Glaucoma treatment cannot cure the condition, but it can dramatically slow or temporarily halt its progress. Glaucoma can be treated with either medication or surgery. Both of these treatments are aimed at lowering intraocular pressure (IOP), or pressure within the eye. In the United States, medications are usually the first-line of glaucoma treatment. If this fails, then glaucoma surgery is the next treatment considered.
Glaucoma medications are either oral or topical. Topical medications such as eye drops, eye ointments, or inserts (strips of medication inserted in the corner of the eye) work to reduce IOP either by increasing the outflow of fluid from the eye or by reducing the amount of fluid produced by the eye. To learn more about the condition, examine the risk factors and symptoms of glaucoma. It is important to tell all of your doctors about any glaucoma medications that you are using. In order for these medications to work, you must take them regularly and continuously as they were prescribed.
Topical Glaucoma Medications
There are five types of topical glaucoma medications, each achieving different purposes:
- Miotics increase the outflow of fluid. These include Isopto® Carpine, Ocusert®, Pilocar®, and Pilopine®.
- Epinephrines increase the outflow of fluid. These include Epifrin® and Propine®.
- Beta-blockers reduce the amount of fluid. These include Betagan®, Betimol®, Betoptic®, Ocupress®, Optipranalol®, and Timoptic®.
- Carbonic-anhydrase inhibitors and alpha-adrenergic agonists reduce the amount of fluid present. These include Alphagan®, Iopidine®, and Trusopt®.
- Prostaglandin analogs increase the outflow of fluid through a secondary drainage route. These include Lumigan®, Rescula®, Travatan®, and Xalatan®.
Oral Glaucoma Medications
Your ophthalmologist can also prescribe oral medications to treat glaucoma. Carbonic anhydrase anhibitors are the oral medications most commonly used in the treatment of glaucoma. These include Daranide®, Diamox®, and Neptazane®.
Patients will be started on one medication or a combination of drugs. If a patient does not respond to one type of drug, he or she can be switched to another until all possibilities have been exhausted. Once this happens, the ophthalmologist may recommend glaucoma surgery.
Price of Glaucoma Medications
In the United States, drug therapy is the first line of treatment for glaucoma, before resorting to surgery. The average patient undergoing drug therapy (medicated eye drops) will spend up to $1,750 per year on medications. The purpose of the medications is to reduce the intraocular pressure that ultimately damages the optic nerve. This is accomplished either by reducing the fluid production of the eye or by increasing the outflow of the fluid that is produced.
For patients who still have an elevated IOP after attempting glaucoma treatment through medication, an ophthalmologist may recommend either laser or conventional surgery.
Glaucoma Laser Surgery
There are three types of glaucoma laser surgery that can be performed in the doctor’s office:
Trabeculoplasty uses a laser to burn tissue from the trabecular meshwork, a structure within the eye that controls the flow of fluid. This procedure increases the aqueous outflow in the area surrounding the laser spot, relieving pressure within the eye. Pressure is reduced in 60 to 70 percent of the patients in whom a laser trabeculoplasty is performed. This type of glaucoma laser surgery is used to treat patients with open-angle glaucoma.
Closed-angle glaucoma occurs when the angle between the iris and the cornea in the eye is too small. This causes the iris to block fluid drainage, increasing inner eye pressure. Iridotomy glaucoma laser surgery makes a small hole in the iris, allowing it to fall back from the fluid channel so fluid can drain.
Cyclophotocoagulation uses a laser to burn ciliary tissue, which decreases the production of fluid in the eye. The procedure, performed under local anesthesia, has only recently become available to glaucoma patients to reduce the intraocular pressure. This type of glaucoma laser surgery is used to treat patients who have failed to respond to other types of glaucoma surgery. Many patients will require more than a single treatment. The procedure appears to have significant success and relatively low risk.
Conventional Glaucoma Surgery
If laser surgery fails to lower IOP, the surgeon may recommend conventional glaucoma surgery, known as trabeculectomy or filtering surgery. This is an outpatient procedure involving the removal of a tiny piece of the eye under the eyelid. This conventional glaucoma surgery creates a new drainage path that increases the outflow of fluid from the eye.
Price of Glaucoma Surgery
If drug therapy fails, laser surgery or conventional surgery will be considered. The goal of surgery is to increase the outflow of fluid. In the case of open-angle glaucoma, the trabecular meshwork that drains fluid from a healthy eye is clogged and is either opened or bypassed by surgery. In the case of closed-angle glaucoma, surgery is used to create an opening in the iris, to allow fluid to pass freely from the front to the back of the eye.
The price of glaucoma surgery varies depending on the type of surgery and the area of the country where it is performed. Visit your ophthalmologist for more information about the price of glaucoma surgery.
Locate a Doctor for Glaucoma Treatment
Preventive glaucoma diagnosis, medication, and treatment are crucial to safeguarding your vision against this debilitating condition. DocShop can help you find a glaucoma specialist in your area who is trained in conventional or laser glaucoma surgery.