How to treat glaucoma?

Treatment for glaucoma is not fully curative and mainly serves to maintain, halt, or slow the progression of the disease. There are a number of modalities, ranging from simple eye drops, to laser and surgery. Each form of treatment has a place and provides specific benefits. It is important that you make your decision regarding treatment choices together with your doctor.

How do you treat glaucoma?

First of all, you should start by diagnosing glaucoma. It can be hard to do, since there is no pain associated with it. Usually, the first symptom is a blurry or double vision that may be permanent. This is because, if left untreated, glaucoma can cause your eyes to permanently lose their optic nerves, which allows you to see. An optometrist (or eye doctor) can test for glaucoma in several ways.

Once glaucoma is diagnosed, a treatment can be determined.

What are the treatments for glaucoma?

The treatment of glaucoma depends on the severity of the condition. In order to maintain the most normal level of vision for the longest time, it is important for a person with glaucoma to have regular check-ups with an eye care professional. There are two types of treatments: medical treatments and surgical treatments.

For early stage glaucoma, a topical ophthalmic medical treatment is recommended. These medications are designed to reduce intraocular pressure and prevent progression of glaucoma. However, with time, the medicine may stop being as effective as it once was. To that end, eye care professionals will want to review the medication and dosage to determine if a new medication should be prescribed.

For an advanced case of glaucoma, surgery may be recommended. Most often, there is a need to perform a trabeculectomy or glaucoma drainage implant surgery in order to successfully lower the intraocular pressure in an advanced case. More specifically, a trabeculectomy is a glaucoma procedure that reduces intraocular pressure by creating a hole in the eye's thin outermost layer of tissue and surgically creating a channel for fluid to flow from the eye.

Glaucoma surgery is not a cure for glaucoma; it is instead a medical procedure for lowering intraocular pressure. Surgery may improve vision and reduce the progression of glaucomatous damage in certain eyes. However, certain eyes may have a loss of vision due to this medical procedure. It is always a good idea to discuss with your doctor when surgery is the best option for you.

When it is not appropriate for you to have surgery, your doctor may still want to treat you with glaucoma medications to lower your intraocular pressure. These include medications that you take as eye drops (such as beta-blockers and prostaglandin analogues) or medications that you take by mouth (such as alpha agonists, carbonic anhydrase inhibitors, and beta-blockers). Most glaucoma medications need to be taken daily to be effective.

Glaucoma treatments that may lower your intraocular pressure and slow or halt glaucoma progression include:

  • oral medications
  • injections
  • eyedrops
  • surgical procedures

Glaucoma surgery is usually an option for people who have advanced glaucoma or have not been able to control their glaucoma with other treatments.

Treatment for glaucoma can be divided into medical and surgical.

How do you find a good glaucoma doctor or clinic?

The most important factor in finding a good doctor is the rapport you have with the doctor. The best doctor is the one who not only monitors your glaucoma effectively, but also has the most compassion. You can know whether you like the doctor or not through the way they explain things and by their bedside manner.

Surgical treatment options for glaucoma

Intraocular pressure (IOP) reduction by surgery is the most important therapy for glaucoma. A low IOP reduces the risk of the progression of visual field loss and nerve fiber damage. In the past it was believed that the low IOP treatment for glaucoma should be below 13 mmHg. However, recent large scale studies do not recommend such a strict IOP level. The aim of the surgery is to reduce the IOP to normal values without damaging the eye tissues. The maximum pressure which the eye can take is approximately 20 mmHg. A low IOP treatment (10 mmHg or less) is appropriate for patients who are at a high risk of glaucoma progression.

In the early stages of glaucoma, it is possible to lower the IOP without surgery by the use of eye drops and eye medication.

Open-angle glaucoma

Open-angle glaucoma (OAG) is usually treated by surgery. First the disease is tested for progression by an ophthalmologist. Further treatments are as follows:

  • surgical glaucoma filtration (shunt) - surgery is done for creating the pathway trabeculectomy - lower IOP without surgery
  • laser trabeculoplasty - changing the pathway in the eyeball
  • trabeculotomy - lower IOP without surgery

Vascular glaucoma

In the vascular form of glaucoma a laser- or photo coagulation is done, so as to re-build the inner wall of the blood vessels. In both forms a filtering surgery is done.

Closed-angle glaucoma

In this form of glaucoma a laser iridotomy is done. This operation is done without anaesthesia.

