Glaucoma is frequently controlled with eye drops, sometimes in combination with pills. These medications decrease eye pressure by either slowing the formation of aqueous fluids within the eye or by improving the flow through the drainage apparatus of the eye.
For these medications to work, patients must take them regularly and continuously. Mild side effects from glaucoma medications are common and should be discussed with the ophthalmologist. The most frequent side effects include a temporary stinging sensation, redness of the eye, changes in pulse or heart rate, every level or breathing, headaches and blurred vision.
Selective laser trabeculoplasty (SLT) is a laser procedure used to lower intraocular pressure in patients with open angle glaucoma. Laser energy is applied to the trabecular meshwork (a specialized section of the draining system of the eye) to stimulate better flow through the eye’s drains. This laser treatment is performed in an office-setting, requires very little pre- and post-procedural preparation, is painless and effective in most patients.
Glaucoma surgeries are reserved for more significant glaucoma cases in which the intraocular pressure cannot be adequately controlled through medications or lasers or in cases where a dramatic decrease in intracoular pressure is indicated. The two most commonly performed glaucoma surgeries are trabeculectomy and tube shunt. In a trabeculectomy, an accessory drainage pathway is made for fluid to escape from the eye. A thin flap is made in the sclera (white outer wall of the eye) and a tunnel is cerated to help regulate flow of aqueous. The conjunctiva (thin, translucent tissue that overlies the sclera) is sutured closed to create a water-tight pocket called a bleb. The fluid that escapes from the eye is held in the bleb and then passes into the bloodstream.
A tube shunt is a glaucoma draining implant that, like a trabeculectomy, facilitates the drainage of fluid from the the inside to regulate intrauouclar pressure. In this procedure, a tube (very small, straw-like devise) made of a synthetic material is placed in the front part of the eye and is tunneled to a plate that is attached to the sclera. The plate grows a scar-like dome of tissue that for a fluid pocket to hold the excess fluid. The tube shunt thus enables the passage of fluid from the front of the eye, through the tube and plate and into a fund pocket on the exterior of the eye before it is absorbed by the bloodstream.