Glaucoma Treatment

What is Glaucoma?

Glaucoma is a complex eye disease characterized by increased intraocular pressure that damages the optic nerve. Glaucoma affects peripheral vision and can often lead to irreversible vision loss.

Treatment Options

Since vision loss due to glaucoma is irreversible, the goal of glaucoma detection and treatment methods is to diagnose the condition early and control the progression of vision loss. Options include special eyedrops, oral medications, laser surgery, conventional surgery, or a combination of procedures.

Eyedrops

After administering anti-glaucoma eyedrops, close your eyes for 1-2 minutes and press your index finger lightly against the inferior nasal corner, close to the tear duct. This will help maximize the amount of the glaucoma medication absorbed into the eye.

Oral Medications

If the eyedrops are not effective, oral medications may be prescribed by your ophthalmologist. Glaucoma medications are generally taken 2-4 times per day/as required. Some medications can cause systemic side effects, so an evaluation of your current condition and any pre-existing illness will be required before administration.

Glaucoma Surgery

When desired results are not achieved with medications, or if the patient experiences intolerable side effects, surgical correction is needed.

Laser Surgery

For OPEN ANGLE GLAUCOMA, a Trabeculoplasty may be performed. There are two types of trabeculoplasties:

Argon Laser Trabeculoplasty – Treats trabecular meshwork of the eye to increase aqueous drainage outflow and decrease intraocular pressure
Selective Laser Trabeculoplasty – A newer laser which uses low energy can select part of the trabecular meshwork, leaving few parts intact. Unlike other types of trabeculoplasty, this procedure can be safely repeated.

For ANGLE CLOSURE GLAUCOMA, the typical laser surgery procedures performed are:

Laser Peripheral Iridotomy – An opening is made through the iris, allowing aqueous fluid to flow from behind the iris directly into the anterior chamber of the eye, bypassing the normal route.
Cycloablation – Transscleral cyclophotocoagulation uses a laser to direct energy through the outer sclera of the eye to reach and destroy portions of the ciliary processes without damaging the overlying tissues.

Traditional Surgery

Conventional Trabeculectomy – performed when medications and laser treatment do not adequately lower intraocular pressure. The surgeon creates a flap in the sclera to drain excess eye fluid. This type of surgery can be performed in cases of open angle or angle closure glaucoma.

Drainage Implant Surgery – Several types of drainage devices are available. They consist of a small silicone tube that extends into the anterior chamber of the eye. The tube is connected to one or more plates which are sutured to the surface of the eye.

Non-Penetrating Surgery – A promising new surgical technique that minimizes post-operative complications and lowers the risk of infection. Long-term studies are needed to assess the viability of the procedure and to determine their role in clinical management of glaucoma patients.

Promising Surgical Alternatives

Express Miniglaucoma Shunt – A stainless steel device is inserted into the anterior chamber of the eye, under the scleral flap. It offers an alternative to either repeating a trabeculectomy or placing a more extensive silicone tube shunt in patients with a high IOP.

Trabectome – New probe-like device that is inserted into the anterior chamber through the cornea. It delivers thermal energy to the trabecular meshwork, reducing the resistance outflow of aqueous humour.

Learn More at the Dada Laser Eye Institute

For more information about glaucoma treatment in Pune, India, schedule an appointment with Dr. Jeevan Ladi at the Dada Laser Eye Institute.