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Jason Wanner, DO
Treatments For Glaucoma
Maryland Eye Associates
. http://marylandeyeassociates.com

Treatments For Glaucoma

Glaucoma is a group of diseases that damage the optic nerves and cause loss of vision. Many types of glaucoma exist, and the goal of treatment is to save vision. Unfortunately glaucoma is the leading cause of irreversible blindness in the world, so once vision is lost from glaucoma it is permanent. Currently, glaucoma is treated by lowering the pressure in the eye. This is most commonly done with topical eye medications. Some of these medications are aimed at decreasing how much fluid is made in the eye and others are aimed at increasing the amount of fluid that drains from the eye. The drops are used between one and four times a day, depending on the medication. Unfortunately we have a limited number of medications that can be used for the treatment of glaucoma. In addition many patients develop allergies to glaucoma medications and side effects from the medications also can exist. Oral medications are sometimes used to treat glaucoma but typically less often and sometimes only for short periods of time until a patient can have surgery. Moderate cardiovascular exercise for 40 minutes four times a week has been shown in several studies to lower eye pressure as well. This can be an excellent adjunctive treatment for glaucoma.
The other mainstay treatment of glaucoma is surgery. Several types of laser and incisional surgeries exist. Laser trabeculoplasty (selective and argon) can be very effective at lowering eye pressure. Iridotomies are another laser procedure that can help in treating as well as preventing certain angle closure glaucomas.
It is common in the treatment of glaucoma to perform laser surgeries early in the disease process and even in some circumstances to prevent some types of glaucoma. Glaucoma can continue to progress despite the best medications and laser treatments. When this occurs, incisional eye surgery is typically the next treatment needed. Incisional eye surgery includes trabeculectomies and aqueous tube shunt procedures. Other surgeries exist, but these are the most commonly performed.
Both of these surgical options work by creating new ways for the fluid to drain out of the eye. By doing so, they lower the intra-ocular pressure and slow down the disease process. Trabeculectomies work without any permanent devices in the eye. Aqueous tube shunts work by placing a permanent tube into the eye.
Trabeculectomies are typically preferred to tube shunts for most types of glaucoma. However, tube shunt procedures are the preferred surgery in certain less common types of glaucoma and sometimes if a Trabeculectomy has failed.
Both surgeries offer patients the option to slow down the disease process when medical and laser treatments cannot adequately control the disease.
In some very advanced glaucoma cases a laser procedure called Transcleral Cyclophotocoagulation can be performed. This surgery is aimed at treating the muscle in the eye that produces fluid. It is often performed after other medical and surgical treatments have already been utilized.
The majority of patients with glaucoma can be treated very well with only topical medications and lasers. Fortunately for more advanced and difficult glaucoma patients several surgical options do exist. The best way to save vision loss from glaucoma is to detect the disease as early as possible and then treat it appropriately.

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