Glaucoma

What is glaucoma?

Glaucoma is a degeneration of the optic nerve of the eye resulting in progressive loss of peripheral vision.   The main cause of glaucoma is an increase in pressure in the eye caused by the inability of the fluid to drain out of the eye.

How do we keep track of your glaucoma?

There are many ways to follow your glaucoma which include visual field testing and microscopic scans of your optic nerves, in addition to your in-office visits with your Doctor.  These tests are serially performed every 6 months to closely monitor for any worsening of the disease.  If your glaucoma gets worse, we can modify the treatment for you.

What are the options to treat glaucoma?

We need to decrease the pressure in the eye with either eye drops, laser therapy, incisional surgery, or a combination of the above used in conjunction with iStent.

Which lasers are used to treat glaucoma?

Selective Laser Trabeculoplasty (SLT)           Laser Peripheral Iridotomy (LPI)

There are 2 types of laser treatment depending on the type of glaucoma you have: SLT (selective laser trabeculoplasty) and LPI (laser peripheral iridotomy).

SLT is a relatively new laser that uses low energy light to increase drainage of fluid to help treat open-angle glaucoma.

LPI is a laser that makes a small hole in the iris to help treat narrow and closed angle glaucoma.

Does SLT or LPI hurt or are there any side effects?

SLT and LPI treatments are usually painless.  Mild discomfort, redness, headache or glare can occur after the procedure.  You will take anti-inflammatory drops for 3 days afterward to decrease these symptoms.

What happens during the procedure?

Eyedrops are administered prior to the procedure.  The Doctor places a lens on your eye and delivers pulses of light through a microscope.  The entire procedure takes only a few minutes in the office.  The Doctor will want to check your eyes with a follow-up visit.

Do I need to continue my glaucoma eye drops following SLT?

Yes.  Each patient responds differently to SLT and has differences in their glaucoma disease.  Your Doctor will review your glaucoma and eye drops at your follow-up appointment.

How long will it take to benefit from the laser surgery?

SLT lowers the intra-ocular pressure by about 20-25% over the next 2-4 weeks in 80% of patients lasting 2 years.  SLT can be repeated many times without any side effects.

LPI significantly lowers your risk of angle-closure glaucoma immediately.

Who will benefit from SLT?

Any patient suffering from open angle glaucoma, especially pseudoexfoliative or pigmentary glaucoma.

Any patient whose intra-ocular pressure continues to increase while on topical medication(s).

Any patient intolerant of topical medications.

Any patient who finds it difficult to adhere to regular topical treatment or cannot afford expensive eye drop medications.

Any patient who does not wish to take eye drops for the rest of their lives for their glaucoma.

What is iStent and how does it work?

iStent is a titanium drainage device that is inserted into the drainage angle of your eye to help control your glaucoma.   It is a very safe procedure that can be done together with your cataract surgery.  There is about an 80% chance that we can reduce your eye drop medications if it works well.

Will I go blind from glaucoma?

With diligent follow up and good compliance with advanced treatment, it is very rare to go blind from glaucoma.  Remember that it is a painless “silent” and potentially-blinding disease so regular eye examinations with your eye Doctor will be essential, especially if you have a positive family history of glaucoma.