There are two main categories of glaucoma, open-angle glaucoma, and narrow-angle (or closed-angle) glaucoma. Your glaucoma needs to be correctly diagnosed to be successfully treated.

Open-angle glaucoma is a slowly progressive disease usually affecting patients later in life. The loss of vision early in the disease is often imperceptible to most patients. As the disease progresses, patients may describe “tunnel vision,” with severe limitations of their peripheral vision. If left untreated, glaucoma can even involve the central vision and lead to blindness. People at high risk include those who are over the age of 40, diabetic, near-sighted, African-American, or who have a family history of glaucoma.

Closed-angle glaucoma is a much more worrisome disease which can lead to severe pain and sudden loss of vision. It usually requires emergent treatment with a special type of laser. Risk factors for closed-angle glaucoma include female gender, increasing age, Inuit or East Asian ethnicity, farsightedness, and genetic factors including family history.

Often, there are no symptoms associated with developing glaucoma. Unless you have closed-angle glaucoma, there will be no pain telling you there is something wrong. Glaucoma needs to be caught in the early stages to prevent vision loss. If you have experienced any sudden changes in vision or notice that you are starting to develop blind spots in vision, contact an ophthalmologist immediately.

Symptoms of open-angle glaucoma include:

• Patchy blind spots in your side or central vision.
• Tunnel vision in advanced stages

Symptoms closed-angle glaucoma include:

• Severe headache
• Pain in the eye
• Vomiting and nausea
• Blurry vision
• Halos around light
• Red eyes

It is critical to seek medical help if you are experiencing symptoms, as undiagnosed and untreated glaucoma can cause severe and permanent vision loss.

While the damage caused by glaucoma is not reversible, some treatments and procedures can be done to stop glaucoma from progressing. Treatment for glaucoma commonly begins with prescription eye drops. These eye drops help to decrease the pressure in the eye that is causing damage. This can either be done by a decrease of fluid your eye creates, or by improving how the fluid drains from your eye.

Oral medications may also be used if eye drops do not significantly lower eye pressure. The common drug prescribed to help further decrease eye pressure is a carbonic anhydrase inhibitor.

Several different procedures can effectively treat glaucoma. Before deciding on surgery, you should consider specialized glaucoma eye drops. These can help decrease pressure in your eyes and eye fluid production. Glaucoma eye drops come in many different forms, including beta-blockers, prostaglandins, and more. If eye drops do not improve your condition, you should certainly consider surgery; this works wonders for many patients. Some specialists also use a variety of therapy techniques to treat glaucomas. These include both laser or filtering therapy and drainage tubes.

Selective Laser Trabeculoplasty (SLT)

SLT is a type of laser procedure performed at a glaucoma treatment center that opens up the drainage channels in the eye, known as the trabecular meshwork, to help decrease the eye pressure. It uses low-frequency energy that is “selectively” absorbed by the trabecular meshwork, leaving surrounding tissues unaffected. SLT is an excellent alternative to pressure-lowering eye drops and can be used as an alternative for those who have been treated unsuccessfully with traditional laser procedures. It can also be safely repeated if necessary.

For more information about SLT, visit this link.

Laser Peripheral Iridotomy (LPI)

LPI is the treatment for narrow angles, narrow-angle glaucoma, or acute angle closure glaucoma. When an LPI procedure is performed in patients with narrow angles, it is considered to be a prophylactic procedure that prevents these patients from developing acute angle closure glaucoma, which they are at higher risk of developing. Acute angle closure glaucoma symptoms are a sudden pain in the eye or around the eye with redness and blurred vision.

For more information about LPI, visit this link.

Minimally invasive procedures (iStent, express shunt)

Other solutions available at our glaucoma treatment center include the iStent implant. It is a novel microsurgical implant, which lowers intraocular pressure and helps to manage mild to moderate open-angle glaucoma. The iStent implant is inserted during cataract surgery. By increasing the eye’s ability to drain fluid, this technology is designed to reduce the pressure in your eye. 

Trabeculectomy

This is a surgical procedure used in the treatment of glaucoma when the medication or laser procedures do not lower pressure adequately. In this surgery, a tiny drainage opening is made in the sclera (the deeper layers of the white of the eye) to relieve intraocular pressure. The conjunctiva, the outer layer of the white of the eye, is then used to cover this opening. The new drainage opening allows fluid to flow out of the eye and into a reservoir created from the eye’s natural tissues, helping to lower eye pressure and prevent damage to the optic nerve.

Glaucoma drainage device implantation (Baerveldt and Ahmed)

Glaucoma drainage devices are designed to divert aqueous humor from the anterior chamber to an external reservoir. These devices have shown success in controlling intraocular pressure (IOP) in eyes with previously failed trabeculectomy and eyes with insufficient conjunctiva because of scarring from prior surgical procedures or injuries. They also have demonstrated success in complicated glaucomas, such as uveitic glaucoma, neovascular glaucoma, and pediatric and developmental glaucoma, among others.