevented with a laser treatment or cataract surgery

Your medical insurance will pay for these treatments

https://www.glaucoma.org/treatment/gonioscopy-what-is-it-and-why-is-it-needed.php 

Laser Treatment for Narrow Angles

Narrow angles are a risk factor for glaucoma which can cause permanent vision loss over time

Narrow angles can be treated with a simple laser procedure

Audio reading of this page

Glaucoma Staging: Mild Disease

Optic nerve abnormalities consistent with glaucoma but with no visual field abnormalities

Glaucoma Staging: Moderate Disease

Optic nerve abnormalities consistent with glaucoma, plus visual field abnormalities in one hemifield, but not within 5 degrees of fixation

Glaucoma Staging: Severe Disease

Optic nerve abnormalities consistent with glaucoma, glaucomatous visual field abnormalities in both hemifields, and/or vision loss within 5 degrees of fixation

 H40.0 Glaucoma suspect

 H40.01 Open angle with borderline findings, low risk

 H40.011 …… right eye

 H40.012 …… left eye

 H40.013 …… bilateral

 H40.02 Open angle with borderline findings, high risk

 H40.021 …… right eye

 H40.022 …… left eye

 H40.023 …… bilateral

 H40.03 Anatomical narrow angle

 H40.031 …… right eye

 H40.032 …… left eye

 H40.033 …… bilateral

 H40.04 Steroid responder

 H40.041 …… right eye

 H40.042 …… left eye

 H40.043 …… bilateral

 H40.05 Ocular hypertension

 H40.051 …… right eye

 H40.052 …… left eye

 H40.053 …… bilateral

 H40.06 Primary angle closure without glaucoma damage

 H40.061 …… right eye

 H40.062 …… left eye

 H40.063 …… bilateral

 H40.1 Open-angle glaucoma

 H40.10 Unspecified open-angle glaucoma

 H40.10X0 …… stage unspecified

 H40.10X1 …… mild stage

 H40.10X2 …… moderate stage

 H40.10X3 …… severe stage

 H40.10X4 …… indeterminate stage

 H40.11 Primary open-angle glaucoma

 H40.111 Primary open-angle glaucoma, right eye

 H40.1110 …… stage unspecified

 H40.1111 …… mild stage

 H40.1112 …… moderate stage

 H40.1113 …… severe stage

 H40.1114 …… indeterminate stage

 H40.112 Primary open-angle glaucoma, left eye

 H40.1120 …… stage unspecified

 H40.1121 …… mild stage

 H40.1122 …… moderate stage

 H40.1123 …… severe stage

 H40.1124 …… indeterminate stage

 H40.113 Primary open-angle glaucoma, bilateral

 H40.1130 …… stage unspecified

 H40.1131 …… mild stage

 H40.1132 …… moderate stage

 H40.1133 …… severe stage

 H40.1134 …… indeterminate stage

 H40.119 Primary open-angle glaucoma, unspecified eye

 H40.1190 …… stage unspecified

 H40.1191 …… mild stage

 H40.1192 …… moderate stage

 H40.1193 …… severe stage

 H40.1194 …… indeterminate stage

 H40.12 Low-tension glaucoma

 H40.121 Low-tension glaucoma, right eye

 H40.1210 …… stage unspecified

 H40.1211 …… mild stage

 H40.1212 …… moderate stage

 H40.1213 …… severe stage

 H40.1214 …… indeterminate stage

 H40.122 Low-tension glaucoma, left eye

 H40.1220 …… stage unspecified

 H40.1221 …… mild stage

 H40.1222 …… moderate stage

 H40.1223 …… severe stage

 H40.1224 …… indeterminate stage

 H40.123 Low-tension glaucoma, bilateral

 H40.1230 …… stage unspecified

 H40.1231 …… mild stage

 H40.1232 …… moderate stage

 H40.1233 …… severe stage

 H40.1234 …… indeterminate stage

 H40.129 Low-tension glaucoma, unspecified eye

 H40.1290 …… stage unspecified

