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Glaucoma treatment options

older man with glaucoma getting eye drops as glaucoma treatment

Once glaucoma is diagnosed, your eye doctor will prescribe one or more methods to reduce your eye pressure (intraocular pressure or IOP). The first type of glaucoma treatment used is typically prescription eye drops. These need to be used daily to keep eye pressure at a normal level. Other possible treatments include oral medication, laser treatment and glaucoma surgery.

Glaucoma eye drops and oral medications

If you have open-angle glaucoma (the most common form), your doctor may prescribe one or more of the following eye drops:

  • Prostaglandins. These drops increase the outflow of aqueous fluid from the eye and typically are used once daily. Brand names (and generic names) include: Lumigan (bimatoprost); Travatan Z (travoprost); Xalatan (latanoprost); and Zioptan (tafluprost).

  • Rho kinase inhibitor. This drop — called Rhopressa (netarsudil) — reduces IOP by increasing aqueous fluid drainage from the eye. Rhopressa is prescribed for once-a-day use.

  • Beta blockers. These slow the production of aqueous in your eye to reduce eye pressure. Examples include Betoptic (betaxolol) and Timoptic (timolol). Depending on your needs, beta blockers may be prescribed for use once or twice daily.

  • Carbonic anhydrase inhibitors. These reduce the production of fluid in the eye. Examples include Azopt (brinzolamide) and Trusopt (dorzolamide). Carbonic anhydrase inhibitors usually are prescribed for use twice a day.

  • Alpha-adrenergic agonists. These can both reduce aqueous production and increase aqueous drainage. Examples include Alphagan P (brimonidine) and Iopidine (apraclonidine). Alpha-adrenergic agonists may be prescribed for use twice or three times a day.

  • Combination eye drops. There also are glaucoma eye drops that are a combination of medicines. If you need more than one medicine to control your eye pressure, this may be a convenient and effective option.

Oral medications (pills) can be prescribed if your eye pressure can’t be controlled with topical (eye drop) medications alone for open-angle glaucoma.

Different medications are used for the acute angle-closure form of narrow-angle glaucoma, which is considered a medical emergency.

SEE RELATED: Common glaucoma medications

Using glaucoma eye drops

Open-angle glaucoma is a chronic condition — meaning it’s likely you may need to use eye drops every day for the rest of your life to prevent vision loss from glaucoma. It’s essential that you take all your glaucoma medication(s) as directed. Being careless and failing to comply with your glaucoma treatment regimen increases your risk of blindness from glaucoma.

If you find that the eye drops you are using for glaucoma are uncomfortable or inconvenient, never discontinue them without first consulting your eye doctor about possible alternative glaucoma treatments.

Side effects of glaucoma medications

Virtually all glaucoma medications have potential side effects. This can range from localized reactions (red, itchy or burning eyes) to more serious effects, including changes to your heart rhythm or blood pressure and other complications.

Be sure to discuss your health with your eye doctor during your consultation for glaucoma treatment, including all medications and dietary or herbal supplements you are taking.

Your doctor can then help you choose the best and safest glaucoma medications for your specific needs.

Glaucoma surgery and other therapies

Sometimes a surgical procedure is the best treatment option to reduce your eye pressure and treat glaucoma. Surgery may be recommended if eye drops and oral medications aren’t controlling your eye pressure well enough.

Minimally-invasive glaucoma surgery (MIGS)

Minimally-invasive glaucoma surgeries (MIGS) are micro-surgery techniques have been developed to reduce or eliminate the need for glaucoma medications. MIGS procedures require only tiny incisions and cause less trauma to the eye than conventional glaucoma surgery. The goal is the same with MIGS and conventional glaucoma surgery: to increase outflow of aqueous humor from the eye to lower IOP and decrease the risk of optic nerve damage and vision loss.

Trabecular and shunt glaucoma surgery

Trabecular and shunt surgeries are more invasive than MIGS procedures, but may be more effective in lowering IOP and reducing the need for glaucoma medications. The goal of these procedures is to create new exit channels for the aqueous humor to drain from the eye more easily.

Laser glaucoma surgery

A commonly used laser surgery for glaucoma treatment is called selective laser trabeculoplasty (SLT). The SLT procedure can be used as a primary treatment for open-angle glaucoma or if medications are ineffective or cause unacceptable side effects.

According to Glaucoma Research Foundation, SLT can lower IOP by about 30 percent when used as initial therapy for open-angle glaucoma, but it may take one to three months for results to appear, and the effect typically lasts one to five years. The treatment can be repeated, but results from a subsequent laser procedure may not be as effective.

SEE RELATED: Different types of glaucoma surgery

Marijuana and CBD

Marijuana and other cannabis-derived substances like CBD are often discussed as glaucoma treatment options.

While marijuana has been proven to lower eye pressure, its effect doesn’t last long enough to be considered a viable treatment for glaucoma. Additionally, early lab testing in mice has suggested that CBD may actually increase eye pressure.

SEE RELATED: Glaucoma and marijuana: Treatment risks and benefits

Can glaucoma be cured?

There is currently no cure for glaucoma. 

However, with timely diagnosis and regular treatment from an eye doctor, glaucoma can usually be successfully managed. Glaucoma treatment can effectively minimize or prevent vision loss in most cases.

The best treatment for glaucoma is prevention — catching the disease before it can cause permanent damage.

Scheduling routine eye exams, even when your vision seems normal, is the number-one method of diagnosing glaucoma early.

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