Glaucoma Treatment
Glaucoma Treatment
There are several different treatments for glaucoma, including eye drops, laser treatment and surgery. The best treatment for you will depend on your circumstances. Glaucoma treatment often starts with prescription eyedrops. These can help decrease eye pressure by improving how fluid drains from your eye or by decreasing the amount of fluid your eye makes.
There are different theories for the cause of glaucoma. It is important to understand that the end result for all the theories is progressive damage to the optic nerve (optic neuropathy).
One such theory is based on elevated intraocular pressure. It is important to note that high intraocular pressure is not synonymous with glaucoma. There are certain types of glaucoma that have normal intraocular pressure.
A clear liquid called aqueous humor circulates the front portion of the eye. To maintain a healthy level of pressure within the eye, a small amount of this fluid is produced constantly while an equal amount flows out of the eye through a microscopic drainage system. Because the eye is a closed structure, if the drainage area for the aqueous humor – called angle – is blocked, the excess fluid cannot flow out of the eye. Fluid pressure within the eye increases, pushing against the optic nerve and causing damage.
Another theory is based on compromise of the blood supply to the optic nerve resulting in progressive damage to the nerve. There may be many factors that come in to play to cause vascular compromise.
Symptoms
Regular eye examinations by your eye doctor are the best ways to detect glaucoma. A glaucoma screening that only checks pressure is insufficient to determine if you have glaucoma. The only way to detect this is with a complete eye exam.
Types of Glaucoma
1. Primary open-angle glaucoma (POAG)
It’s a most commenst form of glaucoma where the eye does not drain the fluid the way it should. Eye pressure builds and optic nerve damage begans. It is usually painless.
2. Angle-closure glaucoma (closed angle / narrow angle)
This happens when the iris gets close to the drainage angle of the eye and hence iris may block the angle.
Treatment
1. Medical management-Eyedrops / oral medications
Eye drops can be used single or in combination. They are absorbed directly into the blood stream. Oral Medication(Pills) are used when eyedrops don’t sufficiently control the IOP. They are prescribed in addition to the drops.
2. Laser
Laser surgery is becoming increasingly popular. The most comman type performed for open-angle glaucoma is called trabeculoplasty. The laser beam is focused upon the eye’s drain. It changes the eye’s drainage system in a very subtle way so that aqueous fluid is able to pass more easily out of the drain, thus lowering IOP. It takes few weeks to achieve the maximum effects. Some aser techniques are ALT, SLT, LPI and Cycloablation.
3. Surgery
Trabeculectomy:
When medications and laser therapies do not adequately lower eye pressure, doctors may recommend conventional surgery. The most comman of these operations is called a trabeculectomy, which is used in both open-angle and closed-angle glaucomas. Many surgeons perform trabeculectomy with an anti-fibrotic agent that is placed on the eye during the healing period. The most common anti-fibrotic agent is Mitomycin-C. Another is 5-Flurouracil, or 5-FU.
Drainage Implants:
They aid the drainage of aqueous out of the interior chamber and lower the IOP. The drain fluid is reabsorbed by the eye tissues. It is performed in patients whose IOP cannot be controlled with traditional surgery or who have previous scarring.