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Glaucoma Treatment and Surgery

The dedicated eye care professionals at Ophthalmology Associates are committed to providing patients who suffer with glaucoma the knowledge and care you need to preserve your vision and maintain your eye health. We offer personalized glaucoma management with a variety of treatment options, including glaucoma surgery, in greater St. Louis.

Glaucoma is a group of eye conditions that damage the optic nerve, often due to increased intraocular pressure (IOP). Glaucoma is a progressive disease that can lead to vision loss and even blindness if left untreated. Early diagnosis and care are essential to preserve vision. At Ophthalmology Associates, we focus on effective glaucoma treatments to help patients in greater St. Louis maintain their eye health.

There are several types of glaucoma, including open-angle glaucoma, narrow-angle glaucoma, and secondary glaucoma. Each type has its own unique characteristics and risk factors.

Primary open-angle glaucoma (POAG) is, by far, the most common type and affects more than three million Americans and almost 60 million people worldwide. In this type of glaucoma, the eye’s drainage system, known as the trabecular meshwork, does not function correctly. This results in a gradual increase in intraocular pressure over time, which can damage the optic nerve and lead to vision loss. When we mention glaucoma without specifying a type, you can assume we are discussing open-angle glaucoma.

Glaucoma is often called the “silent thief of sight” because it typically progresses without noticeable symptoms until significant vision loss occurs. Patients with open-angle glaucoma often do not have any symptoms prior to being diagnosed during an eye exam. Patients with glaucoma that has progressed without diagnosis may notice blind spots or vision loss.

Closed-angle glaucoma has immediate and noticeable symptoms, including eye pain, headaches, nausea, and red eyes. Closed-angle glaucoma, also known as a “glaucoma attack,” is quite rare and should be treated as a medical emergency. 

Glaucoma Treatment Options

Early diagnosis and prompt treatment are essential to managing glaucoma. The type of treatment that is right for you will depend on the type and severity of glaucoma, as well as your overall health and preferences. Our eye doctors will create a treatment plan that is tailored to your needs.

Nonsurgical Treatments for Glaucoma

Nonsurgical treatments may include prescription medications or laser procedures:

  • Medication Management: Prescription eye drops or oral medications can be used to lower intraocular pressure (IOP). These medications work by either reducing the production of aqueous humor (the clear fluid in the eye) or increasing its drainage. Various types of glaucoma medications are available, including beta-blockers, prostaglandin analogs, alpha agonists, and carbonic anhydrase inhibitors.
  • Selective Laser Trabeculoplasty (SLT): SLT is a standard laser procedure used to treat open-angle glaucoma. It works by using a low-energy laser to target specific cells in the trabecular meshwork, which is responsible for draining aqueous humor from the eye. SLT helps improve the outflow of aqueous humor, thus reducing intraocular pressure (IOP).
  • Laser Peripheral Iridotomy (LPI): LPI is used to treat closed-angle glaucoma. It involves creating a small hole in the peripheral iris using a laser. This hole allows the aqueous humor to flow more freely and prevents sudden increases in intraocular pressure that can occur in angle-closure glaucoma.
  • Laser Cyclophotocoagulation (Cycloablation): This laser procedure targets the ciliary body, which produces aqueous humor. By reducing the production of aqueous humor, it can lower IOP intraocular pressure. This option is typically considered in severe cases of glaucoma.

Surgical Treatments for Glaucoma

When nonsurgical treatments fail to control intraocular pressure, surgical intervention may be necessary to manage glaucoma effectively. Our glaucoma surgeons are experienced in different types of glaucoma surgery, including:

  • Trabeculectomy: This is a traditional glaucoma surgery in which the surgeon creates a small channel through which aqueous humor can drain out of the eye. By allowing excess fluid to drain, trabeculectomy can reduce intraocular pressure. 
  • Drainage Implants (Glaucoma Drainage Devices): A drainage implant consists of a small tube (shunt) that is inserted into the anterior chamber of the eye, and a plate that is placed on the outside surface of the eye. The tube helps direct aqueous humor away from the eye, and the plate helps anchor the device in place.  The drainage implant creates an alternative pathway for aqueous humor to exit the eye, bypassing the eye’s natural drainage system, to reduce intraocular pressure. 
  • Minimally Invasive Glaucoma Surgery (MIGS): These innovative procedures are minimally invasive and are often combined with cataract surgery. MIGS aims to reduce intraocular pressure by enhancing the eye’s natural drainage pathways or creating new ones, allowing excess aqueous humor to drain more effectively. They may offer a shorter recovery time than traditional glaucoma surgery. 

If glaucoma surgery is the best choice for you, your eye doctor at Ophthalmology Associates will review your treatment plan and explain all the risks and benefits of surgery. You will be given detailed pre-op instructions that may include discontinuing certain medications prior to surgery. You will also need to arrange for someone to drive you to and from your procedure.

Your eyes will be numbed with anesthetic drops before surgery. The surgical steps and length of the procedure will depend on what type of surgery you are having. Rest assured that your eye doctor will explain the treatment plan, and answer any last-minute questions you may have, prior to surgery. 

Recovery will also depend on what type of procedure you have. Our team will review recovery instructions with you, including how long you should expect recovery to take. We will also review any post-op medications and scheduled follow-up appointments.

What causes glaucoma?

Glaucoma can occur without any known cause. Those over 60, with diabetes, or with a family history of glaucoma may be more likely to be affected by this condition.

Can I prevent glaucoma?

While it’s not always possible to completely prevent glaucoma, there are several steps you can take to reduce your risk and detect it early:

  • Schedule regular eye exams
  • Know your family’s history of glaucoma
  • Wear UV protective glasses when in the sun
  • Maintain a healthy lifestyle with a nutrient-rich diet

Will surgery cure glaucoma?

Glaucoma is often a lifelong condition that requires ongoing management. Glaucoma surgery aims to manage and control glaucoma by reducing intraocular pressure to prevent further optic nerve damage. While surgery can be highly effective in lowering intraocular pressure and slowing the progression of the disease, it may not cure glaucoma. Successful surgery can help preserve your remaining vision and prevent further vision loss, but it’s essential to continue regular follow-up care to monitor and manage the disease.

Can glaucoma surgery improve my vision?

Glaucoma surgery is primarily aimed at preserving the remaining vision and preventing further vision loss. While some patients may experience improved vision, especially if their high intraocular pressure was causing vision problems, the primary goal of surgery is to halt the progression of glaucoma and protect your eyesight.

When is glaucoma surgery necessary?

Surgery for open-angle glaucoma is an option when other treatments, such as eye drops, medications, and laser therapy, fail to effectively control intraocular pressure or when the disease progresses despite these treatments. Attending regular appointments with your eye doctor and discussing any changes in vision will help determine when glaucoma surgery may be right for you.

What does glaucoma Surgery cost?

Most health insurance plans cover glaucoma surgery because it is medically necessary. The total cost of glaucoma treatment, including out-of-pocket costs, will vary depending on the type of procedure and  your individual needs.

Contact Ophthalmology Associates for Glaucoma Treatment

We understand that a glaucoma diagnosis can bring about many emotions, but rest assured that our team is dedicated to caring for your vision. Contact us to learn more about your glaucoma treatment options.

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