Glaucoma is one of the leading causes of blindness, especially among African-Americans over the age of 40, people over the age of 65, and individuals with family history of glaucoma. Usually associated with increased pressure in the eye, it damages the optic nerve and often leads to progressive blindness.
Management of glaucoma as early as possible is the key to preventing blindness from developing. However, in the case of open-angle glaucoma, it is not recognized until the disease has progressed to an advanced stage. With closed-angle glaucoma, the patient usually seeks medical attention as soon as possible due to the sudden eye pain.
The most common and most convenient way to manage glaucoma is through medication in the form of eye drops. Several eye drops are used and the functions are usually to decrease the production of aqueous humor and to increase its outflow leading to decrease in intraocular pressure. Some medications are administrated for short-term and long-term effects so each one is necessary. This requires an effort in the part of the patient since compliance with the regimen is important. According to studies, the blindness among those who are already diagnosed and started medication was changed from non-compliance to home medication.
Beside medication, surgery is also one of the effective managements of glaucoma. It is important to note that surgery does not cure glaucoma. Instead, it only provides symptomatic treatment. To date, there is still no cure for glaucoma.
Trabeculectomy is the conventional surgery for glaucoma patients. This is done by removing a portion of the blocked fluid pathways, making an opening in the sclera of the eye and closing it loosely to function as the new drain of the eye fluid. It is effective in lowering intraocular pressure but may have side effects such as scarring, infection and cataract formation.
Laser trabeculoplasty is a treatment specifically for open-angle glaucoma. The laser stimulates the trabecular meshwork to open and drain fluid more effectively. Laser iridotomy is done by making a hole in the iris of the eye to drain fluid. It is effective among those with closed-angle glaucoma.
Artificial drain may also be implanted in the eye if the response to medication is poor. Another procedure called viscocanalostomy is done by making the front of the eye thinner to help drain the fluid, but this is not as effective as the conventional surgery.