Glaucoma Management, Surgery & Lasers

Glaucoma is an eye disorder in which the optic nerve suffers damage, permanently damaging vision in the affected eye(s) and progressing to complete blindness if untreated. It is often, but not always, associated with increased pressure of the fluid in the eye (aqueous humour). The term ‘ocular hypertension’ is used for cases having constantly raised intraocular pressure (IOP) without any associated optic nerve damage.

Glaucoma can be divided roughly into two main categories, “open angle” and “closed angle” glaucoma. Closed angle glaucoma can appear suddenly and is often painful; visual loss can progress quickly, but the discomfort often leads patients to seek medical attention before permanent damage occurs. Open angle, chronic glaucoma tends to progress at a slower rate and patients may not notice they have lost vision until the disease has progressed significantly.

Glaucoma has been nicknamed the “silent thief of sight” because the loss of vision normally occurs gradually over a long period of time, and is often only recognized when the disease is quite advanced

Glaucoma Surgery:

Filtering surgery creates a new path through the eye’s tissues to let fluid drain from the eye. In the most common filtering surgery, called a trabeculectomy, the surgeon makes a small opening in the white part of the eye (the sclera) to create a new outflow path. The fluid then flows through the new opening and creates a bleb, which is like a small bubble or reservoir on the surface of the eye. The bleb holds the fluid while it is slowly absorbed into the surrounding tissue. The upper eyelid usually hides the bleb, so it’s not noticeable to you or others.

Drainage implant surgery is sometimes performed when a person is not suited for filtering surgery or when filtering surgery has failed. Depending on the kind of implant used, the surgery is called valve, shunt or seton surgery.
Treating Glaucoma with Laser Surgery:

Some people may need eye surgery to control their glaucoma. Lasers are very useful for treating glaucoma because they avoid cutting and have a lower chance of complications (compared to glaucoma surgery).

Laser procedures for Glaucoma:

  • Laser trabeculoplasty
  • Peripheral iridotomy
  • Laser cyclophotocoagulation