Treatments & Drugs
The most common treatments for glaucoma are eye drops and, rarely, pills. Doctors use a number of different categories of eye drops to treat glaucoma. They either decrease the amount of fluid (aqueous humor) in the eye or improve its outward flow, and some do both. Sometimes doctors will prescribe a combination of eye drops.
People using these medications should be aware of their purpose and potential side effects, which a medical professional should explain. Some side effects can be serious. If you are concerned, call your doctor immediately.
Your doctor may use laser surgery to treat open-angle, angle-closure, or neovascular glaucoma. He or she will perform laser surgery on an outpatient basis in the office or clinic after numbing your eye.
To reduce eye pressure, the doctor directs a laser toward the iris, ciliary body, retina, and trabecular meshwork (tissue near the cornea and iris that drains the aqueous humor from the eye into the blood)
Types of Laser Surgery
Trabeculoplasty
The trabeculoplasty procedure is often used to treat open-angle glaucoma.
In argon laser trabeculoplasty (ALT), a high-energy laser is aimed at the trabecular meshwork to open areas in these clogged canals. These openings allow fluid to bypass drainage canals and flow out of the eye.
In selective laser trabeculoplasty (SLT) a low-energy laser treats specific cells in the trabecular meshwork. Because it affects only certain cells without causing collateral tissue damage, SLT can potentially be repeated.
Laser Peripheral Iridotomy
Laser peripheral iridotomy is frequently used to treat angle-closure glaucoma, in which the angle between the iris and the cornea is too small and blocks fluid flow out of the eye. A laser creates a small hole in the iris to allow fluid drainage.
Scatter Panretinal Photocoagulation
This laser procedure destroys abnormal blood vessels in the retina that are associated with neovascular glaucoma.
The most common side effects of laser surgery are:
Temporary eye irritation
Blurred vision
Small risk of developing cataracts
Surgery
Eye doctors often use conventional surgical procedures (also called incisional therapies) for glaucoma after other treatment strategies, such as medications and laser surgery, have failed.
When deciding on a treatment option, an ophthalmologist will take into account the unique aspects of each person's case, including the:
The severity of the disease
Response to medication
Other health issues
Types of Glaucoma Surgery
Trabeculectomy
Trabeculectomy
During a trabeculectomy, the ophthalmologist cuts a flap in the white part of the eye (sclera), removes a piece of trabecular meshwork (eye tissue located around the base of the cornea), and sutures the flap. This creates a new opening (a fluid bubble or bleb will form on the eye's exterior) through which the fluid (aqueous humor) flows and enters the bloodstream.
Peripheral Iridectomy
Peripheral Iridectomy
Eye doctors use this procedure for angle-closure glaucoma. The doctor removes a small section of peripheral iris by incision, which allows fluid to drain more easily from the eye.
Canaloplasty and New Implant Devices
Canaloplasty and New Implant Devices
These devices and procedures are used to enhance the aqueous humor outflow to decrease eye pressure. They include:
EX-PRESS Shunt, a subconjunctival filtration device
Non-penetrating Ab Externo Schlemm's Canaloplasty
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Ab Interno Devices, including the Trabecular Micro-bypass Stent and the Trabectome
Gold Microshunt, a suprachoroidal device
Glaucoma Surgery for Infants
Goniotomy is used almost exclusively for infants with congenital glaucoma. In this procedure, the doctor inserts a tiny blade through the cornea to cut the trabecular meshwork. This procedure allows the eye fluid to flow normally out of the eye.
Trabeculectomy is also used for infants with congenital glaucoma. The doctor makes an incision in the outer portion of the eye and uses a tiny probe to break through the trabecular meshwork. Eye fluid is then able to drain out of the eye, keeping eye pressure in a more normal range.
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