Glaucoma Treatment and Surgery

Glaucoma is a complicated disease in which damage to the optic nerve results in vision loss. There are several forms of glaucoma; the two most common forms are primary open-angle glaucoma (POAG) and angle-closure glaucoma (ACG).

Facts About Glaucoma:

• Glaucoma is a leading cause of blindness
• There is no cure for glaucoma—yet
• Everyone is at risk
• There may be no symptoms

Depending upon the type of glaucoma, treatment may include medication, usually prescription eyedrops, or surgery to lower the pressure in the eye and prevent further damage to the optic nerve. While there is no cure as yet for glaucoma, early diagnosis and continuing treatment can preserve eyesight.

Medications:

A number of medications are currently in use to treat glaucoma. Your doctor may prescribe a combination of medications or change your prescription over time to reduce side-effects or provide a more effective treatment. Typically medications are intended to reduce elevated intraocular pressure and prevent damage to the optic nerve.

Surgical Options:

Surgery involves either laser treatment or making a cut in the eye to reduce the intraocular pressure (IOP). The type of surgery your doctor recommends will depend on the type and severity of your glaucoma and the general health of your eye. Surgery can help lower pressure when medication is not sufficient, however it cannot reverse vision loss.

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A common laser treatment for glaucoma is called selective laser trabeculoplasty, or SLT. Selective Laser Trabeculoplasty (SLT) is becoming a widely accepted treatment option in glaucoma treatment. Dr. Feulner can now lower pressure that can help a patient avoid a more invasive glaucoma surgery. SLT can also reduce dependence on medications or drops. SLT is a laser that treats the drain directly to help increase the outflow of fluid. It treats specific cells”selectively,” leaving the trabecular meshwork intact. For this reason, SLT may be safely repeated. The surgical process involves numbing the eye with topical eye drops so that you will not feel the laser treatment. In SLT, laser treatment is applied to the drain of your eye in order to open it up and let fluid out, lowering the eye pressure and saving your sight. SLT treatment takes only a few minutes, is performed in the office, is safe, and effectively lowers eye pressure in most people. The treatment is approved by the Food and Drug Administration (FDA) for treating glaucoma and is covered by essentially all insurance plans. After the procedure anti-inflammatory drops are used.

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A YAG laser peripheral iridotomy is performed almost exclusively for patients with narrow angles, narrow angle glaucoma, or acute angle closure glaucoma. Aqueous fluid is made in the ciliary body of the eye, which is situated behind the iris. The aqueous fluid primarily escapes the eye by flowing between the lens and iris of the eye, and then drains via the trabecular meshwork, which is located in the angle of the eye (where the front clear cornea meets the iris, essentially). If the flow of aqueous fluid to the drainage angle is obstructed by a forwardly bowed iris, the patient is said to have narrow angles.

YAG PI involves creating a tiny opening in the peripheral iris, allowing aqueous fluid to flow from behind the iris directly to the anterior chamber of the eye. This typically allows an opening up of the angle of the eye. The narrow or closed angle thus becomes an open angle.

The procedure itself is completed with the patient seated at the laser, and requires no sedation. Topical anaesthesia eye drops are instilled, a lens is placed on the eye to better control the laser beam. In general, only a few very brief episodes of slight discomfort are associated with this procedure. However, generally there is no pain involved post operatively. The entire procedure takes only a few minutes.

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An eye exam is the first step in detecting glaucoma. Make your appointment today by calling 410-569-7173 or click here to schedule an appointment.