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TypesofGlaucoma TestingforGlaucoma TreatingGlaucoma PatientResources VideosandWebinars Research CatalystforaCure ShafferResearchGrants ApplyforaGrant PublicationsandAbstracts VideosandWebinars GetInvolved WaystoGive FundraiseforGRF Volunteer PlannedGiving Events Glaucoma360 AnnualGala NewHorizonsForum PatientSummit Webinars GRFBlog News ResearchUpdates PersonalStories EnEspañol More… AboutUs Mission&History People GRFAmbassadors Financials Menu LearnaboutGlaucoma WhatisGlaucoma? TypesofGlaucoma TestingforGlaucoma TreatingGlaucoma PatientResources VideosandWebinars Research CatalystforaCure ShafferResearchGrants ApplyforaGrant PublicationsandAbstracts VideosandWebinars GetInvolved WaystoGive FundraiseforGRF Volunteer PlannedGiving Events Glaucoma360 AnnualGala NewHorizonsForum PatientSummit Webinars GRFBlog News ResearchUpdates PersonalStories EnEspañol More… AboutUs Mission&History People GRFAmbassadors Financials TreatingGlaucoma >>enEspañol<< WhatisGlaucoma? TypesofGlaucoma TestingforGlaucoma TreatingGlaucoma PatientResources Videos Menu WhatisGlaucoma? TypesofGlaucoma TestingforGlaucoma TreatingGlaucoma PatientResources Videos Glaucomaistreatedbyloweringintraocularpressure,andthiscanbeachievedwithlasersurgery,medications,conventional(“incisional”)surgery,oracombinationofthese.Treatmentplanscandifferdependingonthetypeofglaucomaandtheindividualpatient.Treatmentoptionsareorganizedbelowbyglaucomatype. TreatmentofPrimaryOpen-AngleGlaucoma SELECTIVELASERTRABECULOPLASTY(SLT)Selectivelasertrabeculoplasty(SLT),oftenafirst-linetreatmentforOpen-AngleGlaucoma,canalsobeeffectiveinpatientsalreadyoneyedrops.SLTuseslowlevelsoflaserlighttoimprovedrainageofintraocularfluidthroughthenaturaldrainagepathwayoutoftheeye.Formosteyesthisimproveddrainagehelpslowereyepressureandasingletreatment’seffectlasts2to3years,andsometimeslonger.SinceSLTleavesthedrainagecanalsintact,itcanberepeatediftheinitialtreatmentwaseffective.Minorself-limitedinflammationfollowsSLTandmayaidintheeyepressureloweringeffect.SomepatientscanhavetheireyepressurecontrolledwithSLTalone.Othersrequireglaucomamedicationsalsoorincisionalsurgeryintheoperatingroom.Whattoexpect:• SLTisperformedinanoutpatientsetting,frequentlyinthedoctor’soffice.• Yourdoctorwillusespecialeyedropstonumbyoureye.Then,yourdoctorwillhaveyousitatthelaserandplaceaspeciallenswithcontactlensgelonyoureyetohelpdirectthelaserlightontothedrainagecanalsinyoureye.• Youwillhearaseriesofclicksandseebrightlights,likeacameraflash,asyourdoctorperformstheprocedure.Youmayfeelaslighttinglingsensation,buttheprocedureisnearlypainless.• SLTtakesabout5-10minutes.• Attheendofthetreatment,thelensisremovedandyourvisionwillbeblurryuntilthethickcontactlensgelisrinsedoff.• Afterthetreatment,youshouldtakeiteasyforadayandthenreturntoyourdailyroutine.GLAUCOMAMEDICATIONSOpen-AngleGlaucomaisoftentreatedwithmedicationsthateitherhelptheeye’sfluiddrainbetterordecreasetheamountoffluidbeingmade.Medicationsmustbetakendailytokeepeyepressureatasafelevel.Inmostcases,medicationscansafelycontroleyepressureformanyyears.Itisnormalforyourmedicationprescriptionstochangeovertime.Changingmedicationsdoesnotnecessarilymeanthatyourglaucomaisgettingworse.Asyourbodybeginstodevelopatoleranceforamedication,itmayslowlyloseitseffectivenessandmayneedtobereplacedbyastrongerversionofthesamedrugoradifferentmedication.Doctorsoftencanreturntopreviouslyusedmedicationsafteryourbodyhashadachanceto“forget”theoldmedication.Glaucomamedicationsmostcommonlyareintheformofeyedrops.putdropsinyoureyecorrectly.Mostmedicationshavesomesideeffects,includingeffectsonvision,eyecomfort,andsometimesotherpartsofyourbody.Inparticular,olderpeoplewithglaucomashouldlookforchangesinbehaviorormobilitythatmaybeasideeffectofmedications.Ifthesideeffectsareveryuncomfortableorlastawhile,yourdoctormaybeabletoprescribeadifferentmedication.Tomakesureyourglaucomamedicationsarenotinteractingwithothermedicationsyouaretaking,makesuretotellallofyourdoctors,includingyourfamilyphysician,aboutyourglaucomamedicationsandanyotherdrugsyoumaybetaking,includingaspirin,vitaminsandnaturalremedies.Tellyourdoctorsaboutanysideeffectsyoumaybeexperiencingorallergiesyouhave.Thefollowingaresomeofthepossiblesideeffectsofthemainclassesofglaucomamedications:•ProstaglandinAnalogsEyecolorchange,darkeningofeyelidskin,eyelashgrowth,droopyeyelids,sunkeneyes,stinging,eyeredness,anditching•BetaBlockersLowbloodpressure,slowedpulserate,fatigue,shortnessofbreath•AlphaAgonistsBurningorstinging,fatigue,headache,drowsiness,drymouthandnose,allergicreaction•CarbonicAnhydraseInhibitorsIneyedropform—stinging,burning,eyediscomfort;inpillform—tinglinghandsandfeet,fatigue,stomachupset,memoryproblems,frequenturination•RhoKinaseInhibitorsEyeredness,depositsoncornea,stinging,smallbleedsonthewhiteoftheeyeNewTreatmentsontheHorizonNewformsofglaucomadrugdeliveryarebeingdevelopedtoimprovemedicationtreatmentoptions.Oneareaofinterestis“sustained-release”medication.Sustained-releasemedicationevenlyreleasesadrugoveralongertime.Inthisway,medicationscanbeusedweekly,monthly,oratevenlongerintervals.Thiswouldmaketheprocessoftakingmedicationsmoreconvenientandefficientandpotentiallyreducesideeffects.Therearemanysustained-releaseoptionsbeingresearchedanddeveloped.Inaddition,newclassesofdrugstotreatglaucomaarebeingstudied.Researchersareworkingtofindglaucomamedicationswithfewersideeffects,onesthatcanbetakenlessoften,anddrugsthataremoreresponsivetotheeyeandsomoreeffectiveatloweringeyepressure.INCISIONALSURGERYWhenSLT,glaucomamedications,andothertreatmentsdonotlowereyepressuretothedesiredlevel,yourdoctormayrecommendsomeformofincisionalsurgery.Thissurgeryisdoneinahospitalorsurgerycenter,usingamicroscopeandmicrosurgeryinstruments,andincludesmakingacut(incision)intheeye.Whattoexpect:•Beforesurgerybegins,alocalanestheticalongwithamedicationtohelpyourelaxisgiventopreventyoufromfeelinganydiscomfortduringtheprocedure.•Duringsurgery,thedoctorlooksthroughamicroscopethatisplacedseveralinchesaboveyoureye.•Eyesurgerydoesrequiresomerecoverytime,whichwillvaryaccordingtoyourage,dailyactivities,andotherpersonalfactors.Mostpeoplecanmovearoundandreturntotheirnormalactivitiessoonaftergoinghome,thoughyoumayhavetowearaneyepatchtoprotectyoureye.•Foratleastaweekafterglaucomasurgery,itisadvisabletokeepwateroutoftheeye.Itisalsogoodtotakeabreakfromdriving,reading,bending,andstrenuousexercise.