Glaucoma Treatments

Submitted by Thiruvelan on Fri, 06/25/2010

Glaucoma treatment options may be; eye drops, medications, laser treatment, or other surgeries. Which are required to prevent further damage to the optic nerves.

Glaucoma treatment options

Treatment for glaucoma is an aim at reduce intraocular pressure and to prevent optical nerve damage. The most common first line of glaucoma treatment is usually prescription eye drops that must take regularly. In some cases, medications, laser treatment, or other surgery may suggest based on the condition and severity of the disease. Still, there is no known cure for glaucoma, early diagnosis and continuing proper treatment can protect from vision loss.

Eye Drops for glaucoma

Eye drops help to decrease eye pressure by help draining the eye fluid better and/or decreasing the quantity of fluid made by the eyes.

  • Prostaglandin analogs (Xalatan, Rescula, Travatan, Lumigan) works by increasing the eye fluid outflow (drain). Have few side effects but are associated with changes to the eye itself, including change in iris color and growth of eyelashes.
  • Beta-blockers (Timoptic, Betoptic, Optipranolal, and Ocupress) are the second most often used eye drop, which works by decreasing eye fluid production. They are available in the generic form, so relatively inexpensive. Side effects can be minimized by closing the eyes following application or using a technique called punctal occlusion (eye doctor inserts a small plug in one or more puncta to slow the drainage of tears from the eyes) that prevents the drug from entering the tear drainage duct and systemic circulation.
  • Alpha-adrenergic agonists (Alphagan, Iopidine, Propine) work by both decrease eyes fluid production and increasing drainage. Alphagan P has purite preservative that breaks down into natural tear components, so it is more useful for those who are allergic to preservatives. It is available in a generic form.
  • Carbonic anhydrase inhibitors or CAIs (Trusopt, Azopt) works by decreasing the intraocular fluid production. These are also available as medication pills [Diamox® (acetazolamide) and Neptazane® (methazolamide)].
  • Combined eye drops (Cosopt, Combigan) useful to patients who need more than one type of eye drop for the proper treatment of glaucoma. Cosopt is a combination of a beta-blocker (timolol) and a carbonic anhydrase inhibitor (Trusopt). Combigan is a combination of an alpha agonist (brimonidine) and a beta-blocker (timolol).

Oral Glaucoma Medications

If eye drops alone does not produce desired drop in eye pressure, then the doctor may also prescribe oral medication.

The most common oral glaucoma medication is carbonic anhydrase inhibitors; these medication pills, which include acetozolamide (Diamox, Storzolamide, other), dichlorphenamide (Daranide) and methazolamide (neptazane), should be taken along meals to reduce side effects.

Minimize the potassium loss that this medication can cause by having bananas and apple juice. These medications may induce a frequent need to urinate and tingling sensation in the fingers and the toes. These symptoms often disappear after a few days.

Other possible side effects include rashes, depression, stomach upset, fatigue, lethargy, metallic taste, impotence, weigh loss and kidney stones can occur.

Surgeries for Glaucoma treatment

Surgery involves laser or conventional surgery to make a drainage flap in the eye, inserting a drainage valve, or destroying the tissue that creates the fluid in the eye. The aim is to reduce the pressure inside the eye. Surgery may help lower pressure when medication failed to perform, however, it cannot reverse vision loss.

  • Laser’s trabeculoplasty helps intraocular fluid drain out of the eye. A laser beam is useful to stimulate the trabecular meshwork for effective fluid drainage. It may be a temporary relief and may need to repeat in the future.
  • Conventional surgery - If eye drops, medication and laser surgery is not effective in controlling eye pressure, then needs a filtering procedure called a trabeculectomy. Filtering microsurgery involves creating a drainage flap, allowing fluid to percolate into and later drain into the vascular system.
  • Drainage implants - Another type of surgery, called drainage valve implant surgery, may be an option for people with uncontrolled glaucoma, secondary glaucoma or for children with glaucoma. A small silicone tube is inserting in the eye to help drain aqueous fluid.

Treatment for acute angle closure glaucoma

Acute angle closure glaucoma is a medical emergency. Several medications can be useful to reduce eye pressure as quickly as possible. A laser procedure called laser peripheral iridotomy can also perform; a laser beam creates a small hole in the iris to allow fluid to flow freely into the front chamber of the eye where it then has access to the meshwork for drainage.

Normal tension glaucoma (Non-IOP Lowering) treatment

These include the application of oral calcium antagonists, and topical agents such as betaxolol. Newer agents such as brimonidine may have neuroprotective action have yet to be evaluated for use in NTG (Normal tension glaucoma). These agents need to consider where an IOP reduction of 25 to 30% cannot achieve, or if visual field progression continues despite it.

Lifelong glaucoma treatment

There is no cure for glaucoma. Patients with glaucoma need to continue treatment for the rest of their lives. Because the disease can progress or change silently, compliance with eye medications and eye examinations are essential, as treatment may need to adjust periodically.

Early detection with prompt treatment and regular monitoring can help to control glaucoma and there by reducing the chances of progression vision loss.