GLAUCOMA AS IT IS: WHAT IF THERE’S NO DAMAGE YET?

60-70 years ago, when people didn’t live as long, diagnoses of glaucoma were not that common. It’s because glaucoma is a cunning disease. The eyes don’t hurt, and loss of vision doesn’t come for a long time. In case you’ve forgotten, glaucoma is neuropathy of the optic nerve that results in atrophy and fiber loss.

We’re born with 1.5 million fibers and gradually lose them, like most everything else. But if a normal person has lost, let’s say, 10% of fibers over 100 years, those with glaucoma lost a lot more. Those with advanced glaucoma have a completely atrophied optic nerve and are blind.

Risk factors include ethnicity. Heredity is also a factor. People that have close relatives with glaucoma are also at-risk. Since it causes an irreversible loss of fibers and vision, the only thing we can do is slow the process. This requires an early diagnosis, though.

The sooner treatment begins the better, whether that’s eyedrops, painless and effective laser treatment, or surgery. Sticking your head in the sand and reasoning that “Well, if you go to the doctor, they’ll find 

In many people that come to us, we find nothing. We ask them to come back in a few years. The proper attitude is to be vigilant. If your optometrist, or better yet ophthalmologist, notices any changes in the optic nerve, you need to undergo a battery of tests. This is the same with increased intraocular pressure or hereditary risk factors.

It’s a process and you need to go with the flow. They take images of the optic nerve, along with visual field tests using laser interferometry. It measures the thickness of the optic nerve and nerve fibers. They check this year-to-year against a normative database.

All of these tests, unfortunately, only measure damage that already exists. Diagnosis proves difficult if there isn’t any yet. A couple of years ago, we had the new Visual Evoked Potential diagnostic system. It was non-invasive and only involved attaching wires similar to a cardiogram.

When light hits the retina, the brain and optic nerve turns this into electrochemical energy. We measure these electrical signals in wave parameters. Previously, however, this was only available in special laboratories, but it is now included in clinical practices. Some ophthalmologists have it.

A person takes 5 minutes to adapt to the darkness and a technician attaches electrodes under the eyelids and back of the head. They then show the patient images that cause certain waves. They summarize it, analyze it, and compare it to the normative database. And it works for more than glaucoma!

ГЛАУКОМА КАК ОНА ЕСТЬ: А ЕСЛИ ПОВРЕЖДЕНИЙ ЕЩЕ НЕТ?

 60-70 лет назад, когда жили еще не так долго, диагноз «глаукома» встречался не так уж часто. Это объясняется ее коварством: глаз не болит, потеря зрения долго не ощущается. Если кто забыл, глаукома – это невропатия зрительного нерва, который постепенно атрофируется, теряя свои волокна. Мы рождаемся с полутора миллионами нервных волокон, но постепенно их теряем, как и многое другое. Но если нормального человека за сто лет жизни будут потеряны, скажем, 10% волокон, то у пациента с глаукомой – гораздо больше. Есть люди с запущенной глаукомой, у которых полностью атрофирован зрительный нерв, и это означает слепоту.

Факторы риска включают в себя этнические: у белых людей (Caucasian) она встречается реже, чем у афроамериканцев. Поэтому афроамериканцы могут прийти на проверку под эгидой МЕДИКЭР, даже если у них нет жалоб.

Также важна наследственность. Люди, у которых близкие родственники страдали глаукомой, также в зоне риска. Поскольку глаукома вызывает необратимую потерю волокон, а с ними и поля зрения, единственное, что мы можем сделать, это замедлить процесс. Но для этого нужно сделать ранний диагноз.

Чем раньше начинается лечение, будь то капли, безболезненное лазерное лечение, которое работает годами, или иногда хирургическое вмешательство, – тем лучше. Погрузить голову в песок и рассуждать: «Вот придешь к врачу – так обязательно что-нибудь найдут!» – это неправильно.

