Departments

Department of Glaucoma

How is glaucoma treated?

The treatment's goal in patients with glaucoma is to avoid the deterioration of the lesions of the optic nerve, the nerve fibers and the visual field. The main method of treatment for glaucoma is to keep the intraocular pressure low. The medication technology offers many eye drops that can achieve this goal. Research in glaucoma is centered on how to design medication that will achieve increased blood flow in the optic nerve, so that it is better fed, but also medication which will protect the optic nerve (neuroprotection). Today, there already exist some medicines and research tries to increase the number of weapons against glaucoma.

1. MEDICATION
In the form of eye drops, where we can use one type or a combination of more than one eye drops. The doctor decides which treatment is best and whether changes must be made. Some of the medication achieve an increased blood flow in the optic nerve and some others offer neuroprotection. In special cases, pills may be administered for a short period of time for the reduction of pressure. Pills may be administered for a longer period of time to increase the blood flow in the optic nerves. Treatment is given thoughout the patient's lifetime.
In simple ophthalmic hypertonia, no treatment is necessary if there are no alterations in the above examinations and provided pressure does not exceed 25-26. Continuous checking is required though.

2. LASER BEAMS
It is a safe and painless method indicated for some types of glaucoma and usually is complementary to pharmaceutical treatment.

Laser trabeculoplasty (Pic.1) is performed in order to simplify the drainage of the aqueous fluid from the angle between the iris and the cornea. It is performed with the help of a special lens and local anaesthesia with drops. (Pic.2)
In some eyes with anatomical predisposition for acute glaucoma or eyes that already suffer of acute glaucoma, laser iridotomy must be performed as a preventive measure (Pic.3). This procedure also is very simple, it is performed with local anaesthesia and no hospital stay is required.

Pic.1

Pic.2

Pic.3

3. SURGICAL INTERVENTION
It is performed if the previous two therapeutic treatments fail or sooner, if the doctor thinks it is wise. Usually, we operate when the eye's pressure cannot be adjusted with medication and laser and despite treatment, the patient's clinical situation deteriorates. With the surgical intervention the eye’s fluid is drained in the best possible way through an opening that is created.

The goal of the intervention (trabulectomy) is not to reverse the lesions already in place because of the glaucoma. These are irreversible. It neither aims to offer better vision, but it helps a great deal in preventing further progress of the lesions in the visual field and it reduces pressure to levels that are considered low.

Another category of anti-glaucoma interventions which are more and more appreciated in recent years are anti-glaucoma operations where the eyeball is not opened, such as viscocanalostomy and deep sklerectomy.

All of the above surgical operations and laser are performed in the Department of Glaucoma of the Ophthalmological Diagnostic & Surgical Center Hellenic EYESURGERY S.A.