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What Are the Treatments?

Treatment of glaucoma requires controlling the flow and drainage of aqueous humor in the eye to restore the normal intraocular pressure. Most treatments (medication, laser, surgery) are directed at improving aqueous drainage. Open-angle glaucoma may not be diagnosed until it has already significantly affected vision, but once identified, it can usually be controlled. That is why it's so important to have your eye doctor test you regularly for glaucoma.

Both drugs and surgery have high rates of success in treating chronic open-angle glaucoma, but you can help yourself by carefully following the doctor's treatment plan. Some patients' lifestyles cannot tolerate a regimen involving two or three different eye drops and these patients may be hesitant to inform the physician. Be candid and tell the doctor if you cannot follow the medication schedule or if the eye drops cause unwanted side effects. There are always alternative treatments!

Acute closed-angle glaucoma is different: If the high pressure in the eye is not relieved quickly, the result can be blindness. On the other hand, treatments for acute closed-angle glaucoma are usually permanent and do not require long-term therapy. The unaffected eye is usually treated as well to prevent a future attack.

Appropriate treatment depends on the nature and stage of the glaucoma. Your eye doctor may not prescribe any treatment for ocular hypertension - when increased pressure in the eye is minimal and no nerve damage is present. Routine monitoring of your peripheral vision and of the appearance of the optic nerve may be sufficient.

Chronic open-angle glaucoma is initially treated with eye drops that lower pressure in the eye. Because of potential drug interactions, be sure to tell your doctor about any other medical problems you have or other medications you take.

If your glaucoma does not respond to medication, or if you cannot tolerate the side effects, your doctor may change medications or recommend one of several invasive techniques.

• Laser trabeculoplasty creates small laser burns in the area where the fluid drains, improving the outflow rate of aqueous fluid. This relatively brief procedure is done in an ophthalmologist's clinic.
• Trabeculectomy is a surgical procedure that creates a new channel for fluid outflow in advanced cases in which the intraocular pressure is high and the optic nerve damage progresses. Long-term results vary, but generally, the success rate is good.
• Surgery to reduce fluid production may also be used to decrease the amount of fluid and pressure in the eye.

Remember, all treatments offer benefits and potential risks. Before giving your consent always ask the surgeon to clearly explain the proposed benefits and any surgery, effective alternatives, as well as the potential risks of complications.