One of the main causes of vision loss is glaucoma, an eye disease that gradually damages the optic nerve. The disease causes gradual and silent damage without any noticeable symptoms in the early stages. This is why most people with glaucoma don’t even know they are living with the disease. However, it is a dangerous disease that can lead to vision loss that remains untreated. It is estimated that in India at least 12 million people are affected by glaucoma with around 1.2 million people already blind to the disease. Unfortunately, the vision loss induced by glaucoma is irreversible. The disease itself cannot be cured. However, its progression can be contained and damage avoided if diagnosed and treated in time. Comprehensive eye exams, when done regularly, can help people identify glaucoma in the early stages of development.
UNDERSTANDING AVAILABLE GLAUCOMA TREATMENTS
Over the years, the treatment options available for glaucoma have broadened and include the use of eye drops, oral medications, laser treatments as well as surgery. All treatment modalities have a common goal – that of reducing eye pressure on the optic nerve by allowing drainage of accumulated eye fluid. One of the most important conditions associated with glaucoma is increased eye pressure. This high pressure can be especially bad for a damaged optic nerve and relieving it can help prevent further damage and the resulting vision loss. This is why people diagnosed with glaucoma should have regular eye exams to check their eye pressure and ensure regular treatment.
TREATMENTS MAY COME WITH ADVANTAGES AND DISADVANTAGES
Eye drops and laser therapy are first-line treatments for glaucoma and both may be considered by patients when starting treatment. Surgery is mainly performed when eye drops and lasers do not provide the required benefits. But given the wider basket of treatments available, patients often wonder which line of treatment is right for me. While the decision should be made by the patient after careful consultation with the doctor, you need to effectively understand the pros and cons of several treatments before deciding which one to undergo. Here we detail the available treatment options so that you get a better idea and be better equipped to deal with the problem.
Eye drops
Eye drops are the most commonly prescribed treatment for glaucoma. Some classes of eye drops help access fluid flow from your eye while others reduce the amount of fluid generated in the eye. Both types of drugs serve the same purpose of reducing pressure on your optic nerve.
Eye drops or for that matter any other treatment modality will not cure glaucoma, but it will certainly contain its progression and prevent further damage. It is important to remember that these prescription eye drops should be taken regularly every day without skipping to ensure that they are doing their job effectively. Often, many people tend to forget or often skip their doses. In other cases, they deliberately stop using the drugs because they take the disease lightly. This behavior can be dangerous and cost you your eyesight.
Side effects: While most people tolerate eye drops well, a few may experience side effects such as itching, burning, or redness of the eyes along with headaches or even blurred vision. In some patients, the eye drops may not have the desired reduction in eye pressure. In such cases, the doctor may either add oral medications to your prescription or suggest other treatment options.
Laser treatment
Laser treatment or trabeculoplasty is another first-line treatment that patients can opt for at the start of their treatment or even at a later stage. However, in many cases, patients opt for this when the prescription eye drops do not sufficiently reduce eye pressure or in cases where they cause significant side effects.
The procedure uses laser energy to induce a chemical change in the eye tissue that results in better drainage of eye fluid and reduced optical pressure. Although it will take up to 3 months for results to appear, the effect is likely to last for several years. In fact, laser treatment is found to lower intraocular pressure by about 30% when used as an initial treatment. But for patients who are already taking other medications, the effect may not be so profound. At the same time, when the positive effect wears off after a few years, you may need to repeat the treatment. However, repeated treatments are less likely to work as effectively as the first time, which will eventually require you to resume your medications.
Side effects: In a small number of cases, laser treatment may fail and these patients are then managed with other drugs or lines of treatment. Laser treatment can also be accompanied by some form of swelling, pain, or soreness, but it heals quickly and allows the patient to return to normal life. Speak at length to your ophthalmologist to take a final call on whether you want to use the laser as an initial treatment or not.
Surgery
Surgery is considered the last line of treatment when eye drops, drugs, or laser treatment have not had the required effect. Different types of surgeries are offered today to help glaucoma patients cope with increased eye pressure. A quick procedure, a trabeculectomy involves the creation of a tiny opening in the upper part of the eye allowing excess fluid to drain out. Glaucoma implant surgery, on the other hand, involves inserting a very small tube into the eye to speed up the drainage process.
Minimally invasive glaucoma surgeries are the latest advancement that are much safer. In most cases, minimally invasive glaucoma surgery is combined with cataract surgery to achieve a significant reduction in eye pressure.
However, no matter which line of treatment you choose, you will need to undergo regular eye examinations your entire life to make sure that the treatment is producing the desired effects or that the effects do not wear off.
(This article is written by Nikkhil K Masurkar, Executive Director, ENTOD Pharmaceuticals)
Posted: March 13, 2021 1:30 PM | Updated: March 13, 2021 1:51 p.m.