Spotlight on Glaucoma - Part 4
High eye pressure and the several
Types of Treatment for Glaucoma
Whether you are at risk for glaucoma because of high pressure, injury or family history, treatment is targeted at lowering your eye pressure to prevent further damage to your eye nerve. Treatment must be started early enough to prevent your high eye pressure from damaging your optic nerve. Regular visits to your eye doctor are the key to maintaining healthy eyes. There are a number of treatment options for glaucoma and high eye pressure your eye doctor can choose from, including eye drop medication and surgery.
High Eye pressure treatment typically begins with medication (eye drops).
Because eye drops have very little side effects and work effectively to lower your eye pressure, this is usually the first choice by most physicians. There are many types of eye drops that work best against the different types of glaucoma.
Eye drops that help drainage channels open such as Pilocarpine, allow the eye to continue to produce the same amount of fluid, but drain faster may not be suited well if you have cataracts because they cause the pupil to become smaller, allowing less light into the eye.
Eye drops that decrease the production of fluid, such as Lumigan, Travatan and Zioptan may cause some mild redness and an increase in the thickness and length of the eyelashes over time.
Treatment May Change Over Time
Changing or switching your medication or adding another medication that works differently to lower the eye pressure is very common over the course of monitoring and treating eye pressure and glaucoma. This does not mean the condition is getting worse. Your doctor will look at all the data from your Optical Coherence Tomography, Visual field testing, Gonioscopy and High resolution photos to determine the course of the continued health of your optic nerve. For more information on these tests see part 3 of our glaucoma series here. If more effective treatment is available as technology allows this may govern a change in your treatment regimen. Many times, insurance forces changes in a perfectly well working regimen which then means further monitoring and repeat testing to ensure any generic medications are having the same best control for your eye pressure.(See our generic vs branded medication blog here.) This may be inconvenient as we are all told that generic medications are the same as branded medications, but doctors and patients do not always get the same desired effects from generic medications.
Surgery for High Eye Pressure, Surgery for Glaucoma
Both laser and conventional incisional surgery are the main types of surgical treatment for glaucoma. Both are typically outpatient (meaning you do not have to be admitted or stay overnight in a hospital). After surgery you may require to continue using eye drops, and some surgeries may need to be repeated.
Selective Laser Trabeculectomy (SLT Surgery)
This surgery uses a cool beam, low power laser to widen the drainage channels in the eye and allow the fluid in the eye to drain faster, therefore lowering the eye pressure. This procedure is not like LASIK surgery and will not correct nearsighted or astigmatism or farsightedness. (For information on LASIK visit a previous blog here.) The procedure may need to be repeated several times over a few years and is not painful.
Argon Laser Trabeculoplasty (ALT Surgery)
This is an older, but effective, laser that works the same way as SLT. However, it may not be repeated in the same areas as with SLT surgery.
Micropulse Laser Trabeculoplasty (MLT Surgery)
This is very new, and works the same way in lower the eye pressure as ALT and SLT.
Peripheral Iridotomy (PI Surgery)
This surgery is reserved for narrow angle glaucoma or angle closure glaucoma. This very similar to having your ear pierced in that a small hole is created in your iris (the colored part of your eye) to allow fluid drain faster from your eye. This is very painless, and not visible. It usually does not need to be repeated and usually two drainage piercings are completed in one eye at one out patient session.
Express Shunt
If certain medications and laser therapies fail to preserve the health of the optic nerve or eye pressure continues to remain at undesired level, incisional surgery is typically the next step. An express shunt is placed under 
the conjunctival tissue via a cut flap into the white part of the eye (the sclera). Side effects include possible inflammation at the surgery sight and or infection. In many cataract surgeries, if glaucoma is present, the express shunt is placed during surgical removal of the cataract.
Other options are older and not used as much in today’s medicine such as Iridectomy (removing a portion of the iris) and cryotherapy of the ciliary muscle (destroying the muscle that produces the nourishing fluid in our eyes).
What Can You Do?
Your involvement is very important in your eye health and vision care. Learn what you can do to help keep one step ahead of any sight threating diseases such as glaucoma, macular degeneration, cataracts and other vision blinding diseases.
Keep up with your annual eye health and vision examinations
Use your eye drops exactly has they have been prescribed
High eye pressure must be monitored and managed every day of your life.
Visit with your eye doctor regularly. Most cases every 4 months if you are diagnosed with high eye pressure or glaucoma. We offer a complimentary eye pressure and eye nerve analysis this month, stop by and ask about our complimentary glaucoma screening analysis today. We also accept major medical insurances, vision plan insurances and credit card payments. Call today 773-735-6090. We look forward to seeing you soon!
