The underlying cause of glaucoma is poorly understood. What we do know is that lowering the intra-ocular pressure (IOP) reduces the rate glaucoma damage in most cases.
IOP can be reduced using either:
1) Eyedrops (Single drop or multiple drops depending on disease severity)
2) Laser (SLT)
3) Surgery- Trabeculectomy
In most cases, glaucoma is controlled with drops alone. Drops can cause irritation and discomfort and may not reduce the IOP to a satisfactory level which would be an indication to use SLT laser.
SLT laser is relatively painless and is done in 2 sittings per eye. It is successful in lowering the IOP in most cases. There are few known side-effects of the laser and is a good option for someone who is struggling with eye drops alone.
Filtering/ Trabeculectomy surgery is reserved for advanced/poorly controlled glaucoma only. A hole is made in the casing of the eye and the eye fluid drains out through the back of the eye to form a filtering bleb on the eye. Trabeculectomy surgery is successful in most cases but is an invasive procedure which can lead to early and late infection in the eye.
What is glaucoma?
Glaucoma is a complex disease of the optic nerve which leads to progressive peripheral visual field loss (tunnel vision)
What causes glaucoma?
There are multiple causes for glaucoma, intra-ocular pressure(IOP) is the only real treatable component of the disease.
How do you monitor glaucoma? Regular IOP measurements, visual field testing and OCT analysis.
How do you treat glaucoma?
The only proven treatment is IOP control. This can be done with eyedrops, laser or surgery depending on the severity of the disease.
What is an iStent?
An iStent is a device which is placed into the angle of the eye at the time of cataract surgery. It’s very useful in treating mild/moderate glaucoma in the setting of cataract surgery. Dr Van Heerden is an experienced user of iSent during combined cataract and glaucoma surgeries and recommends iStent where appropriate.
What is a Trabeculectomy?
Trabeculectomy is “drainage” procedure which is done to lower IOP in moderate to severe glaucoma.