Glaucoma

There are two main types of glaucoma:

• The chronic open-angle glaucoma
• The Closed-angle glaucoma

Care and treatment of glaucoma:

Drug treatment:

Although glaucoma can not be cured, it can usually be controlled with medication. Whether you're presenting or not symptoms once the diagnosis of glaucoma posed, medication administration will be needed to reduce intraocular pressure to prevent irreversible damage to the optic nerve.

Various anti-glaucoma are available. They are administered usually in the form of eye drops at a rate varying from one to three infusions per day. Eye drops are most often used are based on prostaglandins, beta-blockers or alpha-adrenergic agonists. These eye drops do not work all the same way: they may reduce the secretion of aqueous humor, while others favor its elimination. They all aim to maintain an intraocular pressure below that which is harmful to the optic nerve. Because glaucoma can not be cured, treatment should be continued throughout life.

It may be wise to combine two complementary mechanisms to eye drops, one reducing the production of aqueous humor and the other is promoting elimination. Some medications are also available in tablet form, with a mechanism of action identical to the local form. However, these tablets are less well tolerated than the drops, their prescription is less common.

Surgical treatment:

Trabeculectomy, the oldest technique is to remove the trabecular meshwork. This procedure is used to derive the aqueous humor from the eye and lower eye pressure as well. During this operation, the surgeon opens the eye, removed the trabecular meshwork, then closes the eye by a few stitches.

This procedure is generally well tolerated. After the operation, a small bleb can form in the upper eyelid, which is sometimes felt to the touch. It is quite normal because it is the reservoir of liquid that leaked out of the eye. After surgery, patients sometimes experience eye discomfort, tearing or real pain. Local care in the form of eyedrops or ointments will be anti-inflammatory drugs prescribed to alleviate the inflammatory response due to manipulation of the eye.

Latest advanced technology, the deep sclerotomy is not to remove a portion of the trabecular meshwork resulting in fewer postoperative complications.

Laser treatment not:

Two techniques are currently available: Argon laser trabeculoplasty (ALT - argon laser Trabeculoplasty) and selective trabeculoplasty (SLT - Selective Laser Trabeculoplasty), which is more recent. However, ALT is increasingly neglected in favor of the SLT. The reason is simple: similar efficacy, SLT delivers 100 times less power in the eye, so it is painless and significantly reduces the risk of complications. In the SLT, a hundred laser impacts are delivered selectively to cells of the pigmented trabecular meshwork, thereby increasing the permeability of the latter, which lowers the pressure inside the eye. The SLT laser is a "cold", that is to say, it does not involve any thermal injury. The treatment is performed in one sitting. As this treatment is not indicated for all glaucoma, your ophthalmologist is the best judge to decide whether this technique for you.

In some cases of glaucoma, a laser iridotomy is performed as a preventive measure to prevent the angle closes completely.

Treatment of acute glaucoma:

This is an emergency! If appropriate treatment is not started soon, the vision may be irreversibly affected.

Laser treatment:

Although the intraocular pressure can usually be reduced with medication, surgery is the only way to cure it. This is the laser iridotomy.

During this procedure, a small opening is made at the base of the iris, under local anesthesia with eye drops, to allow the aqueous humor to drain. Other procedures are available, but the iridotomy can be done in consultation in minutes.

Surgical treatment:

If unable to achieve treatment laser iridotomy, the first surgical technique to consider is the iridectomy. It involves removing a portion of the iris to allow better drainage of aqueous humor. If this does not work, surgery type trabeculectomy could be discussed.

Frequently asked questions:

Is this a serious illness?

This is a serious illness as if it is not treated (lower intraocular pressure), it is a blinding disease.

How do we monitor glaucoma?

It should control the intraocular pressure and visual acuity with your ophthalmologist. It will prescribe more tests exploration of your optic nerve (visual fields may be associated with an analysis of the optic nerve and retinal nerve fiber).