Glaucoma treatment seeks to decrease intraocular pressure or use other methods to prevent damage to the optic nerve. Currently, lowering intraocular pressure is the only proven method to treat glaucoma but several other different strategies, including neuroprotective treatment, are being researched and developed. Different types of glaucoma require different therapies to prevent further damage to the eye's structures. At the beginning of treatment, the ophthalmologist will generally recommend medication or a combination of medications or laser treatment to lower the intraocular pressure. Individualized treatment is very important in treating any type of glaucoma.
Eye drops (or a combination of eye drops and pills) to reduce intraocular pressure. Several different classes of glaucoma medications are currently available to lower eye pressure. These include beta-blockers, prostaglandin analogues, alpha-adrenergic agonists, miotics, and oral and topical carbonic anhydrase inhibitors. These medications work by either reducing the rate at which fluid in the eye is produced or increase the outflow of fluid from the eye. Although some categories of medications are best as first line treatment in most situations, the exact type of eye drops used requires careful assessment of a patients individual needs.
Laser treatment to open the drainage angle and reduce intraocular pressure. For angle closure glaucoma the ophthalmologist will likely recommend a laser iridotomy. For open angle glaucoma trabeculoplasty may be recommended. There are two types of trabeculoplasty available. The original type called Argon Laser Trabeculoplasty (ALT) and a newer more advanced type called Selective Laser Trabeculoplasty (SLT). Both of these technologies are available at the Dean McGee Eye Institute. Sometimes in complex cases a different type of laser treatment to reduce intraocular pressure called cyclophotocoagulation (TCPC) will be recommended. Usually these treatments are office procedures and are relatively painless and safe.
Surgery to create a new passage for fluid drainage. Surgery is usually reserved for cases that cannot be controlled by medication or appropriate laser treatment. There are several different surgical approaches used including trabeculectomy, tube shunt implants, and deep sclerectomy surgery. Each patient’s situation is unique and if a patient requires glaucoma surgery careful individual counseling about the different options, as well as risks and benefits will be fully discussed. Very few other locations in the United States offer as many different surgical options as the glaucoma service at the Dean McGee Eye Institute.