Glaucoma

How is glaucoma treated?

The purpose of treatment is to preserve vision and the visual field as they were at the time the visual problem was diagnosed, as it is currently impossible to regenerate optic nerve fibres once they are damaged.

Progression of optic nerve damage is prevented by maintaining normal levels of intraocular pressure.

When the ophthalmologist makes the diagnosis, medical or surgical treatment will be chosen according to the type of glaucoma, as there are some types of glaucoma (such as congenital glaucoma) that only respond to surgical treatment, and the degree of severity at the time of diagnosis.

Medical treatment:

In milder cases, it is very likely that the disease can be controlled with the use of ocular hypotensive eye drops. These eye drops have to be applied one or more times a day, according to the ophthalmologist's prescription and should be continued indefinitely. The eye drops can cause local or generalised adverse reactions, which must be reported to the ophthalmologist immediately so that the treatment can be modified to minimise these adverse effects..

Surgical treatment:

There are two types of surgery for treating glaucoma: laser or conventional surgery.

Laser treatment: In chronic glaucoma, laser is applied to the area that is blocked and stops the flow of aqueous humour, thus helping to improve drainage and reduce intraocular pressure.

The technique for treating glaucoma called trabeculoplasty is very useful in patients who cannot tolerate the medication or have had to stop taking it because of the side effects. It is also recommended for patients in whom it has not been possible to maintain intraocular pressure within normal limits despite treatment.

The possibilities of laser treatment are limited, as it is not effective in young people and its action tends to be insufficient in severe cases.

In acute glaucoma, the use of laser to make a hole in the iris that connects the anterior and posterior chambers of the eye is very effective. This procedure, which is known as iridotomy, has to be performed on both eyes when an acute glaucoma attack occurs in one of them. It is also recommended as a preventative measure in patients who have one or more risk factors for this type of glaucoma.

Trabeculectomy: This is the surgical technique of choice for treating glaucoma in cases diagnosed at a very advanced stage or when medical treatment or laser surgery has failed. The operation involves creating a new outlet for the aqueous humour to leave the eyeball and thus keep the pressure within normal limits.