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.

Glaucoma testing is no longer simply relying on the eye pressure; instead, emphasis should give to test for optic nerve appearance (health).

Glaucoma testing

A diagnosis of glaucoma no longer just based on the presence of pressure within the eye. Because normal tension glaucoma has no increased pressure, and thus it is impossible to diagnose based on eye pressure. Therefore, it is requiring assessing optic nerve appearance, which can clearly see during a dilated eye examination.

Glaucoma is a progressive (worsen over time) disease, with changes in the appearance of the optic nerve, a loss of nerve tissue, and a corresponding loss of vision confirms the diagnosis. Some optic nerves have a suspicious appearance, resembling nerves with glaucoma, but the patients may not have other risk factors or glaucoma symptoms. These patients should closely monitor with frequent comprehensive exams to assess for change.

• Patient history - is to determine the presence of any general health problems and family history that may be contributing to the problem.
• Visual acuity measurement is to determine the extent to which vision may be affected.
• Tonometry is to measure the eye pressure to detect increased risk for glaucoma.
• Pachymetry is to measure corneal thickness. People with thinner corneas are at an increased risk for glaucoma.
• Visual field testing or perimetry - is to assess the field of vision affecting by glaucoma. This test measures side (peripheral) vision and central vision by determining the dimmest amount of light that can detect in various vision locations or by determining sensitivity to targets other than light.
• Retina evaluation - may include photographs of the optic nerve, in order to monitor any changes that might occur over time.
• Gonioscopy - view the angle anatomy, the area in the eye where fluid drainage occurs.
• Other tests include using devices to measure nerve fiber thickness, and look for specific areas of the nerve fiber layer for loss of tissue.

Glaucoma risk factors are certain factors that may increase the chances of having glaucoma, preventing these factors help to prevent glaucoma.

Glaucoma risk factors and how do you prevent them?

• Age – over 60 years are at the highest risk for the disease. However, the increase in risk begins after age 40.
• Family history of glaucoma - increases the risk of developing glaucoma.
• Medical conditions - Some studies indicate that diabetes, high blood pressure, and heart diseases may increase the risk of developing glaucoma.
• Physical injuries to the eye - can immediately increase the eye pressure and further increases in pressure may happen due to internal damage. Injury may also cause dislocation of the lens, blocking of the drainage angle, and further increasing pressure.
• Other eye related risk factors - Corneal thickness and optic nerve appearance is a risk for development of glaucoma. Conditions such as retinal detachment, eye tumors, and eye inflammations may induce glaucoma. Some studies suggest that high nearsightedness may be a risk factor for the development of glaucoma.
• Corticosteroid use – for prolonged time may increase the risk of having secondary glaucoma.

Reducing these glaucoma risk factors helps to preventing glaucoma.

Glaucoma cause is associated with an increase in the fluid pressure inside the eye; other includes lack of adequate blood supply to the nerves.

Based on different types of glaucoma, there are many theories about the causes of glaucoma. Still, the exact cause is unknown.

What causes Glaucoma?

Primary open angle glaucoma - This is the most common form of glaucoma. Glaucoma is considering developing when the eye's drainage system becomes inefficient over time. This develops an increased amount of fluid, and a slowly build-up of pressure within the eye. Other causes of the optic nerve damage include poor circulation, or blood flow, to the optic nerves. Damage to the optic nerve is slow without symptoms, and a large portion of vision can be lost before notice the glaucoma symptoms.

Angle closure glaucoma - This type of glaucoma, also called closed angle glaucoma or narrow angle glaucoma, is a less common form of the disease. A medical emergency can cause vision loss within a day of its onset. This is an acute form of angle closure glaucoma. Although an acute attack often affects only one eye, the other eye may be at risk of an attack as well. Chronic angle closure glaucoma progresses gradually, and so it can diagnose in time and treated to avoid vision loss.

It happens when the drainage angle in the eye (formed by the cornea and the iris) blocked. Most people who develop this type of glaucoma have a very narrow drainage angle. With age, the lens in the eye becomes larger, pushing the iris forward and narrowing the space between the iris and the cornea. As this angle narrows, the aqueous fluid is blocking from exiting through the drainage system, resulting in a buildup of fluid and thus increased eye pressure.

Angle closure glaucoma can be chronic (progressing gradually) or acute (appearing suddenly).

