Glaucoma is one of the most common eye diseases caused primarily by the pressure build-up inside the eye, which damages the optic nerve connecting the eye with the brain. In fact, it can also lead to irreversible blindness if glaucoma treatment is not started on time.
Glaucoma is believed to be the third highest cause of the blindness across the globe, affecting more than 4.5 million people.
Glaucoma diagnosis is not an easy job, as glaucoma symptoms normally don’t appear evidently enough, developing quite slowly over an extended period of time. That’s why it’s so dangerous – a huge majority of its victims consider treatment only after observing sight loss, when the damage has already been done.
In reality, glaucoma refers to a whole group of conditions resulting from inappropriate or incomplete drainage of the normal fluid present in the eye. This lack of drainage increases pressure inside the eye (intraocular pressure or IOP), which ultimately damages the optic nerve, disrupting the normal connection between the eye and the brain, causing sight loss.
Though the precise reason behind glaucoma remains mostly unknown, various factors can increase its risk. Some of them include age, ethnicity, family history, racial background and various other medical conditions like short-sightedness and diabetes. Its victims include people of all ages, but it targets adults most frequently.
There are various types of glaucoma and the treatment depends on the particular type affecting an individual. Unfortunately, no viable glaucoma cure exists right now with no possibility to restore the damage already done to the eye due to this disease. However, you can prevent further sight loss with the help of medication or surgery, and for best results, you need lifelong glaucoma management.
Glaucoma treatment can be carried out with the help of pills, eye drops, traditional glaucoma surgery, glaucoma laser surgery or a combination of all these. Prevention of vision loss remains the ultimate objective of all these treatment methods, as glaucoma induces irreversible vision loss.
However, the good news is that glaucoma management can work effectively if the disease is diagnosed and treated early and appropriate treatment ensures that there is no further sight loss due to this eye disease.
Various Options for Glaucoma Treatment
To avoid vision loss due to glaucoma, it is quite imperative to take regular medication prescribed by your eye doctor, also discussing any possible side effects with him. Though every drug comes with a possibility of some side effects, not every patient necessarily experiences them.
You need to work with your eye doctor as a team, collectively fighting against this sight threatening disease. Your doctor has a host of treatment options, which include:
i) Eye Drops
Controlling your eye pressure requires you to be regular and punctual with using the eye drops prescribed to you. Since medications like eye drops get instantly absorbed into your bloodstream, you better share with your eye doctor any other medication you’re taking at the time, so that he can assess if using them together is safe. You might encounter a burning or stinging sensation initially while using many eye drops, but such a discomfort shall not last longer than a few seconds. Make sure you hold your patience for that long.
In case eye drops don’t work well for you in controlling your IOP, your eye doctor may also prescribe you with pills. You must know that these pills supersede eye drops in systemic side effects, also turning down the eye’s faucet, reducing the fluid production in the eye. You need to take them two to four times a day in most cases.
iii) Surgical Procedure
Surgical treatment for glaucoma is prescribed only when other medication fails to yield you the desired results, or the side effects become unbearable for you.
Surgical procedures commonly used for treating glaucoma can be broadly differentiated into traditional glaucoma surgery and laser eye surgery for glaucoma. Let’s have a look at various options within them.
Glaucoma Laser Surgery
Laser treatment for glaucoma has gained much popularity in past few years, acting much like a stepping stone between glaucoma treatment with drugs and traditional surgery. As the name suggests, this type of treatment involves a laser beam (a high energy light beam) in fixing the drainage system of the eye.
Contrary to what many people believe somehow, instead of burning a hole through the eye, a laser beam fixes the eye’s drainage system in a quite subtle manner, ensuring an easy drain passage to the aqueous fluid of the eye, thus lowering the IOP.
Let’s have a look at some of the most common laser treatments for glaucoma:
- Argon Laser Trabeculoplasty (ALT) for Open-angle Glaucoma Treatment
This laser treatment for glaucoma corrects the drainage outflow of the eye by treating the trabecular meshwork of the eye, which lowers the IOP. Medication will still be needed after the procedure in many cases. Normally, eye doctors treat half of the trabecular meshwork first. They will turn to the other half only if needed in a separate procedure.
