Glaucoma Treatment Options – Eye Drops or Surgery?

While eye medications remain the first choice for the treatment of glaucoma, surgical techniques are becoming increasingly advanced and precise.

What is the best treatment option for you? Let’s discuss this in today’s post.

Photo by Ksenia Chernaya on Pexels.com

Today is Day#5 of World Glaucoma Week. Let’s talk about the various treatment options available for glaucoma patients.

What are the various treatment modalities for Glaucoma?

Glaucoma can be treated with the help of

  1. Medicines
  2. Laser procedures
  3. Surgeries
  4. Glaucoma Drainage implants

Let’s discuss each on of these in detail

Medical treatment for glaucoma

Medical treatment is available in the form of eyedrops as well as tablets. Eyedrops are more commonly used as the drug reaches where it needs to act without causing any side effects to the rest of your body.

Different types of anti glaucoma medications are available, and they all aim at lowering the eye pressure. The mechanism by which they lower the eye pressure differentiates them into two types.

1. Drugs that decrease the formation of the clear fluid in the eye

Certain drugs act on the ciliary body to reduce the formation of the clear fluid known as “aqueous humor” in the eye. Since the rate of formation is decreased, the eye pressure is automatically lowered.

Acetazolamide, dorzolamide and brinzolamide are examples of these types of drugs.

2. Drugs that increase outflow of the clear fluid from the eye.

Certain drugs act on the outflow pathway of the eye and improve the drainage of the clear fluid from the eye thus lowering the eye pressure.

Timolol, betaxolol, brimonidine, latanaprost, travoprost etc. are examples of these kinds of drugs.

If you have been prescribed eye drops for glaucoma, please ensure that you comply with the treatment and instill them as advised. Please understand that glaucoma medications need to be continued lifelong and one should never stop them without consulting their eye doctor. Stopping the medication would lead to a rise in eye pressure and cause damage to the optic nerve resulting in irreversible loss of vision.

I will soon be writing a blog explaining the correct way of instilling eyedrops.

Laser procedures for glaucoma

Lasers are minimally invasive procedures that use a small but powerful beam of laser to open up the blocked drainage channels in your eye. Thus the obstruction to the outflow of aqueous humor is relieved and the eye pressure reduces.

Laser trabeculoplasty is a quick procedure that can be performed in your eye doctor’s office. A numbing drop is instilled in the patient’s eye so that they don’t feel any pain. A laser lens is then placed onto the eye to focus the laser beams. Around 50 shots are applied in one sitting. The laser opens up the drainage pathway and the eye pressure drops.

The whole procedure takes only a few minutes. Since it is an office procedure, no sutures or eye bandages are required and patients can get back to their routine life almost immediately.

Here’s a short video to help you understand the laser procedures done for glaucoma.

Surgery for Glaucoma

The most commonly done surgery for glaucoma is known as “Trabeculectomy”.

In this surgery, a flap is created on the upper portion of the eye, in the area covered by the eyelid. A small piece of trabecular meshwork is removed and an alternate passage is created for the fluid to move out of the eye thus lowering eye pressure. The flap is then stitched back to prevent excess drainage of fluid from the eye. The draining fluid then collects under the conjunctiva which is a transparent membrane on the surface of the eye, and form a “filtering bleb”. A good filtering bleb indicates a successful surgery.

Surgery is not usually the first choice of treatment and is often offered to patients whose eye pressure fails to be controlled by medications or laser procedures.

This animated video will help you understand trabeculectomy surgery.

Glaucoma Drainage implants

Drainage implants are recent advancements in the treatment of Glaucoma.

These implants are usually considered if a trabeculectomy fails.

The most commonly used implant is an Ahmed glaucoma valve. It is an artificial valve that is sutured to the outer surface of the eye, under the upper eyelid. A tube runs from the valve that is inserted in the eye through a small opening. The tube stays inside the eye and continuously drains the aqueous humor out of the eye, thus lowering the eye pressure.

Here’s a short video to help you understand how a glaucoma drainage shunt is implanted and how it works.

With so many options to treat this potentially blinding disease, vision of several glaucoma patients can be saved, if glaucoma is diagnosed in time.

I hope I have helped you understand the various treatment modalities for glaucoma through this post. If you have any questions, feel free to comment below or email me at neha.pednekar1489@gmail.com

I’ll see you tomorrow in another glaucoma related post, till then take good care of your eyes and stay healthy!

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