How is glaucoma treated?

As damage to nerve caused by glaucoma cannot be reversed, the aim of the treatment is to prevent or reduce further damage to the optic nerve. The first step to do that is to lower the eye pressure. The three modalities of treatment are:-
Medical (Eye drops and tablets) Laser treatment Surgery

Medical treatment: –
Your doctor will prescribe you certain medication (Eye drops and tablets) so as to lower your eye pressure. ” You must use the medicines regularly as directed by your ophthalmologist.
You should not stop medicines even if you do not have symptoms.
A regular follow up, as advised by your doctor, is mandatory.

Laser treatment: –
If glaucoma is not controlled with the help of medicines, if the side effects of the medicines are not well tolerated and the patient is non compliant, or cannot afford the cost of the medicines, the second option is LASER TREATMENT. There are various types of lasers that are used in the treatment of glaucoma.

They are: –

YAG Laser Peripheral Iridotomy
A small opening is made in the iris so that the stagnant fluid finds a way to the anterior chamber, the front portion of the eye, and subsequently drained off. This is an OPD procedure, done under local anesthetic drops and takes only a few minutes to be completed. After the laser, you can wash your eye with water and can lead a normal life.

Selective Laser Trabeculoplasty (SLT)
This is a new type of laser, which does not cause any thermal burn in the eye and may be called “COLD LASER”. It stimulates the autoimmune system of the eye to clear the block in the drainage area without damaging the surrounding delicate tissues. SLT is a painless OPD procedure, which takes a few minutes to be completed. One can resume normal activities immediately after the laser. If necessary it can be safely repeated without damaging the eye.

Argon Laser Trabeculoplasty
When applied at the drainage area, the laser causes small burns, which contract to open up the block.

Diode Laser Cycloablation
In this the laser is applied on the area, which produces fluid in the eye. It can be used if the IOP is too high and is intractable.
Your treating doctor will decide which laser is suitable for you.

Operative procedures (Glaucoma Filtering Microsurgery or “By-pass” surgery of eye)
Operation for glaucoma is the only option left for patients in whom the eye pressure is not controlled with medication or laser. It is also the treatment of choice in non-compliant patients, and in infants and children with glaucoma. Filtering microsurgery involves creating a drainage hole with the use of a small surgical tool, to bypass the blockage in the eye’s trabecular meshwork (the eye’s drainage system). This opening helps increase the flow of fluid out of the eye and thereby reduce the eye pressure.