Endocyclophotocoagulation

In this procedure the ciliary body is destroyed using heat, so as to lower the IOP. This surgery is usually done under general anaesthesia. This surgery can also be done under local anaesthesia in the doctor's office.

Myrtle oil

In the early stages of glaucoma, a patient can have a drop of myrtle oil. This oil stops the production of fluid in the eyeball. If this doesn't work, further treatments will be discussed with the patient.

How does weed help glaucoma?

Glaucoma is a chronic disease of the eye and, most frequently, it is related to pressure in the eye, meaning that high eye pressure can lead to loss of vision and even blindness in some cases. Using marijuana could be helpful in decreasing this pressure and therefore helping in the treatment of glaucoma. There are many different compounds in marijuana that can be helpful in the treatment of glaucoma. However, one of the more interesting compounds is THC. THC is the primary psychoactive component of marijuana. It is thought that THC can help treat glaucoma by reducing pressure in the eye through the same mechanism that is used to treat glaucoma with eye drops. When someone suffering from glaucoma applies the drops to their eyes, they are absorbing them through the conjunctiva and then are carried through the bloodstream where they act to reduce pressure in the eye. Unfortunately, no references are listed for this assertion.

Is it true that there is no effective treatment for glaucoma?

Yes there is, and even for the advanced form glaucoma. It is the eye's optic nerve which is damaged. The damaging happens slowly. Often, the patient doesn't notice the vision loss for years.

Glaucoma is an asymptomatic disease. In most cases, the patient suffers from some vision loss at the time of first diagnosis. However, the disease usually progresses slowly, and the vision loss is often hard to notice in the first years after the start of the disease.

The reason is that if there is, just a little, vision left, that vision is needed to help with tasks like navigating and reading. You need some vision to notice any vision loss.

This is why the patient often doesn’t notice the vision loss for years. The reason is that if there is, just a little, vision left, that vision is needed to help with tasks like navigating and reading. You need some vision to notice any vision loss.

However, glaucoma is progressive. And in its course, it can result in complete blindness. To understand glaucoma, and in order to treat it properly, it is important to know the three stages of the disease. All of them can be managed with appropriate medicines, but each one requires a different approach. As glaucoma progresses, there is often a progression from one stage to the next.

Can glaucoma be cured?

Glaucoma is a multifactorial disease involving multiple processes leading to loss of retinal ganglion cell (RGC) neurons in the optic nerve head (ONH). The individual roles of the pathophysiological processes that are thought to be important in the disease are incompletely understood. Progression of the disease is heterogeneous and at least partially genetically determined.

Glaucoma is caused by multiple factors. It is not an inherited condition. Glaucoma is a condition that does not kill the cells. The cells die (and, presumably, other aspects of glaucoma are manifestations of a more general problem) because of the condition(s) associated with glaucoma.

Secondly, glaucoma can be viewed as a multifactorial disease in the same way as, for instance, diabetes is multifactorial. In this perspective, it is not that a defective gene causes diabetes, it is that a combination of factors act on a person to make that person susceptible to diabetes. The exact composition of these factors may differ between individuals, but the condition still results in the exact same end state. If there is one assumption that the authors can make about glaucoma, it is that a combination of factors (perhaps even a very small subset of these factors) will be sufficient to cause glaucoma.

A major point of this article is that the authors have not been able to find studies that satisfy them as being 'fair'. The authors feel they have gone to great lengths to try and exclude studies that are considered by them to be under-powered. They consider these types of studies to be insufficiently rigorous. However, it is not always the case that big studies are better than small studies. For example, it can be argued that small sizes can be more focused on questions related to smaller and more homogeneous groups of people. Hence, these results can be more applicable to specific subsets of a population. On the other hand, big studies may find effects that are not of a great enough magnitude to be clinically relevant and hence do not translate to clinical practice.

What is meant by 'translating to clinical practice' is basically a big factor in whether the results of the study have any impact on the treatment of a specific condition. If a cure is found for glaucoma then patients will want this cure, and a large number of individuals with glaucoma will be interested in this treatment.

If an effective glaucoma drug is found then this drug will be made available to clinicians, who then decide whether they want to use the drug in their own clinics.

If glaucoma research makes a significant progress towards a cure, then this will mean that there is a lot more to be done. The researchers will have found something important that they believe could lead to a cure, but they will then need to carry out more research to discover more information, to build on the findings they have discovered.

This process will have to be repeated many times before a cure for glaucoma is actually found.

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