Secondary glaucoma - This type of glaucoma occurs because of an injury or other eye disease. It may cause by a variety of medical conditions, drugs, physical injuries, and eye abnormalities. Infrequently, eye surgery can be associated with secondary glaucoma.

Normal tension glaucoma - In this form of glaucoma, eye pressure remains normal, still the optic nerve is damage. The reason behinds this is unknown. It is assuming that normal tension glaucoma may be due to an abnormally sensitive optic nerve or short supply of blood to the optic nerves caused by a condition such as atherosclerosis, a hardening of the arteries. Under these circumstances, even normal pressure on the optic nerve may be enough to cause damage.

Majority cases of glaucoma do not have any discrete symptoms until the optic nerve is damage, and side (peripheral) vision is lost.

For this reason, experts suggest regular eye exams to diagnose and treat it at its early stage.

Open angle Glaucoma symptoms

Open angle glaucoma is the most common form, initially has no symptoms. The eye pressure builds up gradually and at some point; the optic nerve is damage and side vision (peripheral vision) is lost. Without proper treatment, total blindness will occur. Similarly, people with normal tension glaucoma will not experience any symptoms until they begin to lose peripheral vision.

Closed angle Glaucoma symptoms

Acute closed angle glaucoma is the result of a sudden blockage in the normal flow of eye fluid (aqueous humor) between the iris and the lens. Symptoms of this condition may include severe pain, nausea, vomiting, blurred vision, and seeing a rainbow halo around lights. It is a medical emergency and must treat immediately otherwise blindness may occur in one or two days. Chronic closed angle glaucoma progresses more slowly and can damage the optic nerve without any symptoms.

Don’t wait for glaucoma symptoms

Therefore, it is advisable not to wait for any symptoms of glaucoma and have regular eye tested to avoid vision loss. For those who have a high risk factor for glaucoma has to have frequent eye examination as suggested by their eye doctor.

Glaucoma is associated with an increase in the fluid pressure inside the eye. This may cause damage to the optic nerve and results in vision loss.

Eye Glaucoma

Advanced glaucoma may cause blindness. Not everyone with high eye pressure will develop glaucoma, and many people with normal eye pressure can develop glaucoma. When the pressure inside an eye is too high for that particular optic nerve, whatever that pressure measurement may be, glaucoma will develop.

There are several forms of glaucoma; the two most common forms are primary open angle glaucoma (POAG) and angle closure glaucoma (ACG).

Primary open angle glaucoma

Glaucoma is the second-leading cause of blindness. Primary open angle glaucoma develops slowly and usually without any symptoms. Many people do not aware they have the condition until significant vision loss has occurred. It initially affects peripheral or side vision, but can advance to central vision loss. If left untreated, glaucoma can lead to significant loss of vision in both eyes, and may even lead to blindness.

Acute angle closure glaucoma

A less common type of glaucoma is acute angle closure glaucoma, usually occurs abruptly due to a rapid increase of pressure in the eye. Its symptoms may include severe eye pain, nausea, and eye redness, seeing colored rings around lights, and blurred vision. This condition is an ocular emergency, and medical attention should seek immediately, as severe vision loss can occur quickly.

Currently, Glaucoma cannot prevent, but if diagnose and treat at its early stages, then it can usually control. Medication or surgery can slow or stop further vision loss. However, if the vision is already lost to glaucoma cannot restore. That is why experts recommend an annual dilated eye examination for people at risk for glaucoma to prevent vision loss. Depending on the specific condition, the doctor may recommend examinations that are more frequent.

Dry eye treatment options include eye drops or other treatments to keep the eyes healthy, more comfortable and prevent vision being the effect.

Dry eye treatment options

The primary treatment option used to treat dry eyes include adding tears, conserving tears, increasing to tear production, and treating the inflammation of the eyelids or eye surface that contributes to this condition.

Adding tears - Mild dry eye cases can easily manage using over the counter artificial tear solutions. These can be useful as often as required to supplement natural tear production. Artificial tear solutions without preservatives are recommending, because preservative could further irritate the eyes. However, some people may have persistent dry eyes that are not responding to artificial tears alone, need additional steps to take to treat it.

