Eye Care Information: Understanding Glaucoma Treatments

Glaucoma refers to a group of eye diseases which damage the optic nerve by increasing pressure within the eye. Glaucoma can result in vision loss, and eventually blindness. It can be controlled through prompt treatment, although glaucoma is not curable. Glaucoma can happen to anyone, although there are risk factors, including age, family history, high blood pressure, long-term use of steroids, or diabetes. There is no known way to prevent or avoid glaucoma, which is the second leading cause of blindness within the United States.

With glaucoma, the drainage system within the eye stops functioning properly. Clear fluid, known as aqueous humor, builds up within the eye, resulting in increased pressure. Over time, this pressure damages the optic nerve. Glaucoma tends to cause loss of peripheral vision first, with the central vision becoming more blurred over time if the glaucoma is not treated. The most common types of glaucoma have no early symptoms. Once vision loss is noticed, it is usually permanent.

Glaucoma must be diagnosed early for the best chance of treatment. A routine eye exam will catch glaucoma, which can then be controlled through treatment options. Treatments for glaucoma are intended to either decrease the production of aqueous humor, or increase drainage of this fluid from the eye. The overall goal is to reduce pressure within the eye to avoid damage to the optic nerve. The three most common treatment methods for glaucoma are medication, laser eye surgery, or conventional surgery, known as filtration surgery.

Glaucoma medications, which usually take the form of eye drops, are used once per day for life to control the effects of glaucoma. Regular use is critical in order to control the eye pressure. Although most patients will not notice any immediate effects after skipping glaucoma medication, the optic nerve will become damaged over time.

There are several laser eye surgery options to treat glaucoma. Selective laser trabeculoplasty creates selective holes within the eye to increase drainage. The iridotomy procedure uses a laser to create a hole near the iris for better fluid flow. Endoscopic CycloPhotocoagulation (ECP) reduces the amount of fluid that is produced. This procedure is often performed along with cataract surgery to alleviate the symptoms of both vision problems in one session.

During filtration surgery, a new drainage channel is created to help the fluid drain from the eye. Because it does not involve the use of lasers, this procedure is referred to as conventional surgery. Filtration surgery is usually performed only on patients who find medication or laser eye surgery unsuccessful or unsuitable.