Medical and Laser Therapy          

The treatment of mild to moderate Glaucoma

For many years the standard method for treating mild to moderate glaucoma has been medical therapy. Medications used for glaucoma reduce the intraocular pressure either by helping to open the drainage channels or by decreasing the production of aqueous fluid.
The most effective and commonly used medications include eye drops such as timolol, latanoprost, dorzolamide and brimonidine. Diamox and neptazane, medicines taken orally, are also occasionally used.

In recent years, a form of laser therapy, called SLT, has also found to be very effective both as an initial treatment and as an adjunct therapy.

Laser Therapy

Selective Laser Trabeculoplasty (SLT)

Selective laser trabeculoplasty (SLT) is an outpatient procedure that uses a specific wavelength of laser energy to target the pigmented cells of the trabecular meshwork, which is the site of the major outflow of fluid from the eye. By targeting this tissue the outflow of fluid can be increased, thereby lowering the intraocular pressure. SLT is safe, performed under topical anesthesia, and takes 10-15 minutes to perform. Most patients see a pressure drop within a few days after the procedure and the effects can last for many months to years. The procedure can safely be repeated multiple times. After SLT you will be prescribed a topical non-steroidal drug for 1 week.

Laser Peripheral Iridotomy

Laser peripheral iridotomy (LPI) is an outpatient procedure that focuses laser energy to open an area of the iris, which is the colored portion of the eye. This procedure is used to treat a subtype of glaucoma called narrow angle glaucoma and can help lower pressure by improving the flow of fluid out of the eye. It can also be used to prevent or even treat a complication known as angle closure glaucoma, where the eye pressure becomes acutely elevated to a level that can be very painful and lead to permanent blindness without prompt treatment.

LPI is a low-risk procedure that takes 10-15 minutes to perform under topical anesthesia. The most common side effects are inflammation and bleeding at the site of laser treatment that can lead to mild temporary reduction in vision and eye discomfort, typically for no more than a day or so. After LPI, patients are prescribed a topical steroid for 1 week.

Minimally Invasive Glaucoma Surgery

Over the recