How is Glaucoma treated?
Glaucoma treatment is targetted at controlling the eye's fluid pressure, as a means of slowing the disease's progression. Such treatment does not cure the disease. Most doctors use medications for newly diagnosed glaucoma; however, new research findings show that laser surgery is a safe and effective alternative.
Several medications, in the form of eye drops or pills, are readily available to increase fluid drainage or decrease the eye's production of aqueous humor. Unfortunately, because anti-glaucoma drugs enter the blood system, they can cause various side effects such as headaches and respiratory problems. When such side effects occur, patients should consult with their eye care professional about alternative treatment regimens.
Glaucoma treatment using an argon laser has proved beneficial in preliminary studies. In this form of treatment, a high-energy beam of light is directed onto the trabecular meshwork--part of the anterior chamber's drainage system--and approximately 100 tiny burns are made on its surface. The burns stretch the existing holes in the meshwork for better fluid drainage. Laser surgery, however, may be effective for only a short time and usually is used in conjunction with drops or pills.
Several procedures may be performed to improve drainage flow, such as a trabeculotomy, goniotomy, and trabeculectomy. All of these involve making a small hole in the anterior chamber through which fluid can leave the eye. Although these procedures have a fairly high success rate, they are generally reserved until medical therapy is no longer effective.
In traditional glaucoma treatments, eye drops or other medications are used to lower intraocular pressure by increasing drainage from the eye or by decreasing fluid production.
With SLT, a specially designed laser is used to apply short pulses of low energy to stimulate and rejuvenate the body's own tissue and cells to increase eye drainage and lower pressure.
Manufactured by Glaukos, the iStent treats patients with open-angle glaucoma; or elevated intraocular pressure (IOP), inside the eye The iStent lowers IOP by improving the outflow between the anterior chamber and the Schlemm's canal in the eye.
National Eye Institute-supported researchers are now studying the aging eye to define the exact sequence of biochemical events that cause open-angle glaucoma. By so doing, a clearer and more effective strategy can be developed to treat the disease. For example, long-term steroid treatment of ocular inflammation can cause an increase in fluid pressure. To understand this effect better, scientists recently developed a research model to study, step-by-step, how steroids influence intraocular pressure. In another study, these same investigators identified the major steroid-induced protein and cloned its gene. In the future, the researchers will attempt to clarify the biochemical switch regulating these genes and glean greater insight into elevated fluid pressure, a feature common to all glaucomas.
Basic studies are also being conducted to learn more about the mechanisms of aqueous humor inflow and outflow, glaucomatous tissue changes in the optic nerve, and the dynamics of trabecular meshwork cells.
Studies are being conducted to streamline current surgical procedures, improve surgical wound healing, understand the possible role of nutrition in preventing open-angle glaucoma, and improve diagnostic techniques.
Through continued laboratory and clinical research, open-angle glaucoma patients should enjoy an even greater range of treatment options in the future that will help spare them progressive loss of vision.