Glaucoma damage is permanent—it cannot be reversed. But medicine and surgery help to stop further damage. To treat glaucoma, your ophthalmologist may use one or more of the following treatments.
Glaucoma is usually controlled with eyedrop medicine. Used every day, these eye drops lower eye pressure. Some do this by reducing the amount of aqueous fluid the eye makes. Others reduce pressure by helping fluid flow better through the drainage angle.
Glaucoma medications can help you keep your vision, but they may also produce side effects. Some eye drops may cause:
- a stinging or itching sensation
- red eyes or red skin around the eyes
- changes in your pulse and heartbeat
- changes in your energy level
- changes in breathing (especially if you have asthma or breathing problems)
- dry mouth
- blurred vision
- eyelash growth
- changes in your eye color, the skin around your eyes or eyelid appearance
All medications can have side effects. Some drugs can cause problems when taken with other medications. It is important to give your doctor a list of every medicine you take regularly. Be sure to talk with your ophthalmologist if you think you may have side effects from glaucoma medicine.
Never change or stop taking your glaucoma medications without talking to your ophthalmologist. If you are about to run out of your medication, ask your ophthalmologist if you should have your prescription refilled.
There are two main types of laser surgery to treat glaucoma. They help aqueous drain from the eye. These procedures are usually done in the ophthalmologist’s office or an outpatient surgery center.
- Trabeculoplasty. This surgery is for people who have open-angle glaucoma. The eye surgeon uses a laser to make the drainage angle work better. That way fluid flows out properly and eye pressure is reduced.
- Iridotomy. This is for people who have angle-closure glaucoma. The ophthalmologist uses a laser to create a tiny hole in the iris. This hole helps fluid flow to the drainage angle.
Operating room surgery
Some glaucoma surgery is done in an operating room. It creates a new drainage channel for the aqueous humor to leave the eye.
- Trabeculectomy. This is where your eye surgeon creates a tiny flap in the sclera. He or she will also create a bubble (like a pocket) in the conjunctiva called a filtration bleb. It is usually hidden under the upper eyelid and cannot be seen. Aqueous humor will be able to drain out of the eye through the flap and into the bleb. In the bleb, the fluid is absorbed by tissue around your eye, lowering eye pressure.
In trabeculectomy, a flap is first created in the sclera (the white part of the eye). Then a small opening is made into the eye to release fluid from the eye.
- Glaucoma drainage devices. Your ophthalmologist may implant a tiny drainage tube in your eye. The glaucoma drainage implant sends the fluid to a collection area (called a reservoir). Your eye surgeon creates this reservoir beneath the conjunctiva. The fluid is then absorbed into nearby blood vessels.
- Cataract surgery. In some cases, removing the eye's natural lens can lower eye pressure. This is most commonly done for people with narrow angles who have high eye pressure, signs of glaucoma, or both. With narrow angles, the iris and the cornea are too close together. If the angle is so narrow that the iris touches the cornea, it will also cover (block) the eye’s drainage channel. Cataract surgery creates more space between the iris and cornea so that more fluid leaves the eye. This can lower eye pressure.
Your role in glaucoma treatment
Treating glaucoma successfully is a team effort between you and your doctor. Your ophthalmologist will prescribe your glaucoma treatment. It is up to you to follow your doctor’s instructions and use your eye drops.
Once you are taking medications for glaucoma, your ophthalmologist will want to see you regularly. You can expect to visit your ophthalmologist about every 3–6 months. However, this can vary depending on your treatment needs.
If you have any questions about your eyes or your treatment, talk to your ophthalmologist.