Understanding the Glaucoma Treatment Options

Amisha Jain
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Dr. Kaushal

Review medical content on WOW Rx Pharmacy, so that accurate drug use information is easily accessible to everybody.
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An elderly man facing issues with Glaucoma

Glaucoma is a condition that affects your eyes.

It can hurt your optic nerve, which sends information from your eyes to your brain about what you see.

Around 80 million people globally suffer from Glaucoma.

This number is expected to reach 111 million by 2040.

But with timely diagnosis and proper treatment, it is possible to manage Glaucoma.

Keep reading to discover the various treatment options your doctor might prescribe you.

Eye drops

Eye drops form the primary Glaucoma treatment.

They reduce eye pressure, called intraocular pressure, with regular use.

It is done by increasing or reducing the outflow of aqueous humor (the fluid that nourishes the eye).

Following are some classes of eye drop medications:

Class of medicationSalt for treatment
Prostaglandin analoguesBimatoprost, Latanoprost, Travoprost, Tafluprost
Beta-adrenergic blockersBetaxolol, Timolol, Levobunolol, Metipranolol, Carteolol
Alpha-adrenergic agonistsApraclonidine, Brimonidine
Carbonic anhydrase inhibitorsDorzolamide, Brinzolamide
Miotic or Cholinergic agentsPilocarpine
Rho kinase inhibitorNetarsudil

These might be prescribed alone or in combination with each other to treat your condition best.

Image of eye drops for Glaucoma treatmentSource: Brittany_Schauer_Photography_from_Getty_Images
eye drops

Some of the possible side effects that you might observe while using these medications include:

  • Irregular heart rate
  • High Blood Pressure
  • Fatigue
  • Dry mouth

You should see your doctor if these symptoms persist or cause trouble.

Do not stop using the medication without talking to your doctor about it.

Medications for GlaucomaApprox. cost
Careprost Plus Eye Drop$25.38
Dorzox T 5 ml$12.05
9 PM Eye Drop$15.19
Bimat 3 ml$12.24
Dorzox Eye Drop 2%$8.90

Laser treatment

Laser treatment is another way to lower eye pressure and treat certain types of Glaucoma.

It can be effective for people with a more progressive form of Glaucoma.

Your eye doctor might also suggest laser therapy if you need additional treatment with the medications. 

A woman performing laser surgery on a patientSource: bojanstory_from_Getty_Images_Signature
A woman performing laser surgery on a patient

Laser Trabeculoplasty

Laser Trabeculoplasty is a brief and painless procedure performed by your ophthalmologist. 

It is an initial surgical option for open-angle Glaucoma treatment.

In this procedure, after numbing the eyes, the doctor holds a special lens on the eye.

Then, a high-intensity laser beam is aimed through the eye’s lens.

This light beam initiates a biological and chemical change in the tissues.

This helps improve fluid drainage from the eye and into the bloodstream.

Once the excess fluid is drained, the intraocular pressure is restored to normal.

There are several kinds of laser therapies. 

  • Argon laser trabeculoplasty
  • Selective laser trabeculoplasty
  • Micropulse laser trabeculoplasty
Warning
Your doctor will determine the best option for you, depending on your condition.


Some common side effects associated with this treatment include inflammation and pain.

The number of sessions you will need over the years will depend on how you respond to the treatment.

Laser Peripheral Iridotomy

Most often, laser peripheral iridotomy is surgery for angle closure Glaucoma treatment.

It may also be used as a preventive therapy for those at risk of angle closure attacks.

These attacks are characterized by the sudden build-up of pressure in the eye.

Laser Peripheral Iridotomy involves using a beam of light to create a tiny hole on the outer edge of the iris.

This hole creates a new channel and allows the aqueous humor to drain from the back to the front of the eye.

This channel thus helps in relieving eye pressure.

The most commonly observed side effects of Iridotomy include:

  • Redness and discomfort
  • Temporary blurred vision
  • Temporary inflammation
  • Increased eye pressure
  • Longer-Lasting Glare or Halos

People usually do not experience significant problems, but you should talk to your doctor for the best advice.

Laser Cyclophotocoagulation

Laser Cyclophotocoagulation is another kind of laser treatment to decrease eye pressure.