•Glaucomasurgerymayhavetoberepeated,especiallyifexcessivescarringcannotbepreventedorafterlongperiodsoftime.MinimallyInvasiveGlaucomaSurgery(MIGS)MinimallyInvasiveGlaucomaSurgery(MIGS)procedureshavebeendevelopedinrecentyearstotreatpatientsearlierandmoresafelythanconventionalsurgery.Aswithallnewprocedures,multi-yearfollow-upstudiesarerequiredtoseewhichoneswillremainusefullong-term.MIGSproceduresincludemicrosurgicalinstrumentsanddevicesandsmallerincisionsthatmanipulatetheeyetissueslessandthereforereducetheriskofcomplications.Theincreasedsafetyofthesesurgeriesistradedforreducedeffectiveness.MIGSproceduresanddevicesmayworkinanumberofways.Someenhancefluidoutflowwithintheeye’sdrainagesystem,somecarryfluidtotheoutsideoftheeye.SometypesofMIGSproceduresaretobedoneonlywithcataractsurgery,whereasotherMIGSprocedurescanbeperformedindependentofcataractsurgery.Cataractsurgeryalonelowerspressure,andthecombinationofaMIGSsurgeryandcataractsurgerycanlowerpressuremoretohelpreducetheneedformedication.ImplantingaMIGSdeviceaddsafewminutestocataractsurgery.TheMIGSgroupofdevicesandsurgeriesaredividedintocategoriesaccordingtohowtheywork:•Miniaturizedversionsoftrabeculectomy:Intheseprocedures,tinytubesareinsertedintotheeyetohelpdrainfluidfrominsidetheeyetounderneaththeoutermembraneoftheeye(conjunctiva).Forexample,theFDAclearedXENGelStentandthePRESERFLO(formerlyInnFocus)MicroShuntclearedoutsidetheUS.•Trabecularsurgery:Severalproceduresusespecializedinstrumentsanddevicestocutthroughorbypasstheeye’sdrainagecanals(trabecularmeshwork)withoutdamaginganyothertissuesinthedrainagepathway.TheTrabectome,Trab360,andKahookDualBladeproceduresareexamplesofthistypeofsurgery.•Totallyinternalshunts:Usingtinytubeswithverysmallinternalopenings,thefrontoftheeyeisconnectedtothedrainagechannelsoftheeyebypassingthetrabecularmeshworktoimprovethedrainageoffluidfromtheeye.ShuntsmadebyGlaukosandIvantisaredevicescurrentlyinuse. Conventionalsurgeriesforglaucomaincludetrabeculectomyoraqueousshunts(seebelow).Whiletheycanbemoreeffectiveatloweringeyepressureandpreventingprogressionofglaucoma,theyalsohavemorepotentialcomplications.TrabeculectomySurgeryInthisprocedure,atinyopeningismadeinthesclera(thewhitepartoftheeye)withasmallsurgicalinstrument.Thisnewopeningallowstheintraocularfluidtobypassthecloggeddrainagecanalsanddirectlyflowoutofthisnewopening.Specialmedications(“antifibrotics”)maybeusedtopreventscarringandclosureofthenewopening.Theopeningiscoveredbyconjunctivacreatingablebonthesclera.Thisprocedurerequiresstitchesandtherecoveryperiodisusuallyafewweeks.AqueousShuntSurgeryDuringaqueousshuntsurgery,atinytubeisimplantedthatdrainsfluidoutoftheeye.Liketrabeculectomy,thisconventionalsurgeryalsorequiresstitchesandtherecoveryperiodisusuallyafewweeks.UNAPPROVEDTREATMENTSTherearemanyunapprovedtreatmentsthatarepromotedontheinternetandelsewhere,includingmarijuana/cannabidiol(CBD),stemcells,herbalmedicines,andnutritionalsupplements.Thesetreatmentsarenotpartofthestandardofcareinglaucomatreatmentandmaynegativelyimpactyourcurrenttreatment.Youshoulddiscussanyadditionaltreatmentsyouareconsideringwithyourdoctorbeforestartingthem. TreatmentofPrimaryAngle-ClosureGlaucoma TreatmentofAngle-ClosureGlaucomaandeyesatriskforthisdiseaseusuallyinvolvesalaserprocedure,laserperipheraliridotomy,tocreateasmallopeningintheouteredgeoftheiris.IfyouhaveAngle-ClosureGlaucomainoneeye,yourdoctormaytreattheothereyeasasafetymeasure.OthertreatmentsaresimilartothoseforOpen-AngleGlaucomaandincludemedicationstolowereyepressure,trabeculectomyortubeshuntsurgery,and,rarely,SelectiveLaserTrabeculoplasty.Tolearnmoreaboutthesetreatments,seethecorrespondingsectionsforOpen-AngleGlaucomaintheTreatingGlaucomasection(above).CataractsurgeryhasalsobeenshowntohelpinthetreatmentofPrimaryAngle-ClosureGlaucoma.Removingthecataractopenstheangleandusuallyhasafavorableeffectontheeyepressure. TreatmentofOtherTypesofGlaucoma