Treatment options for glaucoma

There is no cure for glaucoma, as vision loss caused by irreversible damage to the optic nerve is permanent. However, modern management regimes see many people avoid future damage and further vision loss. The goal of treatment is to lower the pressure in your eye either through increased fluid drainage or decreased fluid production. Your eye care practitioner will decide which procedure will be best suited to your circumstances.

Treatment options include:

Medications, such as eye drops, to reduce fluid production inside your eye or help to improve fluid drainage.

Laser treatment to improve fluid drainage or reduce the fluid production. There are several different procedures available depending on your condition:

• Selective laser trabeculoplasty (SLT) is a treatment to increase the drainage of fluid by stimulating the pigment cells in the trabecular meshwork, and this increases the fluid flow out of the eye.
• Laser peripheral iridotomy (LPI) is a treatment to increase the drainage of fluid by making a small hole in the iris, allowing the fluid to drain.
• Cyclodiode laser treatment is a treatment to reduce the production of the fluid by destroying some of the aqueous producing cells in the ciliary body.
• Argon laser trabeculoplasty (ALT) is a treatment to increase the drainage of fluid, much like SLT.

Surgery which can reduce pressure in your eyes by improving the outflow of fluid. There are several different surgery options available depending on your condition:

• Trabeculectomy surgery creates a new permanent drainage channel in your eye to allow fluid to drain, by making a new opening in the sclera (the white part of your eye). The fluid drains into the conjunctiva (the clear membrane that protects the eye) and forms a non-visible little reservoir called a bleb underneath the upper eyelid where the fluid gets reabsorbed into your bloodstream.
• Aqueous shunt is a small tube-like device implanted into the eye to allow fluid drainage out of the eye. Similarly, it creates a bleb underneath the upper eyelid.
• MIGS (minimal invasive glaucoma surgery) is a name given to a range of microscopic implants or devices to help the fluid drain out of the eye through either creating new drainage channels or opening up/widening existing drainage channels. These surgeries are generally done in conjunction with cataract removals, however in some cases they are done as a standalone procedure. Your eye care practitioner will provide you with the best care options available specific for your condition.

Sustained-Release Drug Delivery: If taking your glaucoma medication becomes problematic, your doctor may suggest a sustained-release drug delivery device, which is a new option available in Australia.

For more information

• Visit Glaucoma Australia.
• Always speak to your GP and eye care professional about the best treatment options for you.