Dr. Guy Eakin: Today I'm talking about glaucoma, the leading cause of irreversible vision loss and ultimately blindness. In this segment I'd like to talk about medical treatments for glaucoma. The first line of treatment for most cases of glaucoma, except emergency situations, is medication.
Dr. Donald Zack: At this point, the only kind of treatment that's available to patients is lowering eye pressure. Although we know there are other factors, we don't know how to treat them at the moment. So all we can do is lower eye pressure. The main way to lower eye pressure for most people is to use eye drops and there are a whole variety of different kinds of eye drops, but all of them function to lower eye pressure.
Dr. Guy Eakin: Eye drops are frequently prescribed, because they tend to have fewer side effects than pills. Make sure, your doctor is aware of any medical conditions you may have, as well as any other medications, such as vitamins or supplements that you are taking. Your eye doctor will determine the best treatment for you based on your unique situation.
It's important to remember that eye drops are medications, so be sure to let your regular doctor know that you're taking prescription eye drops.
To be effective, glaucoma medications must be used consistently and exactly as prescribed by your doctor. If you have trouble remembering to use your eye drops, consider setting an alarm on your clock or your cell phone as a reminder. Have your doctor show you how to correctly administer the eyedrops. Remember, consistent and correct usage of these drops is the best bet for saving your vision. If medications are not effective, the next option is typically surgery.
For some patients, surgery may actually be the best first choice and for others a combination of medication and surgery may be the most successful.
Dr. Donald Zack: The filtration surgery is probably the most common kind of surgery that's used to lower eye pressure. What's good about it is, it's quite effective and it can lower the eye pressure quite a bit. It's putting a small hole in the front part of the eye that lets some of the fluid in a controlled manner, leave the eye to go out. It's almost like in a bath tub, if the pressure is too high, the water is too high, if you let some of it out; the pressure will go down.
So this is a surgery that's done quite frequently. It's reasonably safe, but like any surgery it does have its complications and it needs to be done very carefully with a lot of follow up.
The surgery is usually done as an outpatient procedure, meaning the patient comes in, in the morning, usually goes home that afternoon, they're usually seen by their ophthalmologists the next day, so the first couple of days they need to take it easy, but within several days afterwards they can resume pretty much normal life conditions, and there are also a number of other more advanced surgical procedures that can also be used to lower eye pressure.
Dr. Guy Eakin: So, two exceptions to the medication first rule are infants with congenital glaucoma, who most always require surgery, and cases of acute closed-angle glaucoma, which generally require immediate surgical treatment.
To learn more about glaucoma, check out the other videos in this series, including glaucoma self-care and lifestyle changes.