Glaucoma Treatment

Treatment of Glaucoma

Treatment concentrates on lowering the pressure inside the eye to prevent optic nerve damage. Eye drops are most commonly used to control glaucoma, however, they can be very expensive, have unwanted side effects, and may need to be taken for the rest of your life. If non-surgical methods fail to decrease pressure, surgery may be required. The peripheral iridotomy procedure does not rely on medicines, but uses an advanced laser system to create an alternate route for the draining of the fluid inside your eye. This procedure is reimbursed by Medicare and other insurance providers, which minimizes your out-of-pocket expenses.

SLT Laser Treatment for Glaucoma
How SLT Works

Selective Laser Trabeculoplasty (SLT) is an advancement over other lasers that have been used safely and effectively in the treatment of glaucoma for over two decades. SLT uses a special wavelength and energy to affect only pigmented (melanin containing) cells in the trabecular meshwork at the boundary of the iris, improving the flow of fluid in the eye and reducing pressure.

SLT is usually performed in the doctor’s office and only takes a few minutes. Prior to the procedure, eye drops will be given to prepare the eye for treatment. The laser applications are applied through a special microscope similar to the ones used for eye exams. A lens is placed over the eye to direct the light to the trabecular meshwork.

Your eye pressure may drop as quickly as a day or more after having SLT performed. Your doctor may treat the eye with an anti-inflammatory eye drop that will be continued after the procedure. You will need to return for follow-up visits.

Generally, the laser treatment does not cause pain, though some patients experience a sensation during treatment. You may see a green flash of light but feel nothing from the laser. The lens used on your eye may cause some redness or irritation. Unlike some glaucoma medicines, there are no incidences of allergy or systemic side effects with SLT. Complications are minimal but may include inflammation, temporary increase in eye pressure, blurred vision, headache, iritis, corneal edema, corneal lesion, conjunctivitis, or eye pain. Because each individual reacts differently to SLT, you may need to continue using eyedrops following the SLT procedure.


Peripheral Iridotomy (PI) for Glaucoma
How the Procedure Works

A peripheral iridotomy is a laser procedure used to treat narrow-angle glaucoma, which is a disease that can cause permanent vision loss if left untreated. With this procedure, your doctor will use the laser to create a tiny hole in the upper part of the iris so that the acqueous fluid inside the eye can properly circulate and relieve the intra-ocular pressure (IOP) that has built up.

Before the laser treatment, anesthetic eye drops will be applied to numb the eye and special eye drops will be used to constrict the pupil, allowing the doctor greater access to the iris. A lens lubricated with a gel-like substance will then be placed on the eye to help keep your eyelids from blinking and to allow the doctor to focus the laser onto the iris. The procedure is generally painless, though some patients notice a slight "pinching" sensation from the laser.

Your eye pressure may drop as quickly as a day or more after having the PI performed. Your doctor may treat the eye with an anti-inflammatory eye drop that will be continued after the procedure. Your doctor will need to check your eye's pressure one hour after the procedure before you will be allowed to return home.


Trabeculectomy for Glaucoma
How the Procedure Works

The purpose of a trabeculectomy is to create a new drainage pathway for the fluid to escape the eye and lower the eye's pressure. The procedure is generally performed in a surgery center or hospital under local or general anesthesia and mild sedation.

Your surgeon will create a tiny "pocket" between the conjunctiva (the mucous membrane covering the white surface of the eye) and the sclera (the white surface of the eye). The fluid can then flow from the back of the eye through the "pocket" to the front chamber of the eye, reducing the intra-ocular pressure.

Later that day or the following day, your doctor will want to examine the surgical site and check the eye's pressure. You will be prescribed antibiotic and anti-inflammatory eye drops to control the risk of an infection or inflammation. You may or may not be required to continue glaucoma medications following the procedure, depending on the pressure inside your eye.