I have glaucoma, now what?

Most cases of glaucoma are Primary Open Angle Glaucoma and are not causing any noticeable symptoms to the patient or adversely affecting the patient’s daily visual function.vOur job, along with the patient’s help, is to keep it that way. The only way to keep glaucoma from progressing is to lower the eye pressure or intraocular pressure (IOP).

In the majority of cases, this can be done with daily eye drops or relatively safe laser surgery: Selective Laser Trabeculoplasty (SLT). Between 50-60% of cases can be controlled with “one step.” That is, one treatment of SLT is applied to each eye in lieu of daily eye drops. The other 40-50% require at least “two steps”:vSLT then one type of eye drop, one type of eye drop followed by SLT, or two different types of daily eye drops are necessary to adequately lower the IOP to a safe level.

Upon initial diagnosis, we discuss the pros and cons of starting with SLT versus daily eye drops. After that discussion, some patients decide on drops and others with initial laser.vIf the patient cannot decide, we will make a recommendation depending on her or his particular situation and the patient’s lifestyle. Studies that have researched this dilemma reveal no significant difference in visual acuity or IOP results longterm whichever initial treatment is used.

Given that glaucoma cannot be cured, long term follow-up is essential to ensure that the treatment is adequate and that there isn’t any unnoticed treatment side effects. The only way to ensure adequate treatment are periodic IOP measurements, examination of the optic nerve and drainage angle, and at the very least an annual assessment of your visual field. This requires anywhere from 2-4 eye appointments per year depending on the glaucoma stage and prior treatment response.

If you have questions or concerns regarding your glaucoma treatment, please give our office a call to set up an examination and a review of your current treatment.

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