- Open-angle Glaucoma
- Angle-closure Glaucoma
- Risk Factors
- Diagnosing Glaucoma
- Glaucoma Treatments
Treatments for glaucoma can vary and must be individualized for each patient to meet their personal needs and treat the specific type and severity of their condition. This may include eye drops or oral medications, laser surgery, conventional surgery or a combination of these options.
Although there is no cure for these diseases, there are many effective treatment options available to relieve symptoms and prevent further damage from occurring. Your doctor will determine the best treatment for you after a thorough evaluation of your condition.
Treatment for glaucoma usually begins with eye drops, which are used to reduce fluid production in the front of the eye or to help drain excess fluid. Commonly prescribed eye drops for glaucoma include beta blockers, alpha-agonists, carbonic anhydrase inhibitors and others. Most drops are to be used once or twice a day to manage glaucoma.
It is important for patients to use eye drops exactly as prescribed by their doctor in order to improve the effectiveness of the medication and reduce the risk of side effects. Patients may experience redness, blurry visions, stinging and irritation as a result of eye drop use, but can follow special administration techniques to help prevent these side effects.
Oral medications may be prescribed in addition to eye drops to help lower eye pressure to the desired levels, and may include acetazolamide and methazolamide. It is important to inform your doctor of any allergies you may have, so that he or she can make the necessary adjustments to your treatment plan. Most patients are able to experience effective pain management from eye drops and oral medications.
Selective Laser Trabeculoplasty (SLT)
Selective Laser Trabeculoplasty (SLT) is an advanced laser system that targets specific cells of the eye - those containing melanin, a natural pigment. Using a special wavelength and energy, the SLT targets these specific cells, leaving the surrounding tissue intact and improves the flow of fluid in the eye thereby lowering your eye pressure.
Your eye pressure may drop as quickly as a day or more after having the SLT procedure. You may be treated with anti-inflammatory eye drops that will be continued after the procedure. There are no incidences of allergy or systemic side effects with SLT. The SLT treatment does not cause pain.
The SLT procedure is reimbursed by Medicare and many other insurance providers, which minimizes your out-of-pocket expenses.
Laser Peripheral Iridotomy (LPI)
Laser Peripheral Iridotomy (LPI) uses a focused beam of laser energy to create an opening within the iris, the colored part of the eye, which effectively open up the angle between the iris and the cornea and allows fluid to drain more easily from the eye. This outpatient procedure takes just a few minutes to perform, after which patients may experience blurry vision and eye irritation for a day or two before eye pressure begins to lower.
It is most often performed on patients with angle-closure glaucoma and can even help prevent acute attacks that can lead to severe eye pain and vision loss.
Trabeculectomy is a surgical procedure often performed after medication and laser treatments have failed, and involves creating a new channel to drain fluid from the eye. During this procedure, an incision is made within the sclera, the white part of the eye, which then creates a collection pouch between the sclera and the conjunctiva.
Trabeculectomy is the most commonly performed surgical procedure for glaucoma, and effectively manages the condition in most patients, although it is also considered one of the most invasive treatments available for this condition.
Ahmed™ Glaucoma Valve
The Ahmed™ Glaucoma Valve is a small device that is placed within the sclera of the eye and secured in place with sutures to help drain fluid from the eye and lower eye pressure in patients with glaucoma. Placed using microsurgical techniques, this procedure requires only a topical or local anesthetic, while the eye is held open to prevent blinking. A patch of donor sclera will be placed over the drainage tube to keep it protected and functioning properly.
Most patients experience effective results from valve surgery. The Ahmed valve is most often placed in patients with difficult cases of glaucoma in which other treatments possess a risk of severe damage to the optic nerve.
The Alcon Ex-PRESS® is an FDA-approved shunt used for guarded filtration surgery in the treatment of glaucoma. This safe and convenient device helps reduce intraocular pressure and is commonly performed as an alternative to the trabeculectomy procedure. The Ex-PRESS shunt helps reduce tissue trauma and inflammation while offering comparable results with shorter recovery times and fewer complications.
During surgery, the Ex-PRESS shunt is implanted under a scleral flap to filter out excessive intraocular pressure for patients with open angle glaucoma. The shunt diverts the aqueous humor through a diffuse bleb. The Ex-PRESS device reduces the risk of surgery for glaucoma patients and helps prevent permanent vision loss from this serious condition.
Dr. Kramar- San Fernando Valley native, Dr. Mark Kramar, of The Ophthalmology Associates of the Valley, specializes in glaucoma and comprehensive Ophthalmology.
For more information, or to schedule an appointment, please call 818.990.3623.