Currently, there is no cure for glaucoma. All treatments are undertaken to reduce the risk of progressing visual loss.Usually, if treatment is begun early, the disease can be controlled.
Systemic health issues can also affect glaucoma. Even a regular exercise program and weight loss have been shown to decrease eye pressure! The 3 general categories of glaucoma therapy are medicines, laser surgery, and operating-room surgery.
Medicines are the most common first-line treatment for glaucoma. These eye drops and/or pills work by slowing the production of fluid inside the eye or by improving the flow of fluid through the drainage meshwork. There are five main groups of eye drops: prostaglandins, beta-blockers, carbonic anhydrase inhibitors, adrenergic agonists and miotics. These medications may be taken between one and four times daily. The most common side effect is that the drops can cause burning and stinging. Some drops can cause allergies, which lead to red, itchy eyes. Even though the medicines do not instantaneously make you see better, they should not be stopped without speaking to the doctor. The goal of these eye drops/pills is to decrease your eye pressure and reduce the risk of further vision loss. Dr. Rhodes will discuss with you what medications are recommended specifically for you.
There are several different types of laser surgery: argon laser trabeculoplasty (ALT), selective laser trabeculoplasty (SLT), micropulse laser trabeculoplasty (MLT), and endoscopic cyclophotocoagulation (ECP) are the most common. Each of the first three lasers are applied to the trabecular meshwork, the drainage system of the eye. They can help to increase the amount of fluid drained out of the eye. These procedures can be done in the office, usually take less than five minutes, and only cause temporary mild discomfort. The final laser, ECP, is applied to the ciliary body in an operating-room procedure in order to decrease the production of intraocular fluid. Dr. Rhodes has access to all types of lasers, and will discuss with you which type is best for your eyes.
Laser Peripheral Iridotomy
This treatment is performed in those with angle closure glaucoma. The laser is used to create a small hole in the iris (colored part of the eye). This hole acts as a channel for fluid and helps to provide access for the fluid to reach the drainage system of the eye. The laser usually causes temporary blurred vision and mild discomfort.
This is a new and exciting procedure due to its increased safety over older/traditional glaucoma surgeries. In this procedure, the inner portion of the drainage system (which is usually the portion of the system that is not working properly in glaucoma) is removed with a microscopic instrument. The fluid inside the eye then has a more direct path into the drainage canals, and ultimately results in a lower eye pressure.
This type of surgery is performed in the operating room, and is usually only undertaken if the above medications and lasers have failed to lower the eye pressure appropriately. In this surgery, a small silicone tube is inserted into the eye. The tube, which drains fluid from the eye, leads to a small drainage “lake” that usually is hidden under the upper eyelid. The tube is microscopic, and is usually not noticeable by others.
This type of surgery is performed in the operating room, and is usually only undertaken if the above medicines and lasers have failed to lower the eye pressure appropriately. In this surgery, an alternate route for fluid to flow out of the eye is created. The fluid drains into a lake or “blister” that is normally hidden under the upper eyelid.
Dr. Rhodes has experience with all of the above surgical treatments, and will discuss with you which specific treatments are appropriate for your eye(s).