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What is the treatment for glaucoma?


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Answered 2007-06-23 22:07:17

Three types of treatments are available for Galucoma: 1) medication -- eye drops and pills, 2) laser procedures and 3) incisional surgery. Medications. The four main families of medications are: beta blockers (Timoptic, Betoptic), carbonic anhydrase inhibitors (Trusopt, Azopt), alpha agonists (Alphagan, Iopidine) and prostaglandin (Xalatan). The first three types of medications decrease production of fluid in the eye, while prostaglandin helps fluid leave the eye through a different pathway located at the back of the eye. Laser procedures. An argon laser may be used to perform a procedure called a trabeculoplasty. The laser is focused into the meshwork where it alters cells there to let aqueous fluid leave the eye more efficiently. It is a painless procedure, taking 10-20 minutes, in a doctor's office or outpatient facility. According to the Glaucoma Foundation, nearly 80% of patients respond well enough to the procedure to delay or avoid further surgery. Some patients can eventually discontinue glaucoma medication. However, pressure increases again in more than half of all patients within two years after laser surgery, according to the National Eye Institute. A laser is also sometimes used to make a small hole in the colored part of the eye (the iris) to allow the aqueous fluid to flow more freely within in the eye. Incisional surgery. Open, incisional surgery may be performed if medication and initial laser treatments are unsuccessful in reducing pressure within the eye. One type of surgery, a trabeculectomy, creates an opening in the wall of the eye so that aqueous humor can drain. If it performed under local anesthetic as an outpatient procedure or may require a brief hospital stay. Most patients can discontinue glaucoma medication after surgery, although 10 to 15% will require additional surgery. About one-third of trabeculectomy patients develop cataracts within five years, according to the Glaucoma Foundation. If the trabeculectomy fails, another type of surgery places a drainage tube into the eye between the cornea and iris. It exits at the junction of the cornea and sclera (the white portion of the eye). The tube drains to a plate that is sewn on the surface of the eye about halfway back. A final -- and infrequently used -- surgical procedure uses a laser or freezing treatment to destroy tissue in the eye that makes aqueous humor Surgery may save remaining vision, but it does not improve sight. Vision may actually be worse following surgery. The key to preserving vision in a glaucoma patient remains early detection. With early detection, the disease can be more easily managed without invasive procedures.

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