Glaucoma treatment options include several types of medicated eye drops, laser procedures, and surgical procedures.
Several effective glaucoma treatments can help manage the disease and reduce your risk of vision loss. While there’s no cure for glaucoma, treatment can considerably slow its progression and significantly reduce the likelihood of blindness.
The primary goal of glaucoma treatment is to reduce pressure in your eye. This can be done in different ways, including with medications, laser procedures, and surgery.
The best treatment option for you will depend on your overall health and the health of your eyes.
When you receive a glaucoma diagnosis, a doctor will typically start you on eye drops. Eye drops are generally the first choice because they can help slow the progression of glaucoma and reduce your eye pressure.
While eye drops are definitely the least invasive option, they do require commitment. Depending on your condition, a doctor may prescribe more than one type of eye drop. You’ll need to use these drops at least once a day for the rest of your life in order to prevent disease progression.
Here are the most common types of eye drops for glaucoma.
Potential side effects
Rho kinase inhibitor
Rho kinase inhibitors, such as netarsudil (Rhopressa), lower eye pressure by
Nitric oxide-donating medications, like latanoprostene bunod (Vyzulta), also
Miotic or cholinergic agents
These medications, such as pilocarpine (Salagen), work by constricting the pupil and opening drainage pathways, thus
Side effects of pilocarpine eyedrops can include eyebrow pain and shrinkage of your pupil. But the risk of side effects is much higher when you take these drugs orally.
Beta-blockers such as timolol (Timoptic) decrease fluid production in your eye. You’d typically use these drops once or twice daily. If you have a respiratory condition like asthma or chronic obstructive pulmonary disease (COPD), you might not want to use beta-blockers. Common side effects include eye pain, eye infections, and swollen eyelids.
Laser procedures are another category of glaucoma treatment. They can either be used as initial treatment or when eye drops don’t provide enough pressure reduction.
In this procedure, the surgeon uses a laser to make your eye’s drainage system, known as the trabecular meshwork, perform more effectively and reduce eye pressure. It’s primarily for people with open-angle glaucoma. Potential complications
This type of laser treatment directs laser light to the ciliary body, the part of your eye that produces eye fluid. This helps reduce fluid production and lowers your eye pressure. This treatment is for more serious types of glaucoma or for when other treatment options haven’t worked. Risks may include bleeding (hyphema) and excessively low eye pressure (hypotony).
Laser iridotomy creates a small hole in your iris to improve fluid drainage. This procedure is primarily for people who have or might develop angle-closure glaucoma. Potential risks include eye pain and redness.
There are three main types of surgical procedures for glaucoma.
Trabeculectomy is a surgical procedure in which your ophthalmologist creates a small opening in the white of your eye. This new opening acts as a drainage pathway, helping to reduce intraocular pressure by letting fluid out of your eye.
The main benefits include reducing your eye pressure and slowing the progression of glaucoma. Potential risks include infection and low eye pressure. Recovery time can take up to 8 weeks.
Glaucoma drainage devices
Glaucoma drainage devices (GDDs), or tube shunts, are small, flexible tubes that a surgeon inserts into your eye to increase fluid drainage and reduce eye pressure.
Like all surgical procedures, some risks exist, such as corneal edema or tube failure. But GDDs are beneficial, as they offer a long-term solution for controlling your eye pressure, especially if other treatments have been unsuccessful. The recovery period is about 4–6 weeks.
Microinvasive glaucoma surgery
Microinvasive glaucoma surgery (MIGS) involves implanting tiny fluid diversion devices or surgically creating new fluid pathways to reduce your eye pressure. The main advantage of MIGS is less risk of postsurgical complications and shorter recovery times. Recovery typically takes only a few days to a week.
But the pressure-lowering effect of this procedure might not be as significant as it is with a trabeculectomy or GDDs. As a result, MIGS may not suit everyone, particularly those with severe glaucoma.
Glaucoma is a lifelong disease without a cure. There’s currently no way to repair or reverse any damage to your eyes before starting treatment.
Catching glaucoma early can make a notable difference in outcomes. People with earlier stage glaucoma have more treatment options available to them and can take steps that slow down their vision loss. But people who received a diagnosis later on in the course of their disease still have several options available to them to reduce their risk of vision loss.
That said, there’s still a chance of vision loss, even with regular treatment.
A doctor can help you make a plan to take your prescription medications. And you’ll go in for regular checkups to monitor how well the treatment is working. If a doctor notices disease progression at any point, they can recommend a more effective treatment option.
Glaucoma is a lifelong condition, and there’s no permanent cure. But many treatments are available to slow its progression, reduce symptoms, and help you maintain your vision. These treatments include topical medications, laser procedures, and surgery.