TreatmentofNormal-TensionGlaucomaMostdoctorstreatNormal-TensionGlaucomabyreducingtheeyepressureaslowaspossibleusingmedications,lasertreatments,andsurgery.TreatmentofPigmentaryGlaucomaThetreatmentofPigmentaryGlaucomainvolvesloweringeyepressureusingmedications,lasertreatments,orsurgery.Unfortunately,itisdifficulttoreduceoreliminatethereleaseofirispigment.Therefore,attentionisfocusedonreducingeyepressure.TreatmentofCongenitalGlaucomaBothmedicationandsurgeryareusedtotreatCongenitalGlaucoma.Medicationscanbeintheformofeyedrops,pills,orliquidstobetakenbymouth.Lasersurgeryalsomaybeused.Thesetreatmentshelptoeitherdecreasetheamountoffluidmadeintheeyeorincreasetheamountoffluidoutoftheeyetolowereyepressure.SurgicalproceduresthatareusedtohelpcontroleyepressureinCongenitalGlaucomaincludefilteringsurgery,aqueousshuntsurgery,andgoniosurgery,aspecialprocedurethatopenscanalsinthetrabecularmeshwork.Itissometimesnecessarytorepeatglaucomasurgeryinordertosuccessfullycontroleyepressure. TreatmentofExfoliativeGlaucomaGenerally,thiskindofglaucomaismoredifficulttocontrolwithmedication.PatientswithExfoliativeGlaucomaoftenrequireamoreaggressive,stepwisetreatmentplanandmoreoftenneedlasertreatmentorsurgery.Oftenmorefrequentvisitstotheireyedoctorarenecessarytomonitorfordiseaseprogression.TreatmentofNeovascularGlaucomaTreatmentsforNeovascularGlaucomaofteninvolvedecreasingthegrowthofbloodvessels.Thesetreatmentsincludelasertreatmenttotheretinaandanti-VEGFdrugswhichleadtoregressionofabnormalbloodvesselsintheeye.MedicationsusedforOpen-AngleGlaucomamaybeusedalso,aswellassurgerythatincludestrabeculectomyanddrainageimplantprocedures.TreatmentofUveiticGlaucomaTotreatelevatedeyepressureinUveiticGlaucoma,doctorsusemanyofthesameeyepressure-loweringmedicationsasthoseusedforOpen-AngleGlaucoma.Lasertreatmentstypicallyarenotusedbecausetheycancausemoreinflammation.Incasesthatcannotbecontrolledwithmedication,surgicaltreatmentmayinvolveanaqueousshunt.Inadditiontotreatmentbyaneyedoctor,sometimesarheumatologistwillprescribemedicationtotreattherootcauseoftheinflammation.TreatmentofTraumaticGlaucomaThetreatmentofTraumaticGlaucomavariesdependingonwhenglaucomadevelopsandthetypeofeyeinjury.Whenglaucomaoccursyearsafteraneyeinjury,thetreatmentissimilartoOpen-AngleGlaucomaexceptthatSLTisusuallynoteffective.Whenglaucomadevelopsimmediatelyaftereyeinjury,thetreatmentismainlyguidedbythetypeoftraumaandtheextentofdamagetotheeye. RelatedVideos LASERIRIDOTOMYSELECTIVELASERTRABECULOPLASTY(SLT)CATARACTSINFORMATIONDRYEYETREATMENTOCULARHYPERTENSION Topofpage LearnMore DryEyesandGlaucoma:DoubleTroubles DryEyeSyndromeandglaucomacommonlyoccurtogether. ReadMore>> WhatYouCanDotoManageYourGlaucoma Herearesometipstohelpyoustayontrackwithyourmedicationroutine. ReadMore>> WhenYouHaveCataractsandGlaucoma Patientswithbothcataractsandglaucomarequirespecialconsideration. ReadMore>> EyeDropTips Prescriptioneyedropsforglaucomahelpmaintainthepressureinyoureyeatahealthylevel. ReadMore>> Helpuscureglaucoma.Donatetoday! MoreAboutGRF OurGoals OurMission ConnectingwithOurCommunity CollaborativeResearch LeadershipTeam GRFAmbassadors HowcanWeHelp? 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