Glaucoma Treatment

Early detection and treatment of Glaucoma is extremely important, as any damage to the optic nerve (and resulting peripheral vision loss) is irreversible once it has occurred. Glaucoma symptoms are only normally noticeable as the disease advances, which is the reason why regular eye tests are important. If you fall into a glaucoma risk factor group, then it is especially important to have regular eye checks.

Treatment of Open Angle Glaucoma

Medication (eye drops): This is by far the most common and easiest method of treating glaucoma. The primary aim of the medication is to reduce the pressure within the eye (IOP). Although normal tension glaucoma is not associated with high eye pressures, your ophthalmologist will still typically use eye drops as the initial treatment method to reduce the pressure even further. There are various types of eye drops and most work in a slightly different way. Your ophthalmologist may sometimes use 2 different types of eye drops in tandem to get the maximum results if your eye pressure cannot be controlled. The Glaucoma eye drops typically work in 2 main ways:
  1. They increase the outflow of the fluid from your eye by opening up the drainage channels – Trabecular meshwork. If more fluid is able to leave your eye then the pressure is likely to reduce.
  2. They decrease the production of the fluid. They act on the Ciliary body (part of your eye) which is responsible for producing the aqueous fluid in your eye, so lowering the pressure.
Read more about Eye pressure and the eye in our supplementary guide.

Other Glaucoma Treatments:

In most cases, the eye drops themselves are capable of lowering your eye pressure to a safe level. However, occasionally the eye pressure does not reduce as much as is required and your ophthalmologist will then have to consider alternative options. The main options are as follows:

Laser treatment:

Laser (Trabeculoplasty): A laser can be used to open/enlarge the drainage holes in the Trabecular meshwork meaning that the fluid produced by the eye can drain away more easily, thus lowering the pressure in the eye. This procedure is done under local anaesthetic quickly and easily and only causes mild discomfort. Patients are allowed to go home the same day unless there are any complications. Eye drops may still be required following surgery depending on how well you respond to the treatment.

Glaucoma Surgery:

Surgery (Trabeculectomy): This is normally the last resort for treating Glaucoma as medication and laser (Trabeculoplasty) normally lower the eye pressure effectively. If the eye pressure is still high following all other methods of treatment, your ophthalmologist may deem that surgery is necessary. The procedure is as follows:
  • A tiny opening is made in the wall of the eye.
  • This allows excess fluid to drain away under the conjunctiva (transparent membrane over the white part of your eye).
  • The fluid is then absorbed naturally into the blood stream and your eye pressure is hopefully reduced.
 

Treatment of Acute closed angle Glaucoma:

As the pressure increases rapidly and permanent visual loss can be quick, acute closed angle Glaucoma is considered an eye emergency. Treatment must be immediate and the most likely methods are as follows:
  • Medication – Injected/oral: This can quickly reduce the Eye pressure.
  • Laser treatment – Iridotomy: This restores the normal flow or fluid by creating a hole in your Iris (coloured part of your eye).
  • Surgical – Trabeculectomy: This is the most common type of surgery. (See above).
  This information is provided purely as a guide and in no way constitutes medical advice. If you are in doubt about the health of your eyes you should consult your doctor or optometrist.

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