Glaucoma

Glaucoma

Glaucoma

Glaucoma

What Is Glaucoma?

Glaucoma is a group of eye diseases that cause damage to the optic nerve, which is crucial for transmitting visual information from the eye to the brain. This damage is often associated with increased intraocular pressure, the pressure within the eye. However, glaucoma can also occur with normal or even low intraocular pressure.

The most common type of glaucoma, called open-angle glaucoma, develops gradually and painlessly, often without noticeable symptoms until significant vision loss has occurred. Another type, called angle-closure glaucoma, is less common but can cause sudden and severe symptoms, such as eye pain, redness, and blurred vision.

If left untreated, glaucoma can lead to permanent vision loss and blindness. Regular eye examinations are essential for early detection and management of the condition. Treatment typically involves eye drops, medications, laser procedures, or surgery to lower intraocular pressure and prevent further damage to the optic nerve. Early diagnosis and proper management can help preserve vision and slow the progression of glaucoma.

What is the Goal of Glaucoma Treatment?

At present, glaucoma is not curable. However, treatment can significantly slow the progression of the disease and prevent vision loss over time. Reducing the intraocular pressure is the primary objective of any glaucoma treatment. Treatment typically involves medicated eye drops, laser procedures, or surgery to lower intraocular pressure and prevent further damage to the optic nerve.


What are Standard Glaucoma Treatments?

Eye drops are the most common treatment for glaucoma due to their ease of use and availability. However, there are several challenges that can reduce their effectiveness. Eye drops can be difficult to get in the eye, they must be applied once or more per day, and some can have side effects like burning or red eyes.

If eye drops are ineffective or undesirable due to the above issues, there are laser and/or surgical procedures that can be used to control the eye pressure. The type of surgical procedure used is variable depending on the type of stage of glaucoma one has. See below for more information on the various laser and surgical treatment options.
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Selective Laser Trabeculoplasty

SLT, Or Selective Laser Trabeculoplasty

SLT is a treatment option for open-angle glaucoma, the most common type, where the drainage channels in the eye become clogged over time.

Purpose of SLT:

SLT uses a laser to target and treat the drainage channels of the eye, known as the trabecular meshwork. The laser energy helps to improve the drainage of fluid from the eye, reducing intraocular pressure and preventing further damage to the optic nerve.

Preparing for SLT:

Before the procedure, your eye doctor will perform a comprehensive eye examination to assess your eye health and determine if SLT is the right treatment for you.

The SLT Procedure:

SLT is an outpatient procedure performed in your eye doctor's office or a specialized clinic. Eye drops are used to numb the eye, and a special lens is placed on the eye to focus the laser accurately. The laser is then applied to the trabecular meshwork, targeting specific areas to promote better drainage. The procedure can be mildly uncomfortable during application of the laser, but does not require any pain medication.

After SLT:

You can usually resume your regular activities immediately after the procedure, although it's advisable to rest for the remainder of the day. Your eye doctor may prescribe eye drops to use temporarily to aid in the healing process. It's essential to attend any scheduled follow-up appointments to monitor your eye pressure and assess the effectiveness of the treatment.

Results and Potential Side Effects:

The effects of SLT may not be immediate, and it may take several weeks for the intraocular pressure to stabilize. In some cases, SLT may need to be repeated if the pressure remains high or starts to increase again. Possible side effects include temporary eye discomfort, redness, light sensitivity, and blurred vision, but these usually subside within a few days.

Long-Term Care:

SLT does not cure glaucoma, but it can effectively control intraocular pressure and reduce the risk of further damage. Regular follow-up visits with your eye doctor are necessary to monitor your eye health, adjust treatment if needed, and ensure the glaucoma is well managed.

This information is a general overview of SLT, and it's crucial to consult with your eye doctor for personalized advice and information specific to your condition. We can provide detailed explanations, address any concerns you may have, and guide you through the entire process of SLT treatment.

Laser Peripheral Iridotomy

LPI

LPI, or Laser Peripheral Iridotomy, is a procedure used to treat certain eye conditions, specifically narrow-angle glaucoma and angle-closure glaucoma. It involves creating a small hole in the iris, which allows the flow of fluid in the eye to normalize and reduces the risk of increased eye pressure.

Purpose of LPI:

The primary goal of LPI is to prevent or relieve increased eye pressure caused by narrow or closed angles in the eye. By creating a small opening in the iris, the procedure helps to facilitate the flow of fluid (aqueous humor) within the eye, preventing a buildup of pressure that can damage the optic nerve and affect vision.

Procedure Details:

LPI is typically performed as an outpatient procedure by an ophthalmologist. Before the surgery, eye drops may be administered to constrict the pupil. During the procedure, a laser is used to create a tiny hole in the peripheral part of the iris. The laser is precise and minimally invasive, usually taking only a few minutes to complete.

Preparing for LPI:

Before undergoing LPI, your ophthalmologist will provide specific instructions. It's important to follow any preoperative guidelines, which may include stopping certain medications or eye drops before the surgery. You may also need someone to drive you home after the procedure as your vision might be temporarily blurred.

What to expect during LPI:

LPI is typically performed with the patient seated behind a microscope. Eye drops will be used to numb the eye, and your ophthalmologist may use a special contact lens to stabilize the eye and focus the laser. The laser will create a small opening in the iris, which can cause temporary discomfort. The procedure is usually quick and well-tolerated.

After LPI:

Following the procedure, you might experience mild discomfort or a scratchy sensation in your eye. Your ophthalmologist may prescribe eye drops to help prevent infection and reduce inflammation. It's important to use the prescribed medications as directed and attend any follow-up appointments.

Recovery and Post-Operative Care:

Most individuals recover quickly after LPI. It's important to avoid any strenuous activities or heavy lifting for a few days following the procedure. You may also be advised to wear sunglasses to protect your eyes from bright light or glare. Attend all scheduled follow-up appointments to monitor your progress and ensure proper healing.

Risks and Complications:

While LPI is generally considered safe, like any surgical procedure, it carries some risks. These may include infection, bleeding, increased eye pressure, inflammation, or damage to the cornea or lens. Your ophthalmologist will discuss these potential risks with you and address any concerns you may have.

This information is provided as a general overview of LPI. If you have specific questions or concerns about your condition or the procedure, it's important to consult with your eye care provider. We can provide personalized information and guidance based on your individual circumstances.


​​​​​​​Minimally Invasive Glaucoma Surgery

Minimally Invasive Glaucoma Surgery (MIGS) procedures are small cuts or micro-incisions through the cornea that cause the least amount of trauma to the surrounding tissues. Doctors implant a tiny device to allow fluid to drain from the eye, reducing internal pressure. Some devices are implanted during cataract surgery. Cataract surgery alone lowers pressure, but the combination of both is more effective and can lower the need for medication.

These new techniques minimize tissue scarring, allowing for the possibility of traditional glaucoma surgery in the future if needed. They also give doctors the opportunity to treat patients earlier and more safely than older surgeries.

If you have a glaucoma diagnosis, you can feel confident that your glaucoma treatment options are only going to improve in the years ahead. Although the disease is not curable, it is very manageable with the right treatment.

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