Treatment of Glaucoma

Depending on the severity of your glaucoma and your individual risk of vision loss, our eye doctors and glaucoma specialists can help you with medical treatment using eye drops, laser treatment for glaucoma and, if necessary, eye surgery for glaucoma treatment. These treatment options for controlling glaucoma are quite important, as glaucoma has no cure. The good news is that in almost all cases, glaucoma is treatable, but must be diagnosed as early as possible. Thanks to advances in the medical, laser and surgical treatment of glaucoma your doctor will be able to recommend an individual treatment plan that is best for your situation. The following information is limited to the treatment of Primary Open Angle Glaucoma, as it is the most common type of Glaucoma.

Eye Drops for Glaucoma
Primary Open Angle Glaucoma is most often treated with eye drops. There are many types of eye drops that can be prescribed to lower Intraocular Pressure (IOP). By using a single type of medication, or sometimes 2 eye drops in combination, more than 80% of the patients with Open Angle Glaucoma can be successfully treated. These eye drops work by either decreasing the amount of fluid being produced inside your eye or by increasing the rate of drainage of fluid from your eye. For most patients, by using the eye drops as prescribed 1-2 times per day, it is possible to control the Intraocular Pressure (IOP) and slow, or even halt, the loss of vision.

Unfortunately, some patients are unable to achieve adequate control with eye drops alone, or may experience intolerable side effects from the eye drops, and require laser treatment for glaucoma in order to maintain control.

Laser Treatment for Glaucoma
The Baltimore Washington Eye Center eye physicians and surgeons and glaucoma specialists have found that the use of laser treatment for glaucoma has become an important treatment option for many patients and may in fact be useful as a primary treatment along with eye drops. In the past, laser eye surgery for glaucoma was considered a “last resort” before glaucoma surgery. Today, thanks to advances in lasers, using a laser treatment for glaucoma in conjunction with the eye drop treatment or sometimes even using the laser treatment as the primary treatment, may be excellent options to help maintain control and slow or stop the progression of the disease. Laser treatment for glaucoma is regularly used to help prevent vision loss and is becoming a glaucoma treatment of choice for many patients who have problems with eye drops or are unable to use eye drops properly.

If you need glaucoma laser treatment, we will typically recommend Selective Laser Trabeculoplasty (SLT) as it is quite effective and  SLT can be repeated several times in order to control the pressure and slow or halt the progression of the disease. SLT has become an important treatment option not only for glaucoma patients who are unable to use eye drops and obtain control, but as a primary treatment to help glaucoma patients avoid needing to use eye drops altogether.

Glaucoma Eye Surgery
For a small number of patients even with the maximum medical therapy with glaucoma eye drops and laser eye surgery it is still not possible to achieve good control of their disease and stop the progression of vision loss. For these patients, a number of surgical procedures can be performed to help achieve control of the Intraocular Pressure (IOP) and help to slow or stop the progression of the disease. These include removing a tiny piece of the Trabecular Meshwork, a surgical procedure called “Trabeculectomy”, “Sclerostomy” or “Filtering Procedure”, or even implanting microscopic valves such as the Baerveldt Valve, shunts including the ExPRESS® Mini Shunt, and stents such as iStent® to help reduce and stabilize the Intraocular Pressure (IOP) and prevent vision loss.

Cataract patients with glaucoma may have a new treatment option called the iStent® Trabecular Micro-Bypass Stent. This procedure can be used as a treatment option to reduce eye pressure for cataract patients with glaucoma. With iStent® many patients will need to use fewer eye drops for their glaucoma treatment and might not need to use prescription eye drops at all.

The iStent® is FDA-approved for use in conjunction with cataract surgery to reduce eye pressure in adult patients with mild-to moderate open-angle glaucoma currently being treated with glaucoma medicine eye drops.

If you or someone you know would like to learn more about treatment of glaucoma with eye drops, laser treatment or surgery, or needs an appointment for a glaucoma eye exam, please call Baltimore Washington Eye Center at 800-495-3937 to schedule an appointment.