• Treatment for "Mixed Mechanism" Glaucoma?


    Question:

    What is the treatment for "Mixed Mechanism" glaucoma?


    Answer:

    Someone is said to have "Mixed Mechanism glaucoma" when they have both main types of glaucoma: closed-angle (also called "narrow angle") and open-angle glaucoma.

    Glaucoma occurs when pressure within the eye becomes too high. Think of your eye as a balloon. Your eye constantly creates a clear fluid called "aqueous" to keep your eye at a safe pressure (or properly inflated like a balloon). As more fluid is created, the same amount must leave the eye so pressure doesn’t get too high. When this doesn’t happen as it should, a person may have glaucoma.

    Closed-angle glaucoma is when the drainage angle (where the fluid leaves the eye) becomes blocked due to a "narrow angle." With closed-angle glaucoma, there is often the chance that the eye's drainage angle may close completely, eventually leading to vision loss. In that case, the narrow angle needs to be treated first. A laser iridotomy is usually the first step. This is when a laser is used to create a small hole (about the size of a pinhead) in the iris so fluid can drain from the eye better. Medications may also be used.

    Then, the open-angle glaucoma needs to be treated. With open-angle glaucoma, the drainage angle isn’t in danger of suddenly closing, but it doesn’t drain fluid as it should. Treatment to make the drainage angle work better can include laser, surgery, and medication. Remember, glaucoma in its early stages usually does not have any symptoms. This why it is so important to have routine exams by an ophthalmologist, as recommended by the American Academy of Ophthalmology.