Argon laser trabeculoplasty (ALT) is able to lower eye pressure in up to 75% of the patients treated.
You can get ALT treatment only for two to three times in each eye all through your life. So, make sure you weigh in all your options before going for it.
With relatively lesser complications, ALT for open-angle glaucoma has become much popular in recent years and many centers choose to go with it even before resorting to eye drops in many patients.
- Selective Laser Trabeculoplasty (SLT) for Open-angle Glaucoma SLT is a more contemporary type of laser treatment for open-angle glaucoma involving very low levels of energy. The term “selective” is used for it because some portions of the trabecular meshwork remain intact in this treatment. That’s why experts believe that SLT can be repeated safely for multiple times, unlike various other types of laser surgery. Some experts also report that repeating SLT after ALT can lower IOP quite successfully.
- Laser Peripheral Iridotomy (LPI) for Angle-closure Glaucoma This procedure involves an opening through the iris, offering aqueous fluid a direct passage from behind the iris to the anterior chamber of the eye, bypassing its normal route. Ophthalmologists prefer LPI to treat a host of angle-closure glaucomas that come with certain degree of pupillary blockage. LPI serves best in treating an anatomically narrow angle to ensure prevention of angle-closure glaucoma attacks.
- Cycloablation Also known as “Transscleral cyclophotocoagulation”, this procedure relies upon directing energy through the outer sclera (the white portion of the eye) for reaching and destroying portions of the ciliary processes, without inflicting any damage to the overlying tissues. Endoscopic cyclophotocoagulation (ECP) is used to place the instrument inside the eye by means of a surgical incision. This makes sure that the laser energy is directly being applied to the ciliary body tissue and no damage is done in the adjacent regions.
Traditional Glaucoma Surger
Some common traditional surgery treatments for glaucoma include:
In case of failure of medication and laser therapies to adequately lower the eye pressure, eye doctors may resort to conventional surgery options and trabeculectomy is the most common of those options. Both, open-angle as well as close-angle glaucomas can be treated with it.
A passage is created in the sclera in this procedure to drain excess eye fluid. An ophthalmologist creates a flap, which doesn’t deflate the eyeball, but enables the excess liquid to flow out.
Around 50% of glaucoma patients don’t need glaucoma medications after trabeculectomy for a significant length of time, while 35-40 percent of the people still needing medications have a better control of their IOP.
It is usually performed as an outpatient procedure requiring a varying number of post-operative clinical visits. Activities like reading, driving, heavy lifting and bending are restricted for a period of two to four weeks after surgery.
- Drainage Implant Surgery
To lower the IOP by draining aqueous humor out of the anterior chamber, various devices have been developed over the years, which share a similar design principally. It comprises of a small silicone tube extending through the anterior chamber of the eye. Sutured to the surface of the eye, one or more plates are connected with the tube and are usually invisible. The plates collect the fluid initially, which is then absorbed by the eye tissues.
Although it is believed that this type of eye surgery for glaucoma lowers IOP lesser than the trabeculectomy, but experts prefer it for patients whose IOP remains uncontrolled through traditional surgery or those who have previous scarring.
- Non-penetrating Glaucoma Surgery A promising glaucoma eye surgery, non-penetrating glaucoma surgery is about not entering the anterior chamber of the eye, greatly minimizing the postoperative complications as a result. However, this type of surgery is considered to be a bit inefficient in lowering the IOP compared to trabeculectomy.
Are There Any Other Options As Well?
Yes, better management of glaucoma can help you live your life in a much better way and if the disease has already damaged your eye(s), you better resort to the IrisVision, one of the best low vision aids designed to help you make the most of your leftover vision.
In fact, there are scores of people whose vision and life has improved significantly after resorting to the IrisVision, an FDA approved class 1 device. Let’s have a look at some of the IrisVision customer stories and draw inspiration by how it has transformed the lives of people suffering from various low vision conditions like glaucoma.