Pros and Cons of Various Glaucoma Treatments

Glaucoma, commonly called “the silent thief of the sight”, is a group of eye disorders that occur when the optic nerve found in the back of the eye is damaged. When the drainage angle, a section of the eye where aqueous fluid drains out to keep pressure in the eye stable and nourish surrounding tissues, is not working properly, the fluid builds up in the eye, and the intraocular pressure rises. This is the primary cause of optic nerve damage.

According to the National Glaucoma Research, more than 3.3 million people in the U.S. are currently affected by glaucoma. Because the progression of glaucoma is slow and very few symptoms exist, about half of glaucoma patients cannot tell when they have it until irreversible damage to the optic nerve happens. They only know about it when they start experiencing peripheral vision loss or, eventually, blindness. For those 60 years old and older, this disease is the leading cause of blindness.

For more information on glaucoma, check out Glaucoma: A Common Disease That Can Cause Blindness.

Although there is no known cure for glaucoma, early detection and treatment can often stop further damage to vision and blindness. The recommended treatment may depend on the specific type of glaucoma the patient has and its severity. Ophthalmologists may use one or more of the most common treatments—medicines, laser treatment, and surgery.

To get a better knowledge about these treatments before undergoing one, this article presents their uses, how they are done, and their pros and cons in terms of effectiveness, side effects, and recovery requirements.

Glaucoma medication

Medicated eyedrops are commonly used to control glaucoma progression. When used daily according to the ophthalmologist’s prescription, eye drops can reduce eye pressure or the amount of aqueous fluid in the eyes. Some common eyedrop medicines contain:

  • Prostaglandins (Xalatan, Travatan Z)
  • Rho kinase inhibitor (Rhopressa)
  • Nitric oxides (Vyzulta)
  • Myotic or cholinergic agents (Isopto Carpine)
  • Beta-blockers (Betoptic, Betimol, Istalol, Timoptic)
  • Carbonic anhydrase inhibitors (Trusopt, Azopt)

Before being prescribed any of these, the doctor will consider other medications the patient is taking, as this may cause some problems.

Although these medications help preserve vision, they may also produce side effects, such as the following:

  • Red eyes or red skin around the eyes
  • Stinging or itching sensation
  • Changes in energy level
  • Pulse and heartbeat irregularity
  • Changes in breathing
  • eyelash growth
  • Color changes in the skin around the eyes or eyelid

If one experiences any of the side effects, he should talk with his ophthalmologist first before changing or stopping the medication.

Glaucoma laser treatment

If eyedrops do not improve glaucoma symptoms, laser treatment may be recommended. The type of laser treatment applied depends on the type of glaucoma a patient has.

  • Laser trabeculoplasty is used to treat open-angle glaucoma, the most common form of the disease where only one drainage pathway (trabecular meshwork) is damaged. The procedure involves using a high-energy beam of light to open up the drainage tubes to release some fluid and so pressure inside the eye will decrease.
  • Laser iridotomy is used to treat closed-angle glaucoma, a form of the disease where both trabecular meshwork and uveoscleral outflow drainage pathways are damaged. Here, the laser is aimed at the iris, creating a tiny hole in this section for the easy flow of the aqueous liquid.

During the procedure, the patient may see flashes of bright red or green light. With the use of numbing eyedrops, patients usually feel little or no pain during the treatment.

Just like any treatment, laser treatment may also produce side effects. Some swelling and soreness may be observed around the eyes. Pain may also be experienced if the laser scratches other nearby sections of the eye like the cornea, but it usually goes away quickly as soon as the cornea heals. Eyedrops may be used to ease discomfort.

For most people, regular daily activities may already be resumed the day following the treatment. But to find out whether the treatment worked or not, the patient may have to wait up to 6 weeks to see the result. Moreover, the laser treatment may be repeated as it wears off over time.

 Glaucoma surgery

In rare cases, when neither eyedrops nor laser treatment works, a surgical procedure might be recommended. The different types of glaucoma surgery are:

    • Trabeculectomy is used for treating open-angle glaucoma. Usually done in just less than an hour, this procedure involved making a tiny opening under the eyelid to allow extra fluid to drain away and reduce eye pressure. It also produces barely visible scar as the incision is done under the eyelid, but in case of scarring, anti-scarring medications are available under a doctor’s prescription.
  • Glaucoma implant surgery can treat other types of glaucoma, such as neovascular, congenital, and injury-caused glaucoma. The operation is done also in the hospital and takes up to 2 hours only. The surgeon implants a tiny tube (or shunt) onto the eye’s white part, assisting excess fluid drain out of the eye.
  • MIGS (minimally invasive glaucoma surgery) is used to treat mild glaucoma. This new approach refers to a range of techniques, implants, and devices that also aim to lower the pressure. Since it uses tiny incisions and microscopic equipment, this method brings fewer risks and side effects and faster recovery.

Compared to laser treatment, surgery can only treat only one eye at a time. It also produces side effects like soreness and swelling and risks like cataracts, cornea problems, extremely low eye pressure, and vision loss. These risks are very low, though, where less than 2% only experience possible vision loss. Follow-up visits with the doctor may then be necessary.

However, this method still has high success rates, where 3 out of 5 patients get an effective result of lowered and controlled eye pressure. This generally helps glaucoma patients in preventing the worsening of their eyesight. Another advantage of surgery is that many patients no longer need to use eye drops after the procedure.

NOTICE TO USERS is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified health provider with any questions you may have regarding any health symptom or medical condition. Never disregard professional medical advice nor delay in seeking professional advice or treatment because of something you have read on