К нам приходит много людей, у которых мы ничего не находим и просим зайти через несколько лет. Правильная позиция – это знать.  Если оптометрист, а лучше офтальмолог – замечает какие-то изменения в зрительном нерве, находит повышенное внутриглазное давление, или у вас наследственность, то тогда вы проходите батарею тестов.

Поскольку это процесс, нужно следить за динамикой. Поэтому в числе тестов делают снимки зрительного нерва, тест поля зрения, с помощью лазерной интерферометрии измеряют толщину зрительного нерва, толщину нервного волокна – и все это проверяется из года в год в сравнении с нормативной базой данных.

ГЛАУКОМА: НА КАКОЙ ОНА ВОЛНЕ?

Но! Все эти тесты, к сожалению, измеряют уже имеющиеся повреждения. А если повреждений еще нет, диагноз поставить сложно. Пару лет назад у нас появилась новая диагностическая система зрительно вызванных потенциалов VEP (Visual Evoked Potential). Она не предполагает никакого вторжения – это липучки, подобные тем, что применяются в кардиограмме.

Когда свет в сетчатке, зрительном нерве и мозге переходит в электрохимическую энергию, то образуются электрические сигналы, которые можно измерить и посмотреть на параметры волн. Раньше такие системы использовались только в научных лабораториях, а сейчас поставлены на клиническую службу, и у некоторых офтальмологов они есть.

Человек приходит, 5 минут адаптируется к темноте, техник прикрепляет электроды под веками и на затылке, после чего пациенту показывают разные образы, вызывающие определенные волны. Все это суммируется, анализируется и сравнивается с нормативной базой данных. Причем этот тест работает не только в случае глаукомы!

Do you have glaucoma? Sticking your head in the sand and reasoning that “Well, if you go to the doctor, they’ll find something wrong with you” is dangerous.

Есть ли у вас глаукома? Погрузить голову в песок и рассуждать: «Вот придешь к врачу – так обязательно что-нибудь найдут!» – это неправильно.

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GLAUCOMA AS IT IS: WHAT IF THERE’S NO DAMAGE YET? - Benjamin Eye Institute

Even if nothing hurts, it is not a reason of ignoring a visit to an ophthalmologist. The saying "The sooner you identify it, the better the outcome" applies to one of the insidious diseases Glaucoma - neuropathy of the optic nerve that results in atrophy and fiber loss.

В случае с глаукомой, самое главное правило - не прятать голову в песок, ведь она итак коварна, что так долго остаётся незамеченной. Правильная диагностика в клинике с современными технологиями, знание факторов риска и внимательность к своему организму - ключи, которые сохранят ваш взор ясным.

Maybe the best eye center ever. They care about the patient, service is personalized and awesome. Cannot possibly recommend more! Will never consider another doctor.

Staff was very personable and accommodated my needs.  Dr Benjamin was very professional and great bedside manner.  I would highly recommend the office to friend and family

Dr. Benjamin is an exceptionally honest and professional eye doctor. My mom had cataract surgery with a trifocal implant that corrected her vision for distance, intermediate, and close-up. Now, she sees 20/20 at both near and far distances without needing glasses! After seeing how happy she was with her results, I decided to trust Dr. Benjamin with my LASIK procedure.I’ve been wearing glasses since the first grade, and after my LASIK, my vision is even better than it was with glasses or contacts. It’s truly a life-changing experience.Thank you, Dr. Benjamin, and your amazing, professional staff for this liberating experience. You’ve changed not only my life but my mom’s too. We’re incredibly grateful!

Dr Benjamin and his staff are World Class and second to none! I been bringing my mother to see Dr Benjamin and just recently became a patient myself. If you want to extend the quality of your vision and therefore the quality of your life, go see Dr Benjamin!

Class One from A to Z. Each and everyone from the doctor, optometrists, front office and back office, are professional, super knowledgeable, detailed, and very kind. The office is most elegant with beautiful lighting , equipment and furniture. The glass frames are  the most beautiful you will ever see.

An awesome experience as is the norm for our visits to Dr Benjamin. We have trusted him and his office with our multiple surgeries and care for many years, and plan to continue forward. Thank you Dr Benjamin, and your staff.

