In the United States, more than three million people are living with glaucoma. When left untreated, this condition is the leading cause of blindness. This condition results in damage to the optic nerve. The most common cause is abnormally high eye pressure. There are several treatment options that can help to alleviate this pressure to protect your optic nerve from damage.
Eyedrops for Glaucoma
After glaucoma diagnosis, the first line of treatment for glaucoma is usually an eyedrop prescribed by your doctor. After thorough testing to get an accurate diagnosis, your physician may choose one or more eyedrops as part of your treatment regimen.
These medications are applied directly to your eye. With screening, your physician will determine the cause of your condition and decide which of these eyedrops is the best choice. The eyedrop options for a glaucoma diagnosis include:
• Prostaglandins: These drops increase how much fluid flows from your eye to alleviate your symptoms and eye pressure. This medicine is typically only used once a day.
• Alpha-adrenergic agonists: These medications increase fluid outflow and decrease fluid production. They are typically administered twice a day.
• Beta blockers: These reduce fluid production. Doctors usually prescribe them twice daily.
• Carbonic anhydrase inhibitors: These work to reduce fluid production. They are used two to three times daily.
• Cholinergic or miotic agents: These medicines increase fluid outflow. Due to the potential for side effects, they are not as commonly prescribed as other medicines. Depending on the cause of your glaucoma, they are used up to four times daily.
• Rho kinase inhibitors: These eyedrops suppress rho kinase enzymes to reduce eye pressure. These enzymes play a role in eye fluid increase, so suppressing them decreases how much eye fluid is present.
Medications for Glaucoma
Eye pressure may not decrease with eyedrops alone. In cases where testing shows that eyedrops are ineffective, your physician may consider oral medication to reduce pressure and help with your symptoms. The most commonly prescribed type is a carbonic anhydrase inhibitor. This drug works by reducing intraocular fluid production. Less fluid in the eye translates to reduced eye pressure and fewer associated symptoms.
Studies from the 1970’s showed promising results from the effects of smoking marijuana. However, since the effects of marijuana are often short-lived, you would need to consume high amounts of marijuana in order to treat your glaucoma 24 hours per day.
Although marijuana does lower the eye pressure which improves comfort levels in glaucoma patients, it also lowers blood pressure. Lower blood pressure could result in reduced blood supply to the optic nerve, which in turn might harm the optic nerve. Therefore it is possible that even though marijuana does lower the eye pressure, its use could conceivably make the vision loss from glaucoma worse! For this reason, marijuana should not be your go-to long term solution to treat glaucoma.
While it’s likely that medical marijuana won’t be recommended for long term use, short term relief may be gained from a physician prescribed medical marijuana treatment plan.
Glaucoma Surgical Treatments
If eyedrops and oral medications are not helping, your doctor may do additional testing and screening to find the appropriate surgery to help with your glaucoma. There are four primary types of surgery that can be considered.
Laser therapy is an option if your glaucoma is the open-angle type. Referred to as laser trabeculoplasty, this procedure is performed in your doctor’s office. They will use a small laser beam to target your eye’s trabecular meshwork to open any clogged channels. This helps to encourage fluid drainage to reduce eye pressure. The full effects of this surgery may take a few weeks to be apparent.
Drainage tubes are another option. For this procedure, the surgeon inserts a small tube into your eye. This shunt works to help excess fluid to drain efficiently so that it cannot accumulate and increase your eye pressure.
Filtering surgery is another procedure. It is also called trabeculectomy. During the surgery, the surgeon opens the eye’s white area (sclera) to take away a piece of the trabecular meshwork. This encourages better fluid drainage to alleviate pressure.
Minimally invasive glaucoma surgery (MIGS) is considered less risky than inserting drainage tubes or performing a trabeculectomy. Like the other surgical options, it too reduces eye pressure. It is often combined with cataract removal surgery.
If you suspect that you have glaucoma, it is important to see an eye doctor right away. With screening and an accurate diagnosis, you can reduce your risk of complications by getting prompt and proper treatment for this condition.