Whether you’re a glaucoma suspect or you’ve recently been diagnosed, you should feel reassured that there are many glaucoma treatments available – with more innovations being introduced every year. We’ll cover the three main options – medication, laser surgery, and traditional surgery – so you know what to expect.
Prescription eye drops are the most common treatment for people with glaucoma, but your eye doctor may also prescribe these drugs in pill form. There are several types of glaucoma medications, but the goal for all of them is to reduce pressure in your eyes. Let’s talk about each kind and how they work.
- Alpha Agonists
These drugs reduce how much fluid your eyes produce and keep fluid moving so it doesn’t build up. Patients typically use these drops two or three times a day. Sometimes, they’re used short-term after laser surgery.
- Beta Blockers
These drugs will reduce eye fluid production. They’re provided as either eye drops or pills. Patients typically use them once in the morning or twice a day. It’s important to note that patients susceptible to chest or breathing problems should not take beta blockers.
- Carbonic Anhydrase Inhibitors
Like the two previous types of drops, these will reduce the amount of fluid your eyes produce. They’re used two or three times a day, but sometimes twice a day if combined with another drop. Your eye doctor may also prescribe this drug in pill form.
- Cholinergic Agonists
This drug improves the flow of intraocular fluid by opening the eye’s drainage system. These drops are usually prescribed for three or four times a day, in an eye drop or gel form.
- Prostaglandin/Prostamide Analogues
These eye drops work a little differently. They improve eye fluid drainage through a different pathway. They’re used once a day, usually at night.
If you’ve recently been prescribed medication in one of these drug classes, check out the glaucoma medication page on Drugs.com for a list of side effects, indications, and other helpful information.
Your ophthalmologist may suggest surgery if 1) glaucoma medications are not reducing your eye pressure, 2) you’re experiencing major side effects, 3) you cannot take the medication because of drug interactions, or 4) your eye pressure is dangerously high. Most often, doctors begin with laser surgery since it’s less invasive and less expensive. Let’s look at the most common types of glaucoma laser surgery.
- Argon Laser Trabeculoplasty
This procedure works for about 75% of patients with the most common type of glaucoma. The laser opens clogs in your eye so fluid can drain.
- Selective Laser Trabeculoplasty
The ophthalmologist will beam a highly targeted low-level laser on specific areas of the eye where there’s pressure. It’s often used if Argon Laser Trabeculoplasty doesn’t work as well as expected.
- Laser Peripheral Iridotomy
This laser surgery treats narrow-angle glaucoma, which is caused when the space between your eye’s iris and cornea is too small, causing fluid build-up. This procedure uses a laser beam to create a tiny hole in the iris, so the extra fluid can drain and relieve pressure.
Most surgery treatments work by making it easier for fluid to leave the eye. But if this doesn’t work, some eye doctors might recommend cyclophotocoagulation. This procedure works a little differently. The goal is to reduce the eye’s fluid production. You may need to have this done again if your eye pressure levels rise.
If the glaucoma treatments above aren’t successful in reducing eye pressure, your eye doctor might recommend traditional surgery. This will require going to a hospital or surgery center, and you should anticipate a few weeks to recuperate. There are three main types of glaucoma surgery:
This surgery is best described by the Glaucoma Research Foundation. “A tiny drainage hole is made in the sclera (the white part of the eye). This new drainage hole allows fluid to flow out of the eye and helps lower eye pressure. The inner eye fluid flows through the surgically-created hole and forms a small blister-like bump called a bleb. The bleb, usually located on the upper surface of the eye, is covered by the eyelid, and is usually not visible.”
- Drainage Implant Surgery
Drainage implant surgery enhances the trabeculectomy by positioning a device that keeps the surgically-created opening from healing and closing. Many current implants include a tube through which the fluid passes. However, there are others that allow for the flow of fluid along the surface of the implant.
This procedure isn’t as invasive as the two described above. The surgeon uses a heating device called a Trabectome to make a tiny cut in your eye’s drainage tubes which sends heat to the mesh of tissue inside your eye. This can ease fluid buildup and pressure.
With so many glaucoma treatment options, it’s critical to stay informed and ask your ophthalmologist as many questions as you need to understand his/her plan. Glaucoma is not curable, but you can manage vision loss by following through with these treatments.