ROBERT FRIEDMAN, MD, PC
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1001 PARK AVENUE, NEW YORK, NY 10028
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(212) 772-6202
Glaucoma Treatments
The treatment for glaucoma is specific to the type of glaucoma:
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Open angle glaucoma (POAG) is controlled by lowering the eye pressure (IOP)
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Narrow angle glaucoma is treated with laser
OPEN ANGLE GLAUCOMA:
Treatments include medicines, laser trabeculoplasty, conventional surgery, or a combination of any of these. These treatments are intended to prevent further damage to the optic nerve but do not improve damage that has already occurred.
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Medication:
Medicines are in the form of drops, and occasionally pills. These treatments are long-term and usually must be continued indefinitely.
It is important to tell your ophthalmologist about other medicines, including supplements, that you take. Sometimes the drops, or pills, can interfere with the way other medicines work. It is also important to disclose any medical conditions that you may have to avoid adverse interactions.
Side effects are usually specific to the medication being used. Superficial symptoms may include stinging, burning, and redness in the eyes. More significant complications can occur if a person has breathing issues, like asthma or congestive pulmonary disease.
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Laser:
Laser trabeculoplasty helps fluid drain out of the eye. While it can be very effective, laser does not always deliver the same effect in each patient, or in both eyes of the same patient. Also, laser may partially lower the pressure, but continued use of medication may be necessary.
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Surgery:
Surgery is designed to create fluid flow from inside the eye to outside the eye. There are many techniques in use today, each with relative advantage and drawbacks. While "filtration" - flow from inside to outside - is the objective, this needs to be titrated to the particular person's needs and lifestyle.
LOW TENSION GLAUCOMA:
This variation of glaucoma is treated in the same way as the more common open angle glaucoma, but because the pressure is not high to start, the urgency and measures needed to lower the pressure are greater.
NARROW ANGLE GLAUCOMA
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Symptoms may include severe pain and nausea, as well as redness of the eye and blurred vision. If you have these symptoms, you need to seek treatment immediately. This is a medical emergency. Without treatment to restore the flow of fluid, the eye can become blind.
Usually, prompt laser surgery and medicines can clear the blockage, lower eye pressure, and protect vision.
If the ophthalmologist detects a predisposition to this condition, laser iridotomy may be recommended to prevent a narrow angle glaucoma attack.
Angle-closure glaucoma:
The fluid that is made behind the iris must flow around the lens and through the pupil to leave the eye via the anterior chmber.
In people with small eyes, like far-sighted patients, the anterior chamber becomes crowded as the person lives and the lens gets thicker.
As this process continues, the angle gets blocked by part of the iris. People with this type of glaucoma may have a sudden increase in eye pressure.