Treating Glaucoma

storypic-glaucomaMost glaucoma treatments are aimed at consistently lowering intraocular pressure. Eye drops, oral medications, laser treatment, and surgery can be used to lower intraocular pressure. These treatments do not “cure” glaucoma, but help control the disease.

Eye Drops are the most common treatment for glaucoma. Eye drops work to either decrease the amount of fluid the eye makes, or increases the outflow of fluid. It is important to use eye drops as they are prescribed and not miss doses. Oral medications are some of the most powerful ways to lower intraocular pressure. They carry certain side effects that limit their use long term.

Lasers are available to help lower eye pressure. Laser trabeculoplasty is the most common laser used for glaucoma and can be used in the early or middle stages of the disease. Lasers can often decrease or eliminate the need for eye drops.

Surgery is available when medicines and lasers do not control the intraocular pressure. The most common types of glaucoma surgery either enhance the natural passageway for fluid to flow out of the eye or create a new passageway for fluid to flow out of the eye. Sometimes a tube or shunt is used to direct fluid out of the eye.

Symptoms of Glaucoma

Unfortunately, most glaucoma has no noticeable early symptoms. Usually the eye pressure is not high enough to “feel”, unless it is very high. Vision loss usually takes years to progress to the point someone can notice the blind spots.

Symptoms of glaucoma can include blurring of vision, haloes around lights, and a feeling of pressure or pain around the eye. This usually occurs from wide fluctuations in eye pressure or a rapid rise in eye pressure.

Glaucoma Treatment FAQ’s

Is there any way to prevent glaucoma?

There is no way to prevent glaucoma, and many forms of the disease have no warning signs. Although you may not be able to prevent glaucoma from developing, you can prevent it from damaging your vision. This can be done by having regular vision exams with Dr. Thom. Here are some general timelines:

  • Under age 40 — Every two to four years
  • Age 40 to 54 — Every one to three years
  • Age 55 to 64 — Every one to two years
  • After age 65 — Every six to 12 months

If you have a family history, have diabetes, or are African-American you are at a higher risk and should be tested every year or two after the age of 35.

Timely diagnosis is the key to preventing vision loss. When Dr. Thom spots the early signs of glaucoma he can work to lower your intraocular pressure that is the cause of damage to the optic nerve. With the most common form of glaucoma — primary open angle glaucoma — vision loss is symptom-less, slow, and progressive.

Exercise has been shown to have an intraocular pressure lowering effect. Walking or jogging three or more times per week is good.

You also need to protect your eyes when playing sports or doing work in the yard or the house. Eye injuries can result in traumatic glaucoma or secondary glaucoma.

What is a laser trabeculoplasty?

Laser trabeculoplasty uses a very focused beam of light to treat the drainage angle of the eye. The drainage angle is the point in the eye where the colored part of the eye (iris) and the white covering over the eye (sclera) meet. This is where fluid within the inner eye (which is different from tears that lubricate the eye’s outer surface) drains. Blockage of this angle can lead to increased pressure in the eye, and this can begin to damage the optic nerve, which is glaucoma. This surgery makes it easier for fluid to flow out of the front part of the eye, lowering intraocular pressure.

There are two types of laser trabeculoplasty:

  • Argon laser trabeculoplasty (ALT)
  • Selective laser trabeculoplasty (SLT)

What is the difference between selective laser trabeculoplasty and argon laser trabeculoplasty?

Both of these methods of laser trabeculoplasty are used by Dr. Thom to treat primary open angle glaucoma. In selective laser trabeculoplasty (SLT), Dr. Thom uses a laser that works at very low levels. It treats specific cells “selectively,” leaving untreated portions of the trabecular meshwork intact. This allows SLT to be repeated later, if necessary.

Argon laser trabeculoplasty (ALT) was the original laser trabeculoplasty. It uses higher energy levels for the laser beam to open fluid channels in the trabecular meshwork. In ALT usually half of the fluid channels are treated. If necessary, the other untreated channels can be treated in a separate session at a later date.

SLT can be used if ALT failed to successfully lower eye pressure. In general, both SLT and ALT lower the eye pressure about 75 percent of the time in people who haven’t had surgery on that eye before. Control over the pressure inside the eye may decrease as time passes, which is where SLT could be repeated since it uses a lower level of laser energy and causes less scarring than ALT.

What are the benefits of laser trabeculoplasty?

Laser trabeculoplasty lowers the eye pressure in about three quarters of patients, which then lowers their risk of vision loss from glaucoma. Patients still need to usually continue using glaucoma eye drops to keep their intraocular pressure down, but these laser surgeries will likely lessen the amount needed.

The obvious benefit of these surgeries with Dr. Thom is a decreased risk of vision loss from glaucoma.

What are the risks of laser trabeculoplasty?

Complications with these laser surgeries are rare. The most common complication is an increase in the pressure in the eyes after this surgery. This rise usually occurs within 1 to 4 hours after the trabeculoplasty. To protect against this possibility, Dr. Thom will place medicine in the patient’s eyes before or after the laser trabeculoplasty.

These are other possible complications of laser trabeculoplasty:

  • A brief period of inflammation of the iris
  • Cloudiness of the cornea, which usually quickly resolves
  • Blockage of the drainage angle when the cornea and the iris stick together
    Pain
  • Decreased vision, which is usually temporary

What is recovery like after laser trabeculoplasty?

Dr. Thom performs these surgeries in our offices on University Drive. They don’t dictate much of a recovery. You’ll need someone to drive you home after the procedure. In general, patients can resume normal activities the next day after laser trabeculoplasty. Your eyes may be a bit irritated and your vision slightly blurry immediately after the procedure, but this resolves within a few hours.

Schedule Your Consultation Today!

For more information on treating glaucoma or to schedule an appointment with Thom Eye and Laser Clinic, give us a call today at (701) 235-5200 .

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