GLAUCOMA |
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Glaucoma is a disease that can slowly destroy the delicate nerve fibers that carry signals from the back of the eye to the brain. Generally, high pressure within the eye is responsible for the damage, but even patients with normal pressure can experience loss of this important nerve function due to glaucoma.
Patients do not always feel if eye pressure is elevated and slowly robbing them of their sight. That is why it is important to be checked yearly to be sure that glaucoma is not present.
Because it can be inherited, if one family member has glaucoma, other family members should be checked.
While glaucoma typically affects people age 40 and older, it can strike at any age. Glaucoma is called “the silent thief” because there is no pain or noticeable change in vision during the early stages of the disease.
No treatment can restore vision already lost to glaucoma. The goal of treatment is to prevent further vision loss.
Treating Glaucoma with Medication
Various medications are sometimes useful in treating glaucoma. Beta-blocker eye drops may reduce the amount of fluid produced by the eye. Prostaglandin analogs and alpha-2 agonists may also lower intraocular pressure.
Treating Glaucoma with Trabeculectomy
Your surgeon may recommend a surgical procedure called “trabeculectomy” if medication, eye drops, or another procedure have not been effective in lowering the pressure within your eye.
This procedure helps to lower pressure by altering the eye’s drainage system and creating a controlled leak of fluid.
Treating Glaucoma with Peripheral Iridotomy
Iridotomy is another surgical procedure that may be recommended to lower pressure within your eye. When the eye’s iris blocks the drainage of fluid, the surgeon uses a laser to create a tiny hole in the iris to improve drainage.
Selective Laser Trabeculoplasty (SLT) |
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Selective laser trabeculoplasty (SLT) is a laser procedure used to help lower the intraocular pressure (IOP) of patients with open angle glaucoma. SLT is used to treat the eye’s drainage system, known as the trabecular meshwork. Treating this area of the eye’s natural internal draining system is designed to improve the outflow of fluid from the eye, helping to lower eye pressure—failing to resolve the intraocular pressure can cause damage to the optic nerve and eventually result in loss of vision.
This type of laser surgery may be effective in some patients but not others. Your response may be different than other glaucoma patients, and it is not possible to predict how well the procedure will work before the laser surgery. The laser used in SLT works at very low levels and treats specific cells “selectively,” leaving untreated portions of the trabecular meshwork intact. For this reason SLT, unlike other types of laser surgery, may be safely repeated many times.
For your convenience the procedure may be performed in our office or outpatient surgery center. SLT typically takes about 10 minutes. Once you are settled in, drops will be used to numb the eye and prevent any discomfort. The laser itself makes a little noise, and you may experience a flash of light with each laser application. Although you may feel a little pressure, nearly all patients find the procedure comfortable and pain free.
You may need to use drops both before and after the laser treatment. The pressure in the eye will be checked after the procedure as there is a risk of increased IOP after the procedure. If this does occur, additional medicines may be necessary to lower the eye pressure. Rarely, the pressure in the eye could elevate to a level that may require surgery in the operating room to relieve the glaucoma.
Drops will be used after the laser surgery to help the eye heal correctly, typically for about 1 week. Most people notice some blurring of their vision after the laser treatment. This usually clears within a few hours. Following the procedure it is suggested that you relax for the rest of the day and follow-up visits will be scheduled to continue to monitor your eye pressure. The chance of your vision being permanently affected by this procedure is very, very small.
Although rare, the risks associated with SLT include:
- increased eye pressure, possibly requiring medication or surgery
- bleeding within the eye
- inflammation in the eye
- damage to the cornea, iris, or retina from the laser light
- failure to adequately lower the eye pressure
It will take several weeks to determine how much SLT will lower your eye pressure. It is possible that you may require additional laser surgery, or other glaucoma surgery, if your response is insufficient. You may need to continue glaucoma medications in order to control your IOP; however, SLT may lessen, or eliminate, the need for medication.
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