Stages of Glaucoma Treatment: Part 2

In Part 1 of Stages of Glaucoma Treatment, we covered the first stage of treatment, which is daily eyedrops designed to lower the intraocular pressure. If these eyedrops are ineffective, the following surgical choices are available

1. Trabeculoplasty

One of the structures of the eye is called the trabecular meshwork. It is a spongy tissue near the cornea which drains the aqueous humor (fluid between the cornea and the lens) from the eye. Aqueous humor is not the same as the tears which moisten the eye's surface.

There is a gland behind the iris called the ciliary body which produces the aqueous humor. When the drainage is somehow impaired or slowed, while the ciliary body continues producing more fluid, pressure builds up in the eye, and this is part of glaucoma. That increased pressure can block some of the blood flow to the optic nerve and cause blind spots to develop.

A trabeculoplasty uses a laser to open up the trabecular meshwork a little more, improving fluid drainage. The laser vaporizes tiny pieces of trabecular tissue.

2. Trabectome

A trabectome is a more recently-devised treatment which makes a very small incision in the cornea. A probe is used through that opening to remove a little of the trabecular meshwork, making more space for fluid to drain out of the eye.

3. Trabeculectomy

This is another surgery to increase fluid drainage and is also called filtration surgery. It is performed at the eye's drainage angle – that is, where the white part (sclera) and colored part (iris) connect. A tiny drainage hole is cut and partially covered by a flap of tissue made in the sclera and the conjunctiva (membrane over the sclera). This creates a new drain and allows outgoing fluid to bypass the trabecular meshwork.

If you are over 40 years of age, please visit an experienced eye doctor for a glaucoma screening every two years or so. You should go more often if you have any of the risk factors for glaucoma:

• Diabetes
• Any past eye injury
• African or Hispanic background
• Long-time use of any corticosteroid preparation
• Family history of glaucoma

To find a qualified ophthalmologist in your area, please use the links below.