Unbelievable service! All staff is a highly professional. Each patient is surrounded by the utmost attention and care throughout the entire course of treatment and rehabilitation.Dr. Arthur Benjamin helped me in a virtually hopeless situation. He, like a great magician, returned my eyesight in one day! God bless you!Now I can see good at any distance day or night.  I don't need glasses anymore!I couldn't even dream to have such  a good eyesight ! It's incredible!

I’ve been going to Dr. Benjamin for years. He is straight-up honest, very patient in explaining, thorough, extremely experienced and is a Top Pro in his biz. I went to him for my eyeglass prescriptions for years, and then eventually had multifocal lens surgery in both of my eyes. All went great and to plan! His staff are extremely courteous, friendly, and very helpful. I’ve never done this at a doctors office, but I actually complement his staff in person often. I highly recommend this office. 100%

Great front desk and tech staff. The doctor was super nice and I’m so pleased I found this eye institute! Everyone was great and happy to finally have taken care of an appointment I had been putting off for a while. Great check-in process also for first time patients.

⭐️ My review of LASIK after one year ⭐️I told Dr. Benjamin I would do this a while ago, but I kind of feel like it says a lot I have kept this on my checklist for a year. I feel like a year is a good amount of time to review a procedure like this and give my honest thoughts and recommendation.So, let me tell you about my journey to getting LASIK and how I ended up in the amazing care of Dr. Benjamin. After going to an optometrist for years and him advising against LASIK because of my genetically dry eyes, I finally got a second opinion from an ophthalmologist (Dr. Benjamin). I didn’t know the difference between an optometrist vs. opthalmologist, but once I learned it kind of made sense why my optometrist didn’t want me getting LASIK lol. Because he couldn’t sell me on contact lenses or glasses for the foreseeable future if I got my vision corrected :) I mean, who knows, but I am glad I got a second opinion.I figured being in Los Angeles with some of the best doctors in the world… if anyone is going to touch my big, blue eyeballs, might as well get it done while I’m here. I found this business due to the reviews and they seemed to really know what they were doing and how to talk to clients.Upon meeting Dr. Benjamin he told me that I wasn’t a candidate for LASIK with my dry eyes, but he could put me through treatments for dry eyes and reevaluate after; and that these treatments had a good success rate for most.So, I started doing two treatments every other week for about 2.5 months - IPL laser treatment and Lipiflow. Lipiflow, especially, was a weird painless experience but highly recommend anyone with dry eyes to ask about it regardless of LASIK. I could tell my eyes felt way less dry a couple days after each treatment. There are videos on YouTube that talk about this treatment… Who knew this stuff existed. I’m not gonna lie, it’s an investment to do all these treatments on top of LASIK, but my eyes rarely feel dry anymore so if you’re going to get it done - do it right.Finally, I was approved for LASIK. I ended up waiting until the end of year to make sure I saved up the funds to do it and had some time to heal. I also took advantage of an end of year deal they were offering. $1000 off was a pretty nice forcing function to get me to finally do it after prepping my eyes with the treatments. The procedure itself I couldn’t feel anything even though I was awake the entire time (medicated). Even the scary part when bubbles form on your eyes Dr. Benjamin let me know about in advance so when it happened I just went with the flow. I think the worst part was the recovery the few days after and coming home drugged up lol. I remember day 1 thinking omg what did I do to my eyes. My eyes just hurt and felt weird, but omg I could see 20/15 immediately. And then, day by day it gradually got better. It took a few weeks for my eyes to heal, but after 1 month you couldn’t even tell I had surgery. One eye was a bit more bloodshot than the other.I can see 20/15. It’s been life changing for the past year not having to worry about contacts or glasses. I just got married and was able to walk down the aisle with clear vision. I only wish I had the means to have done this earlier in life. If you’re considering it - do it! And definitely consider Dr. Benjamin to do it right.Lastly, to continue treating my dry eyes, Dr. Benjamin gave me an extra LipiFlow treatment, and also recommended I try punctal plugs (painless plugs inserted into your lids that help your tears last longer). He placed the plugs in my eyes under 5 mins. Wild.I heard from people during the LASIK process they have been nervous to get the procedure so I wrote this to help and because I think highly of this business for changing my life. And, some of the dry eye treatments I would’ve never known about had it not been for them. Again, I wish I would have had been able to do this years ago. It is so, so worth it!Thank you, Dr. Benjamin (and staff!)

