Glaucoma

It is important to realize that there is no cure for glaucoma. Once nerve fibers die and visual function is lost, it cannot be recovered. Treatment can help preserve the remaining vision; hence it is imperative to detect the disease in its earliest stage.

The management of glaucoma must be an individualized effort. Simplistically speaking, in angle closure glaucoma doctors use a laser to create an alternative path for the fluid to drain out. However, this approach works for early cases; advanced cases require medication and surgery as for open angle glaucoma. An attack of closed angle glaucoma is an emergency and the IOP must be lowered as soon as possible to prevent damage to the optic nerve.

For open angle glaucoma initially eye drops are used to lower IOP; your doctor will select the one most suited for your condition. If the disease is advanced, and/or medical treatment fails, surgery may be necessary.

Medical therapy is expensive, and likely to be life-long. As with any treatment, there is a risk of side effects. Sometimes the side effects may be more uncomfortable for the patient, and less acceptable, than living with the disease. Therefore doctors consider the risk-benefit ratio of the treatment options for glaucoma. The main criterion is how much functional capacity is affected rather than the actual degree of vision loss. Your doctor will select the treatment most suited for your condition, please follow the advice meticulously.

In some patients glaucoma may be controlled by medicine alone, while others may need laser treatment or surgery. Surgery usually involves cutting a piece of tissue from the angle of the eye and allowing the fluid to accumulate under the transparent skin that surrounds the eyeball. However, glaucoma surgery is not as predictable as cataract surgery and carries more risks, including loss of the eye from devastating bleeding or infection. It is usually used if drugs fail to control the eye pressure, or for socioeconomic considerations.

Non-penetrating surgery can also help decrease eye pressure and has fewer complications than the standard approach. But its results are not as good. Hence it is not a first line of treatment for glaucoma.

In cases with poor potential for visual recovery or function, a different kind of laser may be used to reduce eye pressure. This is usually reserved for advanced cases.