Glaucoma Treatment
Glaucoma is usually controlled with eye drops given 2 to 4 times a day or by pills given in various combinations. These medications act to decrease eye pressure either by assisting flow of fluid out of an eye or by decreasing the amount of fluid entering the eye. To be effective, these medications must be taken regularly and continuously.
Patients with any type of glaucoma need periodic examination. Glaucoma sometimes gets worse (or better) without the patient being aware of it, and as a result, treatment may need to be changed after awhile. As a rule, damage caused by glaucoma cannot be reversed. Eye drops, pills and surgery are used to prevent further damage from occurring, and to preserve existing vision.
However, treatment may occasionally result in unwanted side effects. Some eye drops may sting, redden the eye and cause blurring or occasional headaches. Such side effects usually disappear after a few weeks. Though rare, other drops may affect pulse, heartbeat, and breathing. Pills sometimes cause tingling of fingers and toes, drowsiness, loss of appetite, bowel irregularities, and occasional kidney stone formation. They are usually prescribed only when absolutely necessary. You should notify your eye doctor immediately if there is a question of possible side effects.
Glaucoma Medication
Pills work by limiting fluid production and decreasing the flow of fluid into the eye. The medication is usually taken from two to four times a day. Some people may have tingling in the hands and feet, stomach upset, nausea, or a loss of appetite, but most people can take the pills without side effects. Glaucoma medication taken in combination with some drugs can cause side effects, so be sure to let any health care professional that treats you know that you are taking medication for glaucoma. In order to control your eye pressure and prevent damage to your vision, you will need to take your medication every day for the rest of your life.
Glaucoma Surgery Facts
Sometimes treatment with eye drops and pills does not control the pressure in your eye, or your doctor for your particular situation does not recommend those treatments. If so, there are surgical means to lower intraocular pressure. Your eye care professional may recommend either trabeculoplasty (laser surgery) or trabeculectomy (traditional surgery). Both techniques involve treating the trabecular meshwork; the drainage area that can clog up and cause elevated eye pressure.
What is a Trabeculoplasty?
 To improve the flow of fluid through the trabecular meshwork, your doctor will use the argon laser in that area of the eye. You will be given anesthetic drops and asked to rest your chin on the platform that is connected to the slit lamp and the laser. You will be asked to remain still, allowing your doctor to direct the laser to the exact part of your eye where the surgery is needed. The procedure takes about fifteen to thirty minutes. After surgery, you may go home and resume your normal activities. Your doctor may want to check your eye pressure later that same day. It may take a few weeks for the full effect of the laser treatment to be seen, and you may need to continue taking medication. It is possible that trabeculoplasty may have to be repeated at a later time.
What is a Trabeculectomy?
 A section of the trabecular meshwork is removed to enable the fluid to drain from your eye and reduce intraocular pressure. A local or general anesthetic will be used. After surgery, you probably will go home that day and rest. Your doctor will want to see you the next day to check your vision and eye pressure. You may need to use medication after your treatment.
What is Laser Iridotomy?
 Laser iridotomy is an outpatient procedure that involves the use of the laser, a highly concentrated beam of energy, which can be focused to a point and used surgically to treat glaucoma. You will be awake during the procedure, seated at equipment that is similar to the equipment used in the office for an examination. Surgical iridectomy is a traditional surgical procedure that is usually done in the hospital. It requires either local or general anesthesia. You may be able to return home the day of your surgery. During laser iridotomy, your doctor makes tiny openings in the iris with a YAG or argon laser, allowing fluid to flow freely from the posterior to the anterior chamber. You will rest your chin on the stand that is attached to the laser equipment, and your eye may be anesthetized. You will be asked to remain still and quiet during the procedure. This enables your doctor to focus the laser on the exact treatment spot in your eye. The laser procedure usually takes less than thirty minutes.
Following Laser Iridotomy
You will be able to go home the day of surgery and resume normal activities. Medication may be prescribed. Your eye doctor may want to check the pressure in your eye later that day. Laser iridotomy prevents further eye damage by relieving the high pressure, but it cannot restore vision that was damaged during the acute attack. A partial loss of sight in the affected eye is often the consequence of an acute attack.
What Happens During Surgical Iridectomy?
 In surgical iridectomy, a small section of the iris is removed during surgical iridectomy to allow the fluid to flow normally and to reduce pressure. A local or general anesthetic will be used. After surgery, a bandage will be placed over the operated eye. You may need to wear it a few days. You may be able to go home the day of surgery, but your doctor may ask you to come to the office the next day to have your vision and eye pressure checked. Although this surgery is effective in preventing further eye damage, it cannot reverse any damage that occurred during the acute attack.
Can acute glaucoma affect both eyes?
If you have an attack of acute glaucoma in one eye, you often will have an attack in the other eye eventually. Your eye care professional may recommend preventive laser iridotomy or surgical iridectomy to guard against an attack in the second eye. When either is performed before an acute attack occurs, the chances for successful surgery (preventing loss of vision) are greater.
Glaucoma and you
Whenever you visit any doctor or other health care professional, be sure to tell him or her the name of the glaucoma medication you’re taking. Keep an identification card in your wallet stating that you are being treated for glaucoma. This could be especially helpful if an emergency arises.
Take extra medication with you when you plan to be away from home for a few days. In fact, it's a good idea to always keep an extra supply of medication on hand in case a supply is lost or destroyed. Be sure to tell our eye care professional if your medication causes any side effects. It may be possible for another drug to be substituted. Because glaucoma runs in families, encourage adult members of your family to have regular eye checkups. For more information about glaucoma, click on the following links:
Glaucoma – Causes and Symptoms
Glaucoma – Types and Testing
Laser Iridotomy
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