The only treatment option available for open angle glaucoma is to lower the IOP via several approaches.
Medical: There are several different classes of eye drops available to lower the eye pressure. These can be associated with local (red, dry eyes) or systemic side-effects.
Laser: These open up the drainage pathway of the eye or reduce the production of fluid inside the eye to lower the IOP.
While eye drops have conventionally been thought of as being the first line treatment for glaucoma, recent studies suggest that selective laser trabeculoplasty (SLT) should be considered as first line treatment for patients with open angle glaucoma for a number of reasons including:
- Similar efficacy to eye drops at lowering IOP
- Minimal risk
- Less side effects associated with eye drops
- Patients do not need to worry about putting drops in on a daily basis
- Less risk of requiring surgery at a later date
- More cost effective
Surgery: Surgery may be required if eye drops or laser treatment is not indicated, do not lower the IOP adequately or if there is evidence of glaucoma progression despite treatment.
Conventional surgery included a glaucoma filtration procedure (trabeculectomy) where a trapdoor is made in the sclera, the white of the eye, to allow fluid to drain from inside the eye to underneath the conjunctiva, the skin of the eye. These can also be achieved with a drainage device (aqueous shunt) that drains the fluid inside the eye via a tube to a plate that is secured to the sclera under the conjunctiva.
Minimally Invasive Glaucoma Surgery: These are a range of procedures that are usually performed together with cataract surgery to lower IOP. While some of these devices do not lower the IOP as much as conventional glaucoma surgery and therefore may not be suitable for all patients, advantages include:
- Less risk of complications
- Quicker surgical procedure
- Reduced need for eye drop medication
To discuss glaucoma assessment and treatment in more detail, please feel free to arrange a consultation with Dr Lee by clicking here.