Patients with open-angle Glaucoma and angle-closure Glaucoma have been prescribed this treatment.

It is usually recommended at the end stage when there are ineffective results from primary treatments.

This procedure aims to lower the production of aqueous humor.

It is done by treating a part of the ciliary body epithelium responsible for producing aqueous humor.

This procedure uses a small incision to direct a laser to this eye area.

This laser energy leads to the destruction of the ciliary processes.

Mostly, the adverse effects of this treatment are mild and temporary. They include the following:

  • Pain 
  • Inflammation
  • Temporarily increased eye pressure
  • Corneal edema

Surgery

Surgical treatments are suggested for whom eye drops and laser treatments prove ineffective.

These could be to improve the current drainage system or to create a new drainage passage for the fluid to drain.

This drainage reduces intraocular pressure.

There are a few types of Glaucoma surgeries that your doctor could consider.

MicroInvasive Glaucoma Surgery (MIGS)

MIGS to lower eye pressure is a group of minimally invasive procedures.

It is recommended for patients with primary open-angle Glaucoma or for whom eye drops or laser trabeculoplasty were ineffective.

Fact
Due to its low-risk profile, MIGS may be a first-line surgical intervention for high-risk or monocular patients.


Trabeculectomy

Trabeculectomy is a standard surgical procedure for treating patients with open-angle Glaucoma or chronic angle-closure Glaucoma.

It involves creating a bleb on the white part of the eye (sclera) underneath the upper eyelid.

A bleb is a small blister of fluid. This fluid gets absorbed into the blood vessels without causing any excess tearing.

Once the new drainage site has been made, your surgeon will put sutures near the area to keep the “flap” over the bleb.

This ensures the site does not close up again during the healing process.

“Most glaucoma patients are able to successfully lower their eye pressure by using eyedrops and/or office-based laser therapy. A small subset of patients may require trabeculectomy if the eyedrops and/or laser therapy do not lower the eye pressure enough, or if there is allergy or other barriers to using eye drops.”

Dr. Thomas V Johnson III, M.D., Ph.D.

Aqueous Shunt

Aqueous shunt insertion is another type of incisional procedure to reduce eye pressure.

It is usually used in patients for whom trabeculectomy cannot be performed.

It can also be suggested for those who previously had multiple unsuccessful trabeculectomies.

Some types of Glaucoma are often treated with an aqueous shunt.

These include congenital Glaucoma, neovascular Glaucoma, and Glaucoma caused by an eye injury, 

Under this procedure, a shunt is implanted into the eye to regulate fluid drainage.

The most commonly used shunts are:

  • Ahmed Glaucoma Valve
  • Baerveldt Glaucoma Implant

Possible complications might include the following:

  • Hyphema during tube insertion
  • Leakage at the insertion site
  • Infection
  • Poorly placed/exposed shunt

Herbal medication

Ginkgo biloba, Bilberry, and Forskolin are said to help Glaucoma patients.

Medicinal marijuana is also said to lower eye pressure.

But it has been rendered inappropriate due to the following reasons:

  • Short duration of action
  • Adverse side effects
  • Potential to cause addiction

However, more extensive studies are required to establish the efficacy of these medications.

Lifestyle

General improvement in lifestyle may have a modest effect on the risk of developing Glaucoma.

 It includes a balanced diet, exercise, meditation, and quitting smoking

Takeaway

Treatments cannot reverse the damages caused by Glaucoma. 

But treatment and checkups regularly may help slow down or prevent vision loss.

Various Glaucoma treatments, including eyedrops, laser treatment, and surgery, are available. 

You should, therefore, consult your ophthalmologist for the best advice.

Frequently Asked Questions

Can Glaucoma be cured?

Glaucoma causes permanent damage to the optical nerve. Hence, it cannot be cured or reversed. It can, however, be treated to slow down the condition’s progression.

Is Glaucoma treatable?

Yes, Glaucoma is a treatable condition. Your doctor might prescribe you eye drops as the first line of treatment. Laser therapy and surgery are also some other treatment options.

How to treat Glaucoma?

Eye drops from the primary course of treatment for Glaucoma. Your doctor might also suggest laser therapy or surgery. This is if eye drops are ineffective or cannot be used for some reason.

Citations:
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