Glaucoma is actually a group of diseases, all related to the same buildup of pressure within the eye due to issues with fluid drainage.
Open-angle glaucoma is the most common variation, which occurs when the fluid within the eye drains too slowly out of the eye, causing a pressure buildup as more fluid fills the eye to nourish the surrounding tissues. This pressure buildup can cause damage to the optic nerve, causing increased deterioration and possible vision loss.
The other type of glaucoma is called closed-angle, which occurs when the drainage pathways for the eye fluid are closed or obstructed for some reason. This can cause a rapid buildup of fluid and pressure within the eye and requires immediate treatment to maintain the optic nerve and prevent long term damage. Closed-angle is much rarer than open-angle glaucoma but requires more immediate treatment.
Several options exist for medications that reduce the pressure buildup in the eyes that can lead to glaucoma. Eye drops and pills are both effective in treating glaucoma and increased eye pressure, and each can be prescribed on their own or used in conjunction in more advanced cases of pressure buildup.
Laser Eye Surgery
Laser surgery has become increasingly popular as an intermediate step between drugs and traditional surgery though the long-term success rates are variable. The most common type performed for open-angle glaucoma is called trabeculoplasty. This procedure takes between 10 and 15 minutes, is painless, and can be performed in either a doctor's office or an outpatient facility. The laser beam is focused upon the eye's drain; the eye's drainage system is changed in very subtle ways so that aqueous fluid is able to pass more easily out of the drain, thus lowering pressure buildup.
When medications and laser therapies do not adequately lower eye pressure, doctors may recommend conventional surgery. The most common of these operations is called a trabeculectomy, which is used in both open-angle and closed-angle glaucomas. In this procedure, the surgeon creates a passage in the sclera (the eye’s white portion) for draining excess eye fluid. A flap is created that allows fluid to escape, but which does not deflate the eyeball. A small bubble of fluid called a "bleb" often forms over the opening on the surface of the eye, which is a sign that fluid is draining out into the space between the sclera and conjunctiva. Occasionally, the surgically created drainage hole begins to close and the IOP rises again.
Drainage Implant Surgery
Several different devices have been developed to aid the drainage of aqueous humor out of the anterior chamber and lower IOP. All of these drainage devices share a similar design which consists of a small silicone tube that extends into the anterior chamber of the eye. The tube is connected to one or more plates, which are sutured to the surface of the eye, usually not visible. Fluid is collected on the plate and then absorbed by the tissues in the eye. This type of surgery is thought to lower IOP less than trabeculectomy but is preferred in patients whose IOP cannot be controlled with traditional surgery or who have previous scarring.
Newer non-penetrating glaucoma surgery, which does not enter the anterior chamber of the eye, shows great promise in minimizing postoperative complications and lowering the risk for infection. However, such surgery often requires a greater surgical acumen and generally does not lower IOP as much as trabeculectomy. Furthermore, long term studies are needed to assess these procedures and to determine their role in the clinical management of glaucoma patients.
Get the Help Your Eyes Need Today
If you have Glaucoma, or believe that your intraocular pressure has risen, it is important to get medical treatment as quickly as possible to prevent or reduce the chances of damage to the optic nerve. We encourage you to contact the Perrysburg Eye Center to schedule an appointment with one of our optometrists today by calling us at 419-874-3125.