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How Is Glaucoma Treated?

How Is Glaucoma Treated?

One of the most common eye diseases among adults, glaucoma, affects nearly three million Americans and is the second leading cause of blindness in the nation. 

Glaucoma encompasses a range of conditions that cause damage to the optic nerve due to increased pressure in the fluid of the eye. This fluid drains typically where the iris and cornea meet through mesh-like tissue. When the body overproduces fluid or drainage is inhibited, pressure builds up.

The gradual damage to the nerve is painless, with vision problems developing very slowly. With little to no symptoms at the onset of the disease, nearly half of the people affected do not know they have the disease. Due to this slow build-up of symptoms, glaucoma may not be diagnosed until some treatments have already become necessary.

What Are The Treatment Options For Glaucoma?

Over our decades of providing quality eye care to western North Carolina, we’ve heard a range of questions and concerns when it comes to the progression and treatment of glaucoma. There remain some common misconceptions when it comes to glaucoma, primarily with regard to treatments.

Chief among those is that surgery can cure glaucoma and that surgery is the only option for treatment. While there are undoubtedly surgical solutions for the treatment of open and closed-angle glaucoma, even surgery cannot guarantee glaucoma will not be a problem in the future.

If caught early enough, symptoms and further damage can be managed with non-operative options for many patients. So let us look at all the current standard treatments available to patients diagnosed with glaucoma, including:

  • Management through medication
  • Laser treatments
  • Surgical intervention

Managing Glaucoma With Medication

Eye drops and various oral medications are available that can help eye fluid flow properly and promote good drainage or reduce the amount of fluid the eye produces; both options work to keep the pressure at normal levels.

Some common eye drops prescribed for glaucoma treatment are:

  • Prostaglandins: like Xalatan (latanoprost), Travatan Z (travoprost), Zioptan (tafluprost), and Lumigan (bimatoprost)
  • Nitric oxides: like Vyzulta (latanoprostene bunod)
  • Alpha-adrenergic agonists: like Iopidine (apraclonidine) and Alphagan P or Qoliana (brimonidine)
  • Beta-blockers: like Betoptic (betaxolol) and Betimol, Istalol, or Timoptic (timolol)

As with any medication, the efficacy and ability to use it as a treatment depends on your own medical history and any other medicines, supplements, or vitamins you take. So long as these keep your eye pressure within normal levels with medication, further damage, vision loss, and the need for other treatments may be prevented.

Treating Glaucoma With Laser Procedures

If medications cannot adequately manage glaucoma symptoms and eye pressure, you and your doctor may consider laser treatments. These are often performed in the office as ambulatory procedures and are relatively painless and safe. The goal of these is to physically help the drainage of your eye. 

There are three main laser eye treatments performed:

  • Iridotomy: Widens the eye's drainage angle and redirects fluid flow by creating a microscopic hole in the iris. This is generally for angle-closure glaucoma.
  • Trabeculoplasty: This type of treatment works to stimulate the eye's drainage mesh and is used to treat open-angle glaucoma.
  • Cyclophotocoagulation: This treatment focuses on lowering the amount of aqueous humor produced in the ciliary body behind your iris, causing less pressure build-up and strain on drainage channels. It applies to either open-angle glaucoma or angle-closure glaucoma.

Surgical Interventions To Treat Glaucoma

When medications and laser treatments have proved ineffective in glaucoma treatment, then surgical options may be recommended. It is important to restate that even surgery can’t currently undo any vision loss, but it is still preventative management to protect what vision you have left.

There are a few different surgery options depending on your own medical history and glaucoma progression. Typically, all these surgeries take 1-2 hours at the hospital but will not require an overnight stay, though you will need someone to drive you home.

  • Trabeculectomy: Creates a tiny opening at the top of the eye (where your eyelid will cover) that allows excess fluid to drain. This is generally used only for open-angle glaucoma.
  • Glaucoma Implant Surgery: A tiny tube or shunt is inserted to help fluid drain out to a reservoir where it can be absorbed into surrounding tissues.
  • Minimally Invasive Glaucoma Surgery: This group of surgeries works similarly to the types above but relies on smaller incisions and implants, allowing for lower side effects.

Managing Your Risk For Glaucoma

While not strictly a treatment for glaucoma, due to the gradual onset of symptoms, it is essential to be aware of your own risk factors to help catch any changes in your vision early. Vision loss can be prevented if caught early. Since anyone can get glaucoma, regular comprehensive eye exams are the best way to detect and prevent damage. 

However, there are several factors that increase your chances of developing glaucoma.

  • Are of African-American, Asian, or Hispanic descent
  • Have a close relative who developed glaucoma
  • Have suffered a severe blunt or penetrating eye injury
  • Display extreme near or farsightedness
  • Are on long-term steroid medications for another health condition
  • Are 60+ years old

Schedule Your Glaucoma Eye Exam

Everyone has different histories and lifestyles, making eye care needs unique. You should have an eye doctor who considers you and can give common-sense recommendations. If you have any risk factors for glaucoma or feel like your vision is changing, schedule an appointment with Asheville Vision and Wellness today to see what experienced care with the latest technology can do for your vision needs. 

For over three decades, we have helped patients throughout western North Carolina with a wide variety of eye care, including comprehensive eye examinations, eyeglasses, contact lenses, and medical eye evaluations. We also have a wide variety of the latest eyewear, from basic to designer.

If you need a regular eye exam or think you may be at risk for eye disease, come in and talk to our specialists today. Our optometrists are certified in diagnosing, treating, and managing ocular diseases.