Concerned about a reoccurring virus, I text Dr Benjamin’s office first thing in the morning seeking immediate advice and an appointment. In quick time I received both sage advice and a same day appointment. Dr B takes a personal interest in his patients well being and has diligent, competent and attentive staff to support the care and support needed. Can’t speak highly enough.

Hi all! 06/06/2024 I came to the office of Dr. with a problem in my right eye. Benjamin, I'm sorry...as a very nice girl from the office, Masha, told me, he was undergoing surgery.  She advised me to come urgently in the morning. I suffered from pain for 4 days, my eye was very swollen, red and itchy. 07/06/2024 after examining me Dr. Benjamin made an emergency decision to remove the pus in his right eye. The small operation lasted 10 minutes, Dr. Benjamin and Dr. Svetlana masterfully removed the pus. My torment is finally over! Thank you to the entire team at Benjamin Eye Institute. You are the best, true professionals in your field. I wish you further success and good luck in your very necessary and difficult work! You give people a new stage of life! Thank you for that!

Been going to Dr B for nearly a decade after trying many other eye doctors in LA.  Beyond solving my chronic dry eye and being the most knowledgeable, he is an all-around great guy and spends time educating. The staff is wonderful as well.

The ophthalmologist that performed my surgery, Dr. Benjamin, was extremely skilled and knowledgeable. He took the time to thoroughly explain the procedure and answer all of my questions. I felt confident in his abilities and knew that I was in good hands.

Dr Benjamin and his team are extremely professional. I had Lasik surgery performed by him and his team and everything to date has gone exactly as described to me. Front office is very friendly and scheduling appointments is easy.

Great staff, great doctors, excellent ophthalmologists and assistants. The optical department for where you get glasses is very good. You may pay a little more, but you get excellent service, both at the optical boutique, and of course with your exam.They have the most advanced equipment in the industry. And the optician knows what she's doing. Overall, I really like this place and will continue to have them examine my eyes and purchase Glasses there. Dr. Yakubin, along with Dr. Benjamin are great and caring. Kathy and Rina also take good care of your needs. Finally the front desk staff is extremely helpful and also caring. It is a great experience to make sure your eyes and vision are taken care of.

The office staff were kind and considerate. The technician that assisted me explained everything she was doing. The Doctor was very nice and explained everything. He was definitely knowledgeable about my condition.

I am so grateful for the care I received at Dr.Benjamin’s office, I had been to other places where no one could figure out what was wrong, but here, they got to the root of the problem in just one visit. The entire staff is amazing—SO professional, kind, and incredibly helpful. From the front desk to the technicians and even the optical shop, everyone made me feel confident and well cared for. If you’re looking for exceptional eye care from start to finish with great and honest opinion this is the place to go.I highly recommended it 🙏❤️ special thank you to Rina who was so helpful and funny.

Dr Benjamin has been the “go to” eye specialist for 3 generations of my family, starting with my father and now grown children. Simply put, he’s an exceptionally capable, trustworthy, and cutting edge doctor with a courteous and professional staff.Without any reservations, I recommend him to anyone seeking an exceptional eye doctor.

The surgeons at Benjamin Eye Institute are true experts in their field - they were able to explain the procedure in detail and answer all of my questions and concerns. The surgery itself was quick and painless, and the recovery was much faster than I had anticipated.

I just completed my first visit and can say that this office deserves every high ranking it gets. The staff are efficient, friendly but highly professional.  The office is modern and sparkling clean. The examination was smooth and thorough. The doctor saw me on time.  He listened closely to the background of my problem, and he clearly communicated his treatment plan and the rationale for it. I absolutely trust him and highly recommend him.

