Glaucoma Treatment

Glaucoma Treatment

How is Glaucoma treated?
Vision loss from glaucoma is permanent but can usually be prevented with early detection and treatment.  Early detection is vital to stopping the progress of the disease. Once glaucoma has been identified, treatment will need to be instituted. Glaucoma management is usually a lifelong process that requires frequent monitoring and constant treatment. The appropriate treatment depends upon the type and stage of glaucoma. Although there is generally no cure per se for open-angle glaucoma, medication or surgery can slow or prevent further vision loss. Treatment for glaucoma generally involves various methods of lowering the eye pressure. This can be achieved through either medications, lasers, or surgery, depending upon how much pressure lowering is needed. Typically, medications are tried first. If there are side effects from the medications or sufficient pressure lowering is not achieved then laser treatment can be added. Surgery is generally reserved for cases in which the combination of medications and laser treatment do not sufficiently lower the pressure to a safe level, or are not well tolerated.

Glaucoma is usually controlled with the daily use of eye drops. These medications lower eye pressure, either by decreasing the amount of aqueous fluid produced within the eye or by improving its outflow through the drainage angle.

Never change or stop taking your medications without consulting your doctor.  Always use your drops when you are coming in for an appointment with your doctor.  If you are about to run out of your medication, ask your doctor if you should have your prescription refilled.  Glaucoma medications can preserve your vision, but they also may produce side effects. You should notify your doctor if you think you might be experiencing side effects.

Side-effects of eye drops may include:

  • A stinging or itching sensation
  • Red eyes or redness of the skin surrounding the eyes
  • Changes in pulse and heartbeat
  • Changes in energy level
  • Changes in breathing (especially with asthma or emphysema)
  • Dry mouth
  • Changes in sense of taste
  • Headaches
  • Blurred vision
  • Change in eye color

All medications can have side effects or can interact with other medications. Therefore, it is important that you make a list of the medications you regularly take and share this list with each doctor you see.

Selective Laser Trabeculoplasty (SLT)
Helm Vision Group is one of the few practices to offer Selective Laser Trabeculoplasty (SLT). SLT is one of the most significant advancements in the treatment of glaucoma. SLT is an extremely safe and effective laser treatment which can help a patient control their glaucoma without the use of eye drops, in many cases. In fact, 80% of patients experience meaningful pressure reduction in only a single treatment. Eye pressure may drop as quickly as a day after the procedure, or may take several weeks to show an effect.

Clinical studies have shown that SLT is very safe, and reduces or eliminates redness and irritation that often occurs with drops.

A virtually painless procedure, SLT stimulates the body’s natural mechanisms to enhance outflow of the fluid in your eye. SLT selectively targets only specific cells leaving surrounding tissue intact. Macrophage cells are activated by the laser and stimulated to remove debris which can clog the meshwork through which fluid escape the eye.

SLT therapy is covered by Medicare and other insurance providers, which can save you up to $500/year on medication costs.

80% of patients experience meaningful pressure reduction with only a single treatment.

When planning for a surgery it is important that you have a thorough understanding of the risks, benefits, and alternatives of the procedure. Dr. Helm may determine that a trabeculectomy is required for treatment of your glaucoma. The benefit of the surgery is to lower the eye pressure, and reduce the risk of glaucoma damage occurring to the optic nerve. The main alternative to trabeculectomy is continued eye drops, accepting the possibility that with a higher pressure there is a risk for continuing glaucoma damage. A trabeculectomy is a safe and effective surgery, with a low risk of severe complications.

Laser Peripheral Iridotomy
Laser Peripheral Iridotomy is used for the treatment of narrow-angle glaucoma or mixed mechanism glaucoma in which a patient has elements of both open and narrow-angle glaucoma. The laser is used to place a small hole in the iris (colored part of eye), which prevents future acute angle closure glaucoma (sudden onset of high pressure in the eye), or decreases risk of further blockage of the drainage area of the eye.

Glaucoma Drainage Device
This procedure includes a surgery to implant a small tube to allow fluid to drain from the inside of the eye to a small plastic plate behind the eye. A Baerveldt glaucoma implant or Ahmed glaucoma implant are the most common types. A drainage device is created to lower eye pressure to prevent vision loss from glaucoma, however, this surgery will not improve vision. Results are overall positive with patients who receive a glaucoma drainage device. In fact, 90% have good pressure control after one year and only 10% may require further surgeries in the first year.

Regular Follow-up Visits
Since there is no way to determine if glaucoma is under control based on how a person feels, it is critical that you continue to use your eye drops daily and that your ophthalmologist perform regular examinations.