Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Glaucoma is a group of eye diseases that affect the optic nerve. When the optic nerve is damaged we call it an optic neuropathy, or in this case glaucomatous optic neuropathy. Left untreated, glaucoma can cause loss of vision or blindness.
In glaucoma, a variety of factors can cause damage to the optic nerve, including elevated eye pressure, known as intraocular pressure. The intraocular pressure elevation is, in part, due to a mismatch of fluid produced by the eye and drained by the eye; either too much fluid is produced or fluid cannot drain adequately. Treatments either reduce fluid production or increase fluid drainage. Each individual’s eye(s) may tolerate the same intraocular pressure differently.
Eye pressure elevation and glaucoma can occur for a number of reasons. There are various ways to lower eye pressure, including medications, laser treatments, or surgery. Other means of treatment that do not involve eye pressure are in research and development stages or not available yet. Some treatments are better suited for a particular type of glaucoma and we will discuss these with you.
Although normal eye pressure is considered to be between 10-21mm Hg (millimeters of mercury), we see many people with optic nerve damage who are safely within this range. In these cases, this so-called “normal” eye pressure may be too high for that particular individual's eye. If you are one of these people, the same treatment options that are designed to lower eye pressure options will apply to you as well.
On the other hand, sometimes you can have high eye pressure without any signs of optic nerve damage. If that’s the case, we may tell you that you have ocular hypertension or you are a "glaucoma suspect," which means that you are at risk of developing glaucoma. If that is the case, we may monitor your eyes and/or treat your eye pressure to prevent the optic nerve from becoming damaged. We may also consider you a glaucoma suspect if the results of your clinical exam indicate other signs of glaucoma.
Some studies have shown that detecting and treating glaucoma early may be beneficial to prevent major vision loss. We also have to weigh the risks of the disease developing further and the benefits and risks of treatments. If you fall into one of the high-risk groups for the disease, contact us to schedule an eye exam.
At an early stage, glaucoma causes no symptoms in most people. Some people may notice that their vision is not as clear or that their peripheral (side) vision is diminished. However, usually, there are no symptoms of vision loss until the glaucoma is significantly advanced. If your eye pressure increases suddenly, you may experience:
If you do have symptoms, the general symptoms of glaucoma are:
The symptoms of chronic narrow or closed angle glaucoma include:
The symptoms of acute angle closure glaucoma develop much more suddenly and require immediate medical attention. They include the following:
If you have any of these symptoms, call my office immediately.
There are a number of common factors that can increase your risk for developing glaucoma. We will talk to you about your medical history during your eye exam. If your eyes have been examined by an eye doctor outside of Kaiser Permanente please bring your medical records with you, including your visual fields and any photographs, so that we can compare current eye measurements to the past findings. If we think you are at risk for developing glaucoma, or already have glaucoma, we will perform some or all of the following tests:
There are steps you can take to reduce your risk of developing glaucoma:
Currently, all glaucoma treatments are designed to reduce intraocular pressure by either improving drainage or reducing the amount of fluid the eye produces. We will discuss all appropriate options with you, including whether, or when, to begin treatment. Your treatment plan may consist of medications, laser treatments or surgery, or a combination of these approaches, depending on your type of glaucoma.
Researchers continue to develop new treatments and therapies for treating glaucoma. Kaiser Permanente has a formal process for evaluating these new approaches, including medications, treatments, lasers, other technology, and surgical procedures. All new therapies and treatments are evaluated by a team of physician experts before we will recommend them to patients. Please ask us if you have questions. Please refer to the "Glaucoma Treatment" section for more details.
Keep your head up to avoid increasing intraocular pressure.
Protect your eyes from steroids – steroids can increase eye pressure.
Avoid risky activities that can worsen your disease.
Watch for signs of infection and contact us immediately if you get an infection.
If your optometrist sees signs of glaucoma during your regular eye exam, he or she will make an appointment for you to see me or one of my colleagues in the Ophthalmology department. If you are not scheduled for a regular eye exam, and you notice symptoms of acute glaucoma such as halos, vision loss, or blurred vision accompanied by pain, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.
If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.
During your office visit, we will discuss your medical and family history and I will perform a comprehensive eye exam. If you have been seen before by an eye professional outside of Kaiser Permanente, please bring those medical records and eye measurements with you. I will administer eyedrops to dilate your pupil so that I can clearly see the structures in your eyes. Your pupils will remain dilated for several hours, so you may wish to bring someone who can drive you home after your exam.
I will explain the findings of your exam and answer any questions or concerns you may have. I may order additional tests to be completed at a subsequent visit. I may also prescribe glaucoma medications, and I will talk to you about how to use eyedrops.
If we decide that your eye(s) need further evaluation, or further treatment or surgery, I will discuss the treatment options that are available, and together we will create a treatment plan that is right for you.
If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.
If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.
I will recommend you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.
If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.
As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available at any time that is most convenient for you. From my home page you can:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.