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GLAUCOMA TREATMENT

The Eye With Glaucoma

In most types of glaucoma, the eye’s drainage system becomes clogged so the intraocular fluid cannot drain. As the fluid builds up, it causes pressure to build within the eye. High pressure damages the

The Optic Disc

You have millions of nerve fibers that run from your retina to the optic nerve. These fibers meet at the optic disc. As fluid pressure within your eye increases, it damages these sensitive nerve fibers and they begin to die. As they die, the disc begins to hollow and develops a cupped or curved shape. If the pressure remains too high for too long, the extra pressure can damage the optic nerve and result in vision loss.

Is There Another Cause?

It was once thought that high intraocular pressure (IOP) was the main cause of this optic nerve damage. Although IOP is clearly a risk factor, we now know that other factors must be involved because people with “normal” IOP can experience vision loss from glaucoma.

The Fluid Inside

Aqueous humor is the clear, watery fluid that is continually produced inside the eye. It is different from your tears. Tears are produced by glands outside of the eye and moisten the outer surface of the eyeball.

Glaucoma is a condition which can affect sight, usually due to build up of pressure within the eye.

Glaucoma often affects both eyes, usually to varying degrees. One eye may develop glaucoma quicker than the other.

The eye ball contains a fluid called aqueous humour which is constantly produced by the eye, with any excess drained though tubes.

Glaucoma develops when the fluid cannot drain properly and pressure builds up, known as the intraocular pressure.

This can damage the optic nerve (which connects the eye to the brain) and the nerve fibres from the retina (the light-sensitive nerve tissue that lines the back of the eye).

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Glaucoma Treatment

Dr. Prashant Srivastava is an experienced and one of the most trusted glaucoma specialist in Kolkata. He has done thousands glaucoma surgeries during his illustrious career.

Glaucoma damage is permanent—it cannot be reversed. But medicine and surgery help to stop further damage. To treat glaucoma, your ophthalmologist may use one or more of the following treatments.

Medication

Glaucoma is usually controlled with eyedrop medicine. Used every day, these eye drops lower eye pressure. Some do this by reducing the amount of aqueous fluid the eye makes. Others reduce pressure by helping fluid flow better through the drainage angle.
Glaucoma medications can help you keep your vision, but they may also produce side effects.
Some eye drops may cause:
  • a stinging or itching sensation
  • red eyes or red skin around the eyes
  • changes in your pulse and heartbeat
  • changes in your energy level
  • changes in breathing (especially if you have asthma or breathing problems)
  • dry mouth
  • blurred vision
  • eyelash growth
  • changes in your eye color, the skin around your eyes or eyelid appearance.
All medications can have side effects. Some drugs can cause problems when taken with other medications. It is important to give your doctor a list of every medicine you take regularly. Be sure to talk with your ophthalmologist if you think you may have side effects from glaucoma medicine.
Never change or stop taking your glaucoma medications without talking to your ophthalmologist. If you are about to run out of your medication, ask your ophthalmologist if you should have your prescription refilled.
Laser Procedure
In trabeculectomy, a flap is first created in the sclera (the white part of the eye). Then a small opening is made into the eye to release fluid from the eye.
There are two main types of laser surgery to treat glaucoma. They help aqueous drain from the eye. These procedures are usually done in the ophthalmologist’s office or an outpatient surgery center.
  • Trabeculoplasty. This surgery is for people who have open-angle glaucoma. The eye surgeon uses a laser to make the drainage angle work better. That way fluid flows out properly and eye pressure is reduced.
  • Iridotomy. This is for people who have angle-closure glaucoma. The ophthalmologist uses a laser to create a tiny hole in the iris. This hole helps fluid flow to the drainage angle.
Operating room surgery

Illustration of a trabeculectomy, when a surgeon creates a tiny flap in the white of your eye to lower intraocular pressure from glaucoma

Some glaucoma surgery is done in an operating room. It creates a new drainage channel for the aqueous humor to leave the eye.
Trabeculectomy. This is where your eye surgeon creates a tiny flap in the sclera. He or she will also create a bubble (like a pocket) in the conjunctiva called a filtration bleb. It is usually hidden under the upper eyelid and cannot be seen. Aqueous humor will be able to drain out of the eye through the flap and into the bleb. In the bleb, the fluid is absorbed by tissue around your eye, lowering eye pressure.
Glaucoma drainage devices. Your ophthalmologist may implant a tiny drainage tube in your eye. The glaucoma drainage implant sends the fluid to a collection area (called a reservoir). Your eye surgeon creates this reservoir beneath the conjunctiva. The fluid is then absorbed into nearby blood vessels.
Your role in glaucoma treatment
Treating glaucoma successfully is a team effort between you and your doctor. Your ophthalmologist will prescribe your glaucoma treatment. It is up to you to follow your doctor’s instructions and use your eye drops.
Once you are taking medications for glaucoma, your ophthalmologist will want to see you regularly. You can expect to visit your ophthalmologist about every 3–6 months. However, this can vary depending on your treatment needs.