Know All About Glaucoma Treatment

CONTENTS

How Do I Cure Glaucoma?

Glaucoma, more commonly called as the “silent thief of sight” refers to a group of eye disorders that cause damage to the optic nerve, which carries information from the eyes to the brain. It initially leads to peripheral vision loss and ultimately blindness, if not treated properly. The drainage angle inside the eye controls the outflow of a watery fluid, called the aqueous humor. This fluid is continuously being produced inside the eye, to nourish tissues.

Glaucoma is characterised by increased intraocular pressure in the eye due to clogging or narrowing of the drainage angle. There exist very few symptoms of glaucoma, so people do not generally realise its existence and it progresses undetected, until the optic nerve has been irreversibly damaged. According to the American Academy of Ophthalmology, 2.2 million people in US are at risk of this disease today and 3.3 million people will be affected by this disease by 2020, due to ageing. Fortunately, early detection and treatment can help preserve your vision. 

 


Glaucoma Treatment can prevent damage to your optic nerve by reducing eye pressure.

What Is Glaucoma Treatment?

There are two main types of glaucoma disorders and hence two treatments.

  1. Open Angle Glaucoma - In this situation, fluid passes slowly through the drainage angle. It develops over time, slowly clogging drainage canal. The condition, however, is painless. Medication and surgery is used to relieve excessive fluid pressure within eye.

  2. Closed Angle Glaucoma - This is a chronic disorder where the iris bows inward. It causes pain and blurred vision. Nausea, vomiting, mild dilated pupils are some of the symptoms of this disease. Treatment aims at opening drainage angle to reduce pressure. 

Angle closure glaucoma, caused due to physical contact between iris and cornea and secondary glaucoma, caused by other diseases, traumas or steroids are other variants of glaucoma disorders. 

 


Who Are The Ideal Candidates For Glaucoma Treatment?

 

The various types of glaucoma are primary open angle glaucoma (POAG), normal tension, closed angle, narrow angle, congenital, pigmentary and secondary. If you have any one of these, you are eligible for glaucoma treatment as prescribed by your ophthalmologist.

If you have IOP (intraocular pressure) that is not due to ocular hypertension (a condition causing high IOP but no nerve damage), which can cause optic nerve damage.


What Are The Different Types Of Procedures To Treat Glaucoma?

The treatment of glaucoma depends upon the kind of the problem the patient has and the severity of it. 

Laser Trabeculoplasty

This procedure is done to treat open angle glaucoma and is of two types - Argon Laser Trabeculoplasty (ALT) and Selective Laser Trabeculoplasty (SLT). Both these techniques help in lowering eye pressure but have not proved to be a permanent solution for patients. Medication is often taken additionally in these cases.

Laser Iridotomy

This is prescribed for people with closed angle glaucoma or with narrow drainage angles. The laser creates a very tiny hole in the iris for the easy flow of aqueous fluid. Iridotomy price is generally more than trabeculoplasty cost, at $1500/per eye in US. 

Peripheral Iridectomy

In this technique, a small piece of the iris is removed to easily allow the aqueous fluid to drain and can be done to treat closed angle glaucoma. This is however rarely necessary as the condition can generally be treated by medication and laser iridotomy.

Trabeculectomy

In this method, the surgeon creates a small flap on the sclera (the white part of the eye). A bleb or a reservoir is created right under the conjunctiva (the thin membrane that covers the eye) which helps in collecting the fluid that drains into it. 

Aqueous Shunt

An aqueous shunt is a small tube or valve that is connected to a reservoir plate. The plate is placed beneath the conjunctiva while the tube is placed inside the eye through a small incision. The fluid is collected in the plate and is absorbed by the blood vessels. This technique is generally opted if trabeculectomy cannot be performed. 

 


 

What To Do Before A Glaucoma Treatment?

  • There are different procedures prescribed for the different types of glaucoma. Generally, your ophthalmologist gives you a consent form that discusses the various benefits and alternatives to the surgery.

  • In order to have surgery, your surgeon would examine your medical history and review your current course of medication.

  • The medical staff must also know about your allergies to anesthesia or certain other drugs since some sort of anesthesia is always given to the patient.

  • Certain drugs are blood thinning. It is important to stop taking aspirin or vitamin tablets that may increase bleeding during the procedure and prolong recovery time. Check with your surgeon about the same.

  • Ensure that you arrange for someone to take you back home as you would not be able to drive. Also ask the person to assist you in the next few days.

 


 

What Is The Post-Operative Care For Glaucoma Treatment? 

  • Generally, patients only feel mild pain or discomfort after the procedure which can be solved by medication prescribed by your surgeon. If extreme pain persists, it is advisable that you call the doctor immediately

  • Right after the surgery, the treated eye is patched for about a day. Once the patch is removed, you are required to wear protective eye wear during the day and a protective eye guard during the night

  • Do not engage in strenuous physical activity like lifting, bending or working out in the couple of weeks that follow the surgery.

  • The patient can shower but must wear the protective eye guard while doing so. Always ensure that you do not bend for long periods of time. If there is dirt in the eye, clean it gently with a soft cloth or cotton.

  • Discontinue all glaucoma related eye drops and pills on the treated eye and ask the doctor for after care medications. 