Conserving tears - An additional approach to reducing the symptoms of dry eyes is to keep natural tears in the eyes longer. This can be by blocking the tear ducts through which the tears normally drain. The tear ducts can block with tiny silicone or gel like plugs (that can be removed, if needed). A surgically closing the tear ducts permanently can also be performed. In both approaches, the goal is to keep the available tears in the eye longer to limit dry eye problems.

Increasing to tear production - the optometrist can recommend prescription eye drop that helps to increase production of tears, as well as omega-3 fatty acid nutritional supplements. RESTASIS (cyclosporine ophthalmic emulsion, 0.05%) - to increase tear production in patients whose tear production is presumed to be suppressed due to ocular inflammation associated with keratoconjunctivitis sicca (chronic dry eye).

Treatment of the contributing eyelid or ocular surface inflammation - Prescription eye drops or ointments, warm compresses and lid massage, or eyelid cleaners may recommend helping decrease inflammation around the surface of the eyes.

Alternative treatment dry eye - Dry eye is the cause of tear gland defects, so to cure it; we need to correct the tear gland and its secretions. There is some eye exercises to correct this dry eye problem; they are:

• 'Yang Eye' Candle Gazing Technique
• Squeeze Eyes Tightly and Open Eyes Widely

Dry eye’s diagnosis test is by comprehensive eye examination, testing of the quantity and quality of tears that produce.

Diagnosis of a dry eye

• Patient history - to determine any dry eye symptoms, presence of any general health problems, medications taken, or environmental factors that may be contributing to this problem.
• External eye examination, which includes lid structure and blink dynamics.
• Evaluation of eyelids and cornea is performing by a bright light and magnification lens.
• Assess the tears for both the quantity and quality, to find any abnormalities in tear film. A special dye may instill in the eyes, which help to observe better tear flow, and to highlight any changes to the outer surface of the eye causes by insufficient tears.

Using the information obtained from testing, the optometrist can determine if the patient has dry eyes and advises treatment options based on the diagnosis test.

Defects in the aqueous layer of tear film are the common causes of dry eye syndrome. This defect may be due to the following reasons.

Causes of dry eye’s syndrome

• Age - dry eye is a part of the natural aging process. Majority of the people with an age over 65 years experiences have this condition.
• Gender - women are more likely to develop dry eyes because of hormonal changes caused during pregnancy, the use of oral contraceptives, and menopause.
• Medications - certain medicines such as antihistamines, decongestants, blood pressure medications and antidepressants, can limit the amount of tears produced in the eyes.
• Medical conditions – such as rheumatoid arthritis, diabetes, and thyroid problems are more likely to develop dry eyes. Eyelid inflammation (blepharitis), eye surface inflammation, or in or out-ward turning of eyelids can cause dry eyes.
• Environmental conditions - exposure to smoke, wind, and dry climates can increase to tear evaporation end up with a dry eye. Failure to blink regularly, such as when staring at a computer screen for long periods, can also contribute to the cause of dry eyes.
• Other factors - long-term use of contact lenses can be a factor in the development of a dry eye. Refractive eye surgeries, such as LASIK, can cause decreased to tear production and dry eyes.

Dry eye the name itself is self-explanatory; this condition makes the eyes feel dry, scratchy, and gritty. Other symptoms may include:

Symptoms of a dry eye

Dry eye is a disorder in the tear film with a deficiency of tears (shortage of tear) or low quality tear (excessive tear evaporation) which causes damage to the outer exposed eye surface (interpalpebral ocular surface) and is related with symptoms of ocular discomfort.

• Eye fatigue
• Discomfort or foreign body sensation
• Burning
• Stinging
• Itching
• Pain
• Light sensitivity
• Abnormal blinking
• Redness
• Blurry vision
• A stringy discharge from the eyes

Why a dry eye is causing watery? - Reflex Tears

It may seem strange that dry eye can cause the eyes to water. This can happen only because of the eye irritation. Excessive tearing occurs the same way, if something got in to the eyes.

However, these tears would not make the eyes feel better. Because the reflex tears, watery type tears, which are produce due to injury, irritation, or emotion does not have the lubricating property necessary to prevent dry eyes. Commonly tear film is made of three layers water, oil, and mucus. All these layers are important for maintaining good eye health. The cornea (front covering of the eye) is in need of a continuous supply of these tears to protect it from infection.