Glaucoma cannot currently be cured.  However, there are a number of treatments available that can make the condition a lot more manageable and in most cases prevent further optic nerve damage and vision loss. 

In this article I will be providing you with an overview of each of these treatment options.

Eye Drops

Eye drops are generally the first cause of action when it comes to treating glaucoma.  There are four main types of eye drops that are used: 

Beta Blockers:- These are normally the first eye drop that your doctor will recommend for glaucoma.  They reduce intraocular pressure (fluid pressure) within your eyes by slowing down the production of fluid.  In most cases they need to be applied twice a day.  However, if you have asthma or a heart condition you may not be able to use beta blockers.  Additionally, if your doctor does prescribe these eye drops you may still experience burning, dryness and itching in the eyes.

Prostaglandin Analogues:- If beta blockers fail or are not practical you may then be put on prostaglandin analogue eye drops.  These eye drops allows more fluid to flow out of your eye and can help lower intraocular pressure.  In most cases they need to be administered once a day.  Possible side effects of using prostaglandin analogue eye drops include blepharitis (a condition where the eyelids become inflamed), darker eyes, headaches, increased eyelash growth, pain in the eyes and red eyes.

Carbonic Anhydrase Inhibitors:- These eye drops are not as effective as beta blockers and prostaglandin analogues but they do have less severe side effects.  They act in a similar way to beta blockers and lower intraocular pressure by reducing the amount of eye fluid that is produced.  In most cases they need to be administered two or three times each day.  Using carbonic anhydrase inhibitors may lead to bitterness and dryness in your mouth, eye irritation and nausea.

Sympathomimetics:- These eye drops reduce intraocular pressure by minimising the production of eye fluid and also allowing it to drain from the eye more easily.  In most cases they need to be applied twice a day.  However, if you have high blood pressure or a heart condition you may not be able to use sympathomimetics.  Additionally, if you are advised to take these eye drops they may still cause your eyes to become red and painful. 

Laser Treatment 

Laser treatment is generally used as an alternative to eye drops or if the eye drops are not working as expected.  There are two main types of laser treatment for glaucoma:

Laser Trabeculoplasty:- This type of laser treatment uses high energy beams to unblock the trabecular meshwork (a collection of tissues that are responsible for draining eye fluids) which then reduces intraocular pressure by allowing fluid to drain more easily.

Cyclodiode Laser Treatment:- This type of laser treatment uses high energy beams to destroy small parts of the eye that produce fluid which then lowers the overall amount of fluid in the eye and therefore reduces intraocular pressure.

Surgery

Surgery is usually a last resort and only used when eye drops and laser surgery are not possible or when they are proving ineffective.  There are four main types of glaucoma surgery:

Trabeculectomy:- This is the main type of surgery for glaucoma.  The procedure involves removing part of the trabecular meshwork which allows fluid to pass through the eye’s drainage system more easily and results in lower intraocular pressure.

Viscocanalostomy:- This type of surgery involves removing part of the sclera (the white area of the eyeball) which then allows the fluid to flow out of your eye and into your body, thereby reducing intraocular pressure.

Deep Sclerectomy:- This type of surgery involves removing a deep piece of the sclera, part of the trabecular meshwork and the front of Schlemm’s canal (a channel that collects fluid from the eye and carries it to the blood) to create extra space.  This extra space then allows additional fluid to flow out of the eye and lowers intraocular pressure.

Aqueous Shunt Implant:- This type of surgery involves inserting a tube into the eye which then allows extra fluid to be removed.  This results in lower intraocular pressure.  Aqueous shunt implants are generally only used when the above surgeries have failed or are not practical.

Summary

Whilst glaucoma cannot be cured, effective treatment can make it manageable and minimise the impact it has on your eyes and vision.  I hope this article has provided you with a good introduction to the glaucoma treatment options that are available to you.  If you want to find out more about treating this disease your doctor or eye specialist will be able to answer many of your questions or concerns.

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