Treatment for Glaucoma

How is glaucoma treated?

As a rule, damage caused by glaucoma cannot be reversed.  Eyedrops, laser surgery, and surgery in the operating room are used to help prevent further damage. In some cases, oral medications may also be prescribed.

With any type of glaucoma, periodic examinations are very important to prevent vision loss. Because glaucoma can progress without your knowledge, adjustments to your treatment may be necessary from time to time.

Medications

Glaucoma is usually controlled with eyedrops taken daily and / or laser surgery with Selective Laser Trabeculoplasty.  Both medications and laser surgery lower eye pressure.  Medications work by either by decreasing the amount of aqueous fluid produced within the eye or by improving the flow through the drainage angle.  Laser surgery works by increasing flow through the drainage angle.

Never change or stop taking your medications without consulting your ophthalmologist. If you are about to run out of your medication, ask your ophthalmologist if you should have your prescription refilled.

Glaucoma medications can preserve your vision, but they may also produce side effects. You should notify your ophthalmologist if you think you may be experiencing side effects.

Some eyedrops may cause:

• a stinging or itching sensation
• red eyes or redness of the skin surrounding the eyes
• changes in pulse and heartbeat
• changes in energy level
• changes in breathing (especially with asthma or emphysema)
• dry mouth
• changes in sense of taste
• headaches
• blurred vision
• change in eye color.

All medications can have side effects or can interact with other medications. Therefore, it is important that you make a list of the medications you take regularly and share this list with each doctor you see.

Laser surgery

Laser surgery treatments may be recommended for different types of glaucoma. In open-angle glaucoma, the drain itself is treated. The laser is used to modify the drain (trabeculoplasty) to help control eye pressure.  See short video Laser Treatment for Glaucoma with ALT and SLT.

In closed-angle glaucoma, the laser creates a hole in the iris (iridotomy) to improve the flow of aqueous fluid to the drain. See short video Laser Treatment for Glaucoma with Laser Iridotomy.

Surgery in the operating room

When surgery in the operating room is needed to treat glaucoma, your ophthalmologist uses fine microsurgical instruments to create a new drainage channel for the aqueous fluid to leave the eye. Surgery is recommended if your ophthalmologist feels it is necessary to prevent further damage to the optic nerve. As with laser surgery, surgery in the operating room is typically an outpatient procedure. See short video Surgical Treatment for Glaucoma with Trabeculectomy and Surgical Treatment for Glaucoma with Seton.

What is your part in treatment?

Treatment for glaucoma requires teamwork between you and your doctor. Your ophthalmologist can prescribe treatment for glaucoma, but only you can make sure that you follow your doctor’s instructions and use you eyedrops.

Once you are taking medications for glaucoma, your ophthalmologist will want to see you more frequently. Typically, you can expect to visit your ophthalmologist every three to six months. This will vary depending on your treatment needs.

Loss of vision can be prevented

Regular medical eye exams can help prevent unnecessary vision loss. Recommended intervals for eye exams are:

• Ages 20 to 29: Individuals of African descent or with a family history of glaucoma should have an eye examination every 3 to 5 years. Others should have an eye exam at least once during this period.
• Ages 30 to 39: Individuals of African descent or with a family history of glaucoma should have an eye examination every 2 to 4 years. Others should have an eye exam at least twice during this period.
• Ages 40 to 64: Every 2 to 4 years.
• Ages 65 or older: Every 1 to 2 years.