I had my first visit with Dr. Benjamin today and it was amazing from start to finish. The office itself is immaculate and everyone I interfaced with was super friendly and professional. This includes Dr. Benjamin. He was extremely thorough and spent a lot of time with me as a new patient. I look forward to being under his care for years to come. I highly recommend this practice to anyone in need of an ophthalmologist in the LA area.

Dr. Benjamin is always personable and thoughtful and very much an expert.  He has been my eye doctor for many years.  Now that I am older I am very grateful that he is still my ophthalmologist. Everyone in the office is very helpful. I, of course, highly recommend Dr. Benjamin.

One of the things that sets the Benjamin Eye Institute apart from other ophthalmology practices is their team of experienced and highly trained surgeons. The surgeons at the Benjamin Eye Institute have performed thousands of cataract and LASIK surgeries, and have a wealth of experience in these procedures. They are committed to providing the best possible care for their patients and strive to achieve excellent outcomes.

Dr. Benjamin and his staff were amazing. Everyone was friendly and professional! I didn’t feel rushed during my appointment and Dr. Benjamin  took the time to explain everything and answer questions. His assistant who helped in doing all of the eye tests was great, too! Happy to have found a great eye doctor!

No exaggeration, this was the best visit with any doctor I've ever had. The facility is very nice, the staff is exceptionally thorough, professional, and efficient and Dr Arthur had by far the best bed side manner I've ever encountered. I 100% recommend him and his team

My experience at Benjamin Eye Institute was exceptional.  I’m not sure if I’ve ever encountered such an efficient and professional staff in a doctor’s office.  The front desk was communicative and everyone up to the doctor was beyond detailed in their care.  I would recommend this place to anyone who has eye problems because they have the most advanced equipment and Dr. Benjamin is caring, thorough and knowledgeable.

Dr Benjamin and his staff are excellent! 3/5 members of my family are patients from senior to adult to teen. Great care and professionalism. Highly recommend!

The entire experience at Benjamin Eye Institute is excellent.  Dr. Benjamin genuinely cares about his patients.  He and his staff have gone above and beyond to provide the highest quality care for my eye condition.  They respond quickly, even when Dr. Benjamin is out of the office. The entire team takes the time to discuss and explain treatment options.  Highly recommended!

I can’t say enough great things about this ophthalmology office!After visiting other places that couldn’t figure out my issue, I came to Dr Benjamin and they identified the problem in just one visit. The entire team is incredibly professional, helpful, and organized. From the front desk staff to the technicians the optometrist and the optical shop, everyone goes above and beyond to provide outstanding care. If you’re looking for the best place to get treatment for your eyes from A-to-Z, this is it. Highly recommend!

Immediately after  cataract surgery, I can see my husband’s face accross the room for the first time in 40 years! No more glasses since childhood, both distance and close up. If you are thinking, should you spend the big bucks to see everything both near and far?  I can tell you it’s so worth it! Thank you Dr. Benjamin and all the wonderful people in your office! I appreciate your efficiency, attentiveness, professionalism and welcoming space! Please feel free to use me as a reference any time!

With expert staff, modern surroundings and equipment, this is the doctor of choice in Los Angeles. After over 15 years i can attest to Dr. Benjamin's superior expertise in cataract removal and implants. I love the new treatments. State of the art.

I can’t ever express my deep gratitude for Dr . Benjamin and his entire extraordinary team at the Benjamin Eye Institute.I was nervous as eyes are so sensitive,  but his incredibly kind receptionists and nurses make you feel at ease and diminish all fears right away . He offers impeccable medical knowledge and state of the art technology to heal . My son and I have both experienced his phenomenal treatment and have had all our eye issues resolved . I am so thankful and can’t recommend him and the Benjamin Eye Institute highly enough 🙏

Dr Benjamin was the first doctor that made me feel comfortable enough to finally get LASIK!Context: I had consultations with various doctors over the years for LASIK and every time I didn’t feel comfortable with the doctor or the office. I had resigned myself to thinking I would never get LASIK done. That was until I was referred to Dr Benjamin by a new optometrist.From booking my consultation to my 3 month post-op appt today, the entire staff has been incredibly friendly and helpful every step. The entire process was thoroughly explained, making sure I always knew what to expect along throughout my experience. Pre-op was a breeze and I knew exactly what to expect when going in for my procedure. The actual day went as smoothly as possible. Even on the day of the procedure, the person picking me got caught in traffic and then accidentally went to the wrong address but the front desk staff stayed late and even walked me down to the car to make sure everything was fine.Highly recommend Dr Benjamin if you’re considering LASIK!

