Mr Akash Raj MBBS & MD (AIIMS), MRCS, DRCOphth, FRCS, FRCOphth, PG Dip (Distinction) Consultant Ophthalmologist, Glaucoma specialist and Cataract surgeon, Birmingham, Dudley, Midlands, UK

How to treat Glaucoma/ what are the various Glaucoma treatments?

Every treatment for every type of glaucoma is aimed at reducing the introcular pressure (pressure in the eye) and thereby better managing glaucoma. Glaucoma is an incurable and chronic eye disease, the aim of the treatment is to slow down the rate of progression of glaucoma so that vision could be preserved and risk of blindness could be cut down.

Vision once lost from glaucoma can not be regained. All treatments or operations for glaucoma is aimed at slowing down the rate of progression of glaucoma so that the risk of complete blindness in one's lifetime may be reduced.

Glaucoma can be treated with eye drops, tablets, laser treatment, traditional glaucoma drainage surgery or a combination of these methods. By far the commonest initial treatment is with eye drops, followed by laser treatment and if needed followed by glaucoma drainage surgery. With the availability of more modern and safer laser treatments like Selective Laser Trabeculoplasty (SLT) or Micropulse Diode Laser Trabeculoplasty (MDLT) there is however a recent trend to avail the benefits of initial laser treatment than face many challenges posed by eye drops for many a patients.

Eye Drops: There are various anti-glaucoma eye drops available. They are usually used once a day only to upto four times a day for some. The type prescribed may depend on:

How your condition is progressing
Whether you have other medical conditions
Whether you are taking any other medications
Whether the eye drops cause side effects when you use them

Using eye drops

It is important to use eye drops as directed. Even if you have not yet noticed any problems with your vision, without treatment glaucoma can cause permanent vision loss.

To use eye drops:

laying down on bed or couch may be a better idea
use your finger to gently pull down your lower eyelid
hold the bottle over your eye and allow a single drop to fall into the pocket you have created in your lower lid
try putting the drop at the inner corner of your eye
close your eye and keep it closed for several minutes

If you are using two different types of eye drops, allow at least 30 minutes between using the different types.

Also follow any other advice Mr Raj and his team might have given you.

It is important to take your medications regularly and exactly as prescribed if you are to control your eye pressure. Since eye drops are absorbed into the bloodstream, tell your GP about all medications you are currently taking. Ask your GP and/or pharmacist if the medications you are taking together are safe. Some drugs can be dangerous when mixed with other medications. To minimize absorption into the bloodstream and maximize the amount of drug absorbed in the eye, close your eye for one to two minutes after administering the drops and press your index finger lightly against the inferior nasal corner of your eyelid to close the tear duct which drains into the nose. While almost all eye drops may cause an uncomfortable burning or stinging sensation at first, the discomfort should last for only a few seconds.

Tablets/Pills: At times eye drops may not sufficiently control eye pressure, pills may be prescribed in addition to drops. These pills, which have more systemic side effects than drops. These medications are usually taken from two to four times daily. It is important to share this information with all your other doctors so they can prescribe medications for you which will not cause potentially dangerous interactions.

Laser treatments for Glaucoma: Micropulse Diode Laser Trabeculoplasty (MDLT), Selective laser trabeculoplasty (SLT), Yag laser iridotomy, Cyclodiode laser treatment

Glaucoma drainage surgery: Minimally invasive glaucoma surgery (iStents), Trabeculectomy, Glaucoma tube implantation surgery

Video on how to put eye drops:http://www.youtube.com/watch?v=KJjxRxoU8V0

http://www.youtube.com/watch?v=8VcFa0VcJg0

http://www.nhs.uk/Conditions/Glaucoma/Pages/Treatment.aspx

http://www.glaucomafoundation.org/treating_glaucoma.htm