How is glaucoma treated?

There are two main ways to treat glaucoma. The first approach involves using medicated eye drops, which work to decrease the pressure in your eye. Sometimes, additional oral medications may be prescribed to further lower eye pressure. If medications fail or if the pressure in the eye is severely elevated, surgery may be necessary.

Dr. Laura C. Fine, MD
Ophthalmologist (Eye Specialist)

An important goal of treatment for glaucoma (a group of eye diseases that cause vision loss through damage to the optic nerve) is to control eye pressure and stop the progression of the condition. Your physician may tailor your medication schedule to prevent fluctuations in eye pressure and to provide consistent eye pressure reduction throughout the day. Taking your medications on a regular schedule and not skipping any doses is important to keep your eye pressure under control throughout the day and preserve your vision.

Regular exams are equally important because, without an exam, you don't know whether fluid pressure in your eye is in a safe range or whether your visual field is slowly deteriorating. People who have questions about their medications, trouble following their treatment plans, or difficulty using their medicine should ask their doctors for advice and solutions.

Dr. Audrey K. Chun, MD
Geriatric Medicine Specialist

Glaucoma is caused by impaired outflow of aqueous humor from the eye. The initial treatment is a prescription of eye drops that can increase aqueous outflow and reduce inflow. Surgery is only performed when drops alone aren't effective in lowering eye pressure, and it involves either laser treatment or making a small incision in the eye to reduce intraocular pressure. Eye drops may still be required after surgery. Glaucoma treatments can be very effective, but it's important that you visit your eye doctor regularly to help reduce your risk of vision loss.

Glaucoma treatments generally focus on reducing intraocular pressure to a level the healthcare professional believes will not cause further damage to the optic nerve. This level is often called the target pressure, and it differs from person to person and may change over the course of treatment. Eye pressure is measured in millimeters of mercury (mm Hg). It varies, even throughout a single day. Generally, eye pressure readings between 10 and 21 mm Hg are considered normal, although a person may have glaucoma even with pressures in this range.

Most newly diagnosed cases of glaucoma are treated with medications, which come in topical and oral form. Topical medications may be eyedrops or eye ointments. Oral glaucoma medications come in pill and tablet form.

Once it’s diagnosed, chronic glaucoma usually can be treated with eye drops. Sudden-onset, or congenital, glaucoma may require surgery.

As a rule, damage caused by glaucoma cannot be reversed. Lowering eye pressure is the only proven way to treat glaucoma. Eyedrops, laser surgery and surgery in the operating room are used to lower eye pressure and help prevent further damage. In some cases, oral medications may also be prescribed.

With any type of glaucoma, periodic examinations are very important to prevent vision loss. Because glaucoma can progress without your knowledge, adjustments to your treatment may be necessary from time to time.

Ok, so your optometrist has worked the tonometer, the pachymeter, the ophthalmoscope and found the bad news.

You have glaucoma.

So what can you do?

There is no cure, but there are treatments.

In cases of primary open-angle glaucoma, those treatments generally start with eye drops. The drops either aid the trabecular meshwork in the draining of the aqueous humor, or they stem the production of the aqueous humor so that the system is not overloaded. The goal? Reduce intraocular pressure and either delay, or prevent, the occurrence of glaucoma. But if there was already damage, the drops will do you no good. They cannot reverse any damage that has occurred. And, as with all medications, consult your physician, because there can be adverse reactions with other drugs.

If the eye drops fail, your eye doctor may turn to pills to stem the damage to your optical nerve. But more likely, the doctor will employ laser surgery, which will create minute openings in the trabecular meshwork, increasing its drainage capacity. This may work for a few years, but you may need even more surgery later. Laser surgery is especially likely in acute cases of angle-closure glaucoma, in which the symptoms force the patient to the hospital.

Finally, there is a procedure called trabeculectomy, where an eye surgeon will create a new drainage system for the eye by cutting a new flap into the eye, allowing the aqueous humor to drain out. This procedure is how congenital glaucoma is treated and can be an option for those suffering from angle-closure glaucoma.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.