 H40.1291 …… mild stage

 H40.1292 …… moderate stage

 H40.1293 …… severe stage

 H40.1294 …… indeterminate stage

 H40.13 Pigmentary glaucoma

 H40.131 Pigmentary glaucoma, right eye

 H40.1310 …… stage unspecified

 H40.1311 …… mild stage

 H40.1312 …… moderate stage

 H40.1313 …… severe stage

 H40.1314 …… indeterminate stage

 H40.132 Pigmentary glaucoma, left eye

 H40.1320 …… stage unspecified

 H40.1321 …… mild stage

 H40.1322 …… moderate stage

 H40.1323 …… severe stage

 H40.1324 …… indeterminate stage

 H40.133 Pigmentary glaucoma, bilateral

 H40.1330 …… stage unspecified

 H40.1331 …… mild stage

 H40.1332 …… moderate stage

 H40.1333 …… severe stage

 H40.1334 …… indeterminate stage

 H40.139 Pigmentary glaucoma, unspecified eye

 H40.1390 …… stage unspecified

 H40.1391 …… mild stage

 H40.1392 …… moderate stage

 H40.1393 …… severe stage

 H40.1394 …… indeterminate stage

 H40.14 Capsular glaucoma with pseudoexfoliation of lens

 H40.141 Capsular glaucoma with pseudoexfoliation of lens, right eye

 H40.1410 …… stage unspecified

 H40.1411 …… mild stage

 H40.1412 …… moderate stage

 H40.1413 …… severe stage

 H40.1414 …… indeterminate stage

 H40.142 Capsular glaucoma with pseudoexfoliation of lens, left eye

 H40.1420 …… stage unspecified

 H40.1421 …… mild stage

 H40.1422 …… moderate stage

 H40.1423 …… severe stage

 H40.1424 …… indeterminate stage

 H40.143 Capsular glaucoma with pseudoexfoliation of lens, bilateral

 H40.1430 …… stage unspecified

 H40.1431 …… mild stage

 H40.1432 …… moderate stage

 H40.1433 …… severe stage

 H40.1434 …… indeterminate stage

 H40.149 Capsular glaucoma with pseudoexfoliation of lens, unspecified eye

 H40.1490 …… stage unspecified

 H40.1491 …… mild stage

 H40.1492 …… moderate stage

 H40.1493 …… severe stage

 H40.1494 …… indeterminate stage

 H40.2 Primary angle-closure glaucoma

 H40.20 Unspecified primary angle-closure glaucoma

 H40.20X0 …… stage unspecified

 H40.20X1 …… mild stage

 H40.20X2 …… moderate stage

 H40.20X3 …… severe stage

 H40.20X4 …… indeterminate stage

 H40.21 Acute angle-closure glaucoma

 H40.211 …… right eye

 H40.212 …… left eye

 H40.213 …… bilateral

 H40.219 …… unspecified eye

 H40.22 Chronic angle-closure glaucoma

 H40.221 Chronic angle-closure glaucoma, right eye

 H40.2210 …… stage unspecified

 H40.2211 …… mild stage

 H40.2212 …… moderate stage

 H40.2213 …… severe stage

 H40.2214 …… indeterminate stage

 H40.222 Chronic angle-closure glaucoma, left eye

 H40.2220 …… stage unspecified

 H40.2221 …… mild stage

 H40.2222 …… moderate stage

 H40.2223 …… severe stage

 H40.2224 …… indeterminate stage

 H40.223 Chronic angle-closure glaucoma, bilateral

 H40.2230 …… stage unspecified

 H40.2231 …… mild stage

 H40.2232 …… moderate stage

 H40.2233 …… severe stage

 H40.2234 …… indeterminate stage

 H40.229 Chronic angle-closure glaucoma, unspecified eye

 H40.2290 …… stage unspecified

 H40.2291 …… mild stage

 H40.2292 …… moderate stage

 H40.2293 …… severe stage

 H40.2294 …… indeterminate stage

 H40.23 Intermittent angle-closure glaucoma

 H40.231 …… right eye

 H40.232 …… left eye

 H40.233 …… bilateral

 H40.239 …… unspecified eye

 H40.3 Glaucoma secondary to eye trauma

 H40.30 Glaucoma secondary to eye trauma, unspecified eye

 H40.30X0 …… stage unspecified

