Open angle glaucoma is typically treated with eye drop medications or laser therapy that lowers IOP. Different medications work by different mechanisms: some reduce fluid production; others increase fluid outflow. Laser trabeculoplasty is a gentle, safe, effective treatment involving the application of laser energy directly to the drain. It is office-based and typically only takes two to four minutes.
Closed angle glaucoma is typically not initially treated with medication. Whether acute or chronic, it is first treated with laser. The laser is used to make to a small opening in the iris (iridotomy) to modify the flow of aqueous fluid and to allow the iris to move away from the blocked drain. A second laser procedure called iridoplasty is sometimes also required when the drain does not open sufficiently with an iridotomy. Both of these procedures are safe and gentle, typically taking two to three minutes. Patients with closed angle glaucoma will sometimes need eye drop medication if their IOP does not normalize after laser.
When medication and laser treatment fail to control glaucoma, a variety of surgical procedures can be performed in order to reduce the IOP to a safe level. While these procedures are performed in an operating room, they are typically done on an outpatient basis, without the need for hospitalization.
A healthy lifestyle is critical in preventing visual loss from glaucoma. Good aerobic fitness helps maintain good blood-supply and oxygen levels to the optic nerves. A balanced healthy diet helps ensure control of blood pressure and cholesterol, which may aid optic nerve health as well. Smoking has a direct impact on blood vessels and should be avoided. Patients who have advanced glaucoma may be more susceptible to damage from activities such as eye rubbing or leaning on the eyes while sleeping.
Treatment for glaucoma requires dedication from both patient and doctor. Strictly adhering to medical therapy is essential…even occasional missed dosages can result in significant elevation of IOP. Most patients with glaucoma require changes in therapy as time goes. Being honest with your doctor regarding side effects, affordability and access to medication is important, as there are a number of alternatives for those patients who do not do well with medication.
Most patients with glaucoma need to be monitored every three to six months, with visual field testing performed on a yearly basis. If changes in therapy become necessary, more careful follow-up may be appropriate.
At Westchester Eye Associates, we treat even the most advanced cases of glaucoma. We are a referral center for patients with difficult to manage glaucoma. We offer cutting edge technology for diagnosis and treatment of glaucoma. If you have any questions about glaucoma, please ask your eye doctor. We’re here to help.