Glaucoma Surgery

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Glaucoma Surgery


Glaucoma is a disease that damages your eye's optic nerve. It usually happens when fluid builds up in the front part of your eye. That extra fluid increases the pressure in your eye, damaging the optic nerve.

Open-angle glaucoma

This is the most common form of glaucoma. Typically, open-angle glaucoma has no symptoms in its early stages and your vision remains normal. As the optic nerve becomes more damaged, blank spots begin to appear in your field of vision.

Normal-tension glaucoma

In this glaucoma, the eye pressure is normal, but optic nerve damage and loss of vision still occur.

Closed-angle glaucoma

A closed-angle glaucoma attack is a medical emergency and must be treated immediately. Symptoms of an acute attack include:

  • Your vision is suddenly blurry
  • Severe eye pain
  • Headache
  • Nausea and vomit
  • Rainbow-colored rings or halos around lights
Congenital glaucoma

Congenital glaucoma develops in infants and young children and can be inherited. This condition can be devastating, often resulting in blindness if not diagnosed and treated early.

Secondary glaucoma

Secondary glaucoma is glaucoma that results from another eye condition or disease. For example, someone who has had an eye injury, someone who is on long-term steroid therapy or someone who has a tumor may develop secondary glaucoma.

Glaucoma Treatment

How your glaucoma is treated will depend on your specific type of glaucoma, the severity of your disease and how well it responds to treatment.

  • Glaucoma medication

    Medicated eye drops are the most common way to treat glaucoma. These medications lower your eye pressure in one of two ways — either by reducing the amount of fluid created in the eye or by helping this fluid flow out of the eye through the drainage angle.

  • Glaucoma surgery

    In some patients with glaucoma, surgery is recommended. Glaucoma surgery improves the flow of fluid out of the eye, resulting in lower eye pressure.

Laser trabeculoplasty

A surgery called laser trabeculoplasty is often used to treat open-angle glaucoma. There are two types of trabeculoplasty surgery: argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT). During ALT surgery, a laser makes tiny, evenly spaced burns in the trabecular meshwork. The laser does not create new drainage holes, but rather stimulates the drain to work better. SLT uses a newer, lower-energy laser which only treats specific cells in the drainage angle.

Laser iridotomy

Laser iridotomy is recommended for treating people with closed-angle glaucoma and those with very narrow drainage angles. A laser creates a small hole about the size of a pinhead through the iris to improve the flow of aqueous fluid to the drainage angle.

Trabeculectomy

In trabeculectomy, a small flap is made in the sclera (the outer white coating of your eye). A filtration bleb, or reservoir, is created under the conjunctiva. The bleb looks like a bump or blister on the white part of the eye above the iris, but the upper eyelid usually covers it. The aqueous humor can now drain through the flap made in the sclera and collect in the bleb.

Aqueous shunt surgery:

If trabeculectomy cannot be performed, aqueous shunt surgery is usually successful in lowering eye pressure. An aqueous shunt, or glaucoma drainage device, is a small plastic tube or valve connected to a reservoir (a roundish or oval plate). The plate is placed on the outside of the eye beneath the conjunctiva (the thin membrane that covers the white part of your eye). The tube is placed into the eye through a tiny incision and allows aqueous humor to flow through the tube to the plate. The fluid is then absorbed into the blood vessels.

Resources

www.aao.org