Dr.Benjamin is the best of the best.Very personable, knowledgeable and kind.I had a stye and in a bad shape.He  took me right in.His staff polite , kind and very professional.Highly recommended.

My 18-year-old son has been under Dr. Benjamin's care, and we were truly impressed by the level of service we received at Benjamin Eye Institute. From the moment we stepped into the clinic, the staff was incredibly helpful and accommodating.Dr. Benjamin conducted a comprehensive eye exam for my son, and his expertise and professionalism were evident throughout the entire process. He took the time to explain everything clearly, making sure my son understood his eye health and any potential concerns. His patience and attentiveness were truly appreciated.We highly recommend Dr. Benjamin to anyone seeking exceptional eye care. He and his team exceeded our expectations, and we are grateful for the outstanding service we received. Thank you, Dr. Benjamin!

Dr Benjamin and Alba were great. He is very professional, kind and with clear explanations. I had an eyelid quick surgery and I’m just missing the glasses prescription, I left the office and forgot to ask for it. But he and his team were amazing!

I was referred to Dr. Benjamin from both my eye doctor and a very close friend of mine who also had her LASIK performed there. My experience was exceptional. Every single person that you meet in the office is a joy to work with. Whether it was the constant and clear communication, or the fact that they were always listening to feedback and answering my questions and concerns, they went out of their way to make me feel comfortable trusting my vision to them. They were very kind and never once pressured me into anything (including when I had to push my surgery back after I broke my leg).I would recommend this place to anyone who has eye problems because they have the most advanced equipment and Dr. Benjamin is caring, thorough and knowledgeable.

Top notch service and staff! By far the best experience I’ve had at a doctors office in 20 years. I wish every office was as well trained, friendly, and professional as Benjamin Eye Institute. Seriously if you have eye problems you won’t find a better doctor.

More than everything I value professional people. Dr. Arthur Benjamin is one of them. He is taking care of me and my husband for pretty long time. All I can say we are very thankful to the doctor and people who work as a team to make us healthy and happy !

LASIK Eye Surgery- The short is go see Dr. Benjamin!I visited Dr. Benjamin Eye Institute after deciding I wanted to learn more about Lasik eye surgery and what the process would look like. I stare at computer screens for very long periods of time so I was nervous to make this life change but ready to ditch my glasses for good! The entire team from day 1 of my consultation made me feel very comfortable. The office is clean the staff are extremely welcoming, friendly and all took the time to answer any questions I had about the procedure - which was very quick and painless the day of. They also have awesome social content for educational purposes and just to make you laugh!I am about a month post procedure and it has been life changing and a freedom restored. Your eyes are important so make sure you consult with the best.Thank you Dr. Benjamin and team!!!

Unbelievable service! All staff is a highly professional. Each patient is surrounded by the utmost attention and care throughout the entire course of treatment and rehabilitation.Dr. Arthur Benjamin helped me in a virtually hopeless situation. He, like a great magician, returned my eyesight in one day! God bless you!

I am so happy and grateful that I have Dr. Benjamin to help me and show me how to take care of my eyes.Dr. Benjamin preformed life changing procedures a few years ago that gave me an amazing view of the world each and every day I awake and open my eyes.Thank you, Doctor.

Dr. Benjamin is an exceptional doctor and eye surgeon. He is innovative, and anticipates a patient’s needs. Above all Dr. Benjamin is kind and caring. My results are outstanding. I can thank him for changing my life. Thank you.

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