 H40.30X1 …… mild stage

 H40.30X2 …… moderate stage

 H40.30X3 …… severe stage

 H40.30X4 …… indeterminate stage

 H40.31 Glaucoma secondary to eye trauma, right eye

 H40.31X0 …… stage unspecified

 H40.31X1 …… mild stage

 H40.31X2 …… moderate stage

 H40.31X3 …… severe stage

 H40.31X4 …… indeterminate stage

 H40.32 Glaucoma secondary to eye trauma, left eye

 H40.32X0 …… stage unspecified

 H40.32X1 …… mild stage

 H40.32X2 …… moderate stage

 H40.32X3 …… severe stage

 H40.32X4 …… indeterminate stage

 H40.33 Glaucoma secondary to eye trauma, bilateral

 H40.33X0 …… stage unspecified

 H40.33X1 …… mild stage

 H40.33X2 …… moderate stage

 H40.33X3 …… severe stage

 H40.33X4 …… indeterminate stage

 H40.4 Glaucoma secondary to eye inflammation

 H40.40 Glaucoma secondary to eye inflammation, unspecified eye

 H40.40X0 …… stage unspecified

 H40.40X1 …… mild stage

 H40.40X2 …… moderate stage

 H40.40X3 …… severe stage

 H40.40X4 …… indeterminate stage

 H40.41 Glaucoma secondary to eye inflammation, right eye

 H40.41X0 …… stage unspecified

 H40.41X1 …… mild stage

 H40.41X2 …… moderate stage

 H40.41X3 …… severe stage

 H40.41X4 …… indeterminate stage

 H40.42 Glaucoma secondary to eye inflammation, left eye

 H40.42X0 …… stage unspecified

 H40.42X1 …… mild stage

 H40.42X2 …… moderate stage

 H40.42X3 …… severe stage

 H40.42X4 …… indeterminate stage

 H40.43 Glaucoma secondary to eye inflammation, bilateral

 H40.43X0 …… stage unspecified

 H40.43X1 …… mild stage

 H40.43X2 …… moderate stage

 H40.43X3 …… severe stage

 H40.43X4 …… indeterminate stage

 H40.5 Glaucoma secondary to other eye disorders

 H40.50 Glaucoma secondary to other eye disorders, unspecified eye

 H40.50X0 …… stage unspecified

 H40.50X1 …… mild stage

 H40.50X2 …… moderate stage

 H40.50X3 …… severe stage

 H40.50X4 …… indeterminate stage

 H40.51 Glaucoma secondary to other eye disorders, right eye

 H40.51X0 …… stage unspecified

 H40.51X1 …… mild stage

 H40.51X2 …… moderate stage

 H40.51X3 …… severe stage

 H40.51X4 …… indeterminate stage

 H40.52 Glaucoma secondary to other eye disorders, left eye

 H40.52X0 …… stage unspecified

 H40.52X1 …… mild stage

 H40.52X2 …… moderate stage

 H40.52X3 …… severe stage

 H40.52X4 …… indeterminate stage

 H40.53 Glaucoma secondary to other eye disorders, bilateral

 H40.53X0 …… stage unspecified

 H40.53X1 …… mild stage

 H40.53X2 …… moderate stage

 H40.53X3 …… severe stage

 H40.53X4 …… indeterminate stage

 H40.6 Glaucoma secondary to drugs

 H40.60 Glaucoma secondary to drugs, unspecified eye

 H40.60X0 …… stage unspecified

 H40.60X1 …… mild stage

 H40.60X2 …… moderate stage

 H40.60X3 …… severe stage

 H40.60X4 …… indeterminate stage

 H40.61 Glaucoma secondary to drugs, right eye

 H40.61X0 …… stage unspecified

 H40.61X1 …… mild stage

 H40.61X2 …… moderate stage

 H40.61X3 …… severe stage

 H40.61X4 …… indeterminate stage

 H40.62 Glaucoma secondary to drugs, left eye

 H40.62X0 …… stage unspecified

 H40.62X1 …… mild stage

 H40.62X2 …… moderate stage

 H40.62X3 …… severe stage

 H40.62X4 …… indeterminate stage

 H40.63 Glaucoma secondary to drugs, bilateral

 H40.63X0 …… stage unspecified

 H40.63X1 …… mild stage

 H40.63X2 …… moderate stage

 H40.63X3 …… severe stage

 H40.63X4 …… indeterminate stage