Medical, Laser & Surgery Treatment for Glaucoma

The glaucoma specialists at Eyecare Medical Group in Portland provide the full scope of medical examinations, laser procedures and surgery options for the treatment of glaucoma. There are three main methods of treating glaucoma: medical treatment of glaucoma, laser treatment of glaucoma and surgical treatment of glaucoma. These treatment options for controlling glaucoma are quite important, as glaucoma has no cure. The good news is that in almost all cases, glaucoma is treatable, but must be diagnosed as early as possible. Thanks to advances in medical treatment for glaucoma, laser eye surgery for glaucoma and surgery for glaucoma, our glaucoma specialists will be able to recommend an individual treatment plan that is best for you.

The following information is limited to the treatment of primary open-angle glaucoma, as it is the most common type of glaucoma. Primary open-angle glaucoma is treated by the three different approaches above depending on the severity of the disease and the ability of each treatment option to slow or halt the disease progression and preserve your vision.

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Medical Treatment of Glaucoma

Primary open-angle glaucoma is most often treated with eye drops. There are many types of medications that can be prescribed to lower your Intraocular Pressure (IOP). By using a single type of medication or sometimes 2 eye drops in combination, more than 80% of the patients with open-angle glaucoma can be successfully treated. These eye drops work by either decreasing the amount of fluid being produced inside your eye or by increasing the rate of drainage of fluid from your eye. For most patients, using the eye drops as prescribed-1-2 times per day it is possible to control the Intraocular Pressure (IOP) and slow or even halt the loss of vision.

Unfortunately, some patients may experience side effects of these eye drops making the use of eye drops a poor treatment option. Also, some patients are unable to achieve adequate control with eye drops alone and require laser eye surgery for glaucoma in addition to the eye drops in order to maintain control.

Laser Treatment of Glaucoma

The use of laser eye surgery for treatment for glaucoma has become an important treatment option for many patients. In the past, laser eye surgery for glaucoma was considered a “last resort” before glaucoma surgery. Today, thanks to advances in lasers, using a laser treatment for glaucoma in conjunction with the eye drop treatment or sometimes even using the laser treatment as the primary treatment are excellent options to help maintain control and slow or stop the progression of the disease. Laser treatment for glaucoma is widely used to help prevent vision loss and is becoming a glaucoma treatment of choice for many patients who have problems with eye drops or are unable to use eye drops properly.

Argon Laser Trabeculoplasty (ALT) is a type of glaucoma laser treatment that helps to reduce the Intraocular Pressure (IOP) by creating more effective drainage of fluid through the Trabecular Meshwork, however, for some patients, the effect of ALT decreases over time, rendering it ineffective. This is limiting, as ALT cannot usually be repeated. Another type of

Laser Treatment for Glaucoma is called Selective Laser Trabeculoplasty (SLT). This type of laser treatment is the preferred treatment for glaucoma for a number of important reasons. First, SLT appears to be considerably gentler on the eye. Second, should the effect decrease over time, SLT can be repeated several times in order to control the pressure and slow or halt the progression of the disease. SLT is becoming an important treatment option not only for glaucoma patients who are unable to use eye drops and obtain control but as a primary treatment to help glaucoma patients avoid needing to use eye drops altogether. Our eye physicians and surgeons routinely perform all types of laser eye surgery for glaucoma. If laser treatment is the best option to help you control your glaucoma, they will spend the time necessary to explain the risks and benefits so that you fully understand your treatment options.

Surgical Treatment of Glaucoma

For a small number of patients, even with the maximum eye drop therapy combined with glaucoma laser treatment, it is still not possible to achieve good stable control of their disease and stop the progression of vision loss. For these patients, there are surgical procedures available to help achieve control of the Intraocular Pressure (IOP) and slow or stop the progression of the disease. These include removing a tiny piece of the Trabecular Meshwork, a surgical procedure called “Trabeculectomy”, “Sclerostomy” or “Filtering Procedure”, or even implanting microscopic Glaucoma valves and stents.

Stents such as the iStent® shunts such as the Ex-PRESS Mini Shunt and tubes such as the single or double plate Ahmed valve to help reduce and stabilize the Intraocular Pressure (IOP) and prevent vision loss.

Glaucoma is a very complex eye disease and not simply an elevated Intraocular Pressure (IOP). Nonetheless, when detected early it can be successfully treated. Eyecare Medical Group eye doctors and our Glaucoma specialists provide the full scope of advanced technology diagnostic testing and treatment, as well as taking the time necessary to give each patient the personal education needed to fully understand their condition and get the best possible outcomes for their patients.