What Is The Diet For A Glaucoma Treatment?

The patient can start consuming a normal well balanced diet after the surgery. Consuming nutrient rich foods that have vitamins A, E and C aids eye health.

Drink plenty of water and fluids to keep yourself hydrated.

Avoid drinking alcohol heavily during the recovery period.

Smoking and exposure to smoke after the procedure may cause irritation to the eye.

Ensure you take the prescribed medication for the condition. Check with your doctor if other prescriptions that you are on interfere with the recovery.


What Are The Realistic Expectations From Glaucoma Treatment?

  • The surgery aims to stabilise the pressure in the eye and result in clear vision. However, the treatment can have certain side effects if the surgery isn’t performed in the right manner. This generally happens if the surgeon is erroneous. If you are getting treatment from a foreign country, you might have to go back for another consultation, round of tests, or treatment. It is also realistic to extend the trip after the surgery in order to avoid the making another trip. 

  • Complications such as swelling, bleeding, loss of vision and infection can arise if the medical staff doesn’t perform efficiently. Hence, choosing the right surgeon is of utmost importance for a safe result. 

  • For at least two week after the surgery, you cannot wear contact lenses and need to keep a pair of prescription glasses ready to use in that time period. After two week, in the final recovery stages, you can use contact lenses. 

 


What Are The Pros And Cons Of Glaucoma Treatment?

  • Pros

  • Cons

  • Glaucoma surgery improves the flow of fluid out of the eye, resulting in lower eye pressure.

  • The surgery has high success rates. Eye pressure is effectively controlled in three out of four people who have eye surgery for glaucoma. 

  • Although regular follow-up visits with your doctor are still necessary, many patients no longer need to use eye drops after surgery.

  • The most important benefit of glaucoma surgery is that it prevents the eyesight from worsening.

  • Glaucoma surgery carries some risks with like infection in the eye.

  • Blurred vision or permanent loss of central vision may occur, though in less tha 2% cases.

  • There may be continued changes in the nerve at the back of the eye related to glaucoma. 


Who Should Avoid Undergoing Glaucoma Treatment?

A few individuals are not appropriate candidates for this surgery, such as:

  • Individuals who are aged less than 18 years as the vision actuity changes with change in eye size till that age.

  • Individuals who can get allergic to a clerestory device; planted behind the eye.  

  • Individuals who already have undergone laser surgery to treat short sightedness or cataract. 

 


 

What Are The Alternatives To Glaucoma Treatment?

Medicated Eye Drops

Glaucoma can be treated through medicated eye drops. These medicated eye drops reduce the pressure on your optic nerve and prevent further damage. It is necessary to take these eye drops regularly as per the prescription of your ophthalmologist. It is imperative to speak to your ophthalmologist about your other medical conditions so that he/she will give you medications keeping your health concerns in mind. Do not discontinue your medications without consulting your ophthalmologist as this will have adverse effects on your eyesight.
Food and nutrition - Limiting caffeine intake can contribute to reducing or at least prevention of aggravating the eye disorder. Maintaining a good nutrition and eating food rich in Vitamins C,E and A, zinc and copper, like fish oil, broccoli and grape seeds can help in curing glaucoma. These aim at reducing Oxidative Stress and Vascular Dysregulation by providing antioxidants to the body. 


Meditation, Acupuncture And Herbal Therapies

These treatments are are used extensively in different cultures to treat Glaucoma. They work by refocusing the body’s energy. However, these methods are not clinically tested.
 

Exercises

Moderate exercising can reduce Intraocular Pressure by up to 14%. However, this is temporary and a very slow process to treat glaucoma with uncertain results. 

 


 

Does Glaucoma Treatment Lead To Scarring?

Normally, the bleb from the trabeculectomy is hardly visible to other people as it is hidden by the eyelid. In case of scarring after the surgery as a part of the body’s natural healing tendency, anti- scarring medication is prescribed on an office visit . Doctors can also break up the scar tissue through a procedure called ‘bleb needling’ if the problem is observed in a later stage.

 


 

What Are The Temporary Side-effects Of Glaucoma Treatment?

Pain 

Pain after the surgery is generally dealt with over the counter pain medications.

Redness and Inflammation

Redness and inflammation are minor complucations and can easily be dealt with at home through measures such as cold compressing.

Bleeding

Some initial bleeding is common after any surgery and it usually subsides within 3-5 days of the surgery.

Infection

If the side effects are more severe, such as infection, it needs to come to the attention of the concerned doctor. Hence, in such a case, call your doctor. He/she will either prescribe you appropriate medication or you might have to make a trip to the hospital. 

 


 

How To Choose A Surgeon For A Glaucoma Treatment?

Choosing a surgeon for glaucoma requires you to do a thorough research. He/she should have a strong background in the procedure and should have performed it enough times to prevent the possibility of any complications. You should choose a surgeon who has credentials, such as a certificate from the International Council of Ophthalmology. 

Generally, doctors practising in popular medical destinations have considerable experience. This is because hospitals situated in medical tourism destinations see considerable inflow of patients due to their affordable prices. If the surgeon is as qualified as he/she should be, the following complications can be avoided: 

  • Very high or low eye pressure

  • Loss of vision 

These complications might require you to undergo further treatment.

 

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