"The groundwork of all happiness is health." - Leigh Hunt

New considering on glaucoma treatment

When the doctor says you've got glaucoma, there's likelihood it's open-angle glaucoma, probably the most common type of vision-robbing disease. It can also be likely that you just can be given eye drops to stop the disease from progressing. This is frequently the primary line of treatment. But some people may initially profit from this procedure, which is frequently reserved as a second step.

What is Glaucoma?

There are many types of glaucoma. All of those damage the optic nerve, which carries visual signals to the brain. Damage often occurs when a poor drainage system increases pressure in the attention. Normally, fluid moves through the attention and out through a mesh of tissue called the trabecular meshwork. In most cases of open-angle glaucoma, the meshwork is full of debris. Fluid then backs up, which progressively increases the pressure contained in the eye, causing damage to the optic nerve.

Sometimes the optic nerve is broken though the drainage “angle” stays open and fluid and intraocular pressure don't increase. This kind of open-angle glaucoma known as normal-tension glaucoma.

In each cases, open-angle glaucoma has no symptoms until the optic nerve is broken. That's why it's necessary to have regular eye exams, including a straightforward test to detect glaucoma before symptoms appear. Once damage to the optic nerve occurs, an individual with open-angle glaucoma will experience significant vision loss.


The goal of treatment for open-angle glaucoma is to lower the pressure in the attention—even when the pressure is normal—and stop damage to the optic nerve.

If eye drops don't reduce eye pressure enough, or if eye drops are difficult to tolerate (which might cause irritation, dry eye, or allergic reactions), treatment with low-energy laser procedures may progress to what known as selective laser trabeculoplasty. SLT). It takes place within the doctor's office and only takes just a few minutes. “SLT uses light pulses that stimulate inflammatory cells to clear debris clogging the trabecular meshwork. It improves drainage and lowers eye pressure by 20% to 30% over five years. reduces,” explains Dr. Shane.

Eye surgery can also be an option for treating open-angle glaucoma, but it could possibly cause clouding of the attention's lens (cataract). It is due to this fact often performed during surgery that's required to remove an existing cataract or is reserved for individuals with advanced glaucoma.

Treatment shift

In some cases, individuals with newly diagnosed mild to moderate open-angle glaucoma can now skip the eyedrop phase and go for SLT. Doctors began offering this method after a randomized controlled trial published online on March 9, 2019. The Lancet, found that SLT was secure and effective as initial treatment and had greater advantages than eye drops. “Those who had previously had SLT had similar eye pressure measurements over time compared to those who used drops, and more than 70% remained drop-free at three years,” says Dr Lucy Shane. “It was a real game changer, and made us think differently about when to offer SLT.”

What is the advantage of stopping drops? “It removes a burden for people who can't tolerate medications or who would otherwise have difficulty prescribing, paying for, or remembering to use eye drops,” says Dr. Shane. are.”

Other professions: Medicare covers SLT. And receiving SLT doesn't rule out other treatment options in the longer term. “If you need eye drops or surgery later, you can still get them,” explains Dr. Shane.

SLT disadvantages

Like any procedure, SLT has some downsides. “One is that it can't work,” says Dr. Shane. “In my experience, 80% of patients respond to it. But new studies have shown that if someone doesn't respond to SLT the first time, they can get it again safely, and that's for them. can work.”

The effects of SLT wear off after three to 5 years. When this happens, chances are you'll must repeat the procedure or use eye drops.

“There is also a risk that the pressure may increase when you get SLT. But that risk is extremely low and rarely happens in experienced hands,” says Dr. Shane.

Are you a candidate?

It will depend on the kind of glaucoma you've got, eye pressure, amount of harm to the optic nerve, and family history of glaucoma.

Also, “the best candidates for SLT are those with mild or moderate open-angle glaucoma and have not yet used eye drops. We don't know why, but some eye drops work better than SLT.” reduce the likelihood of it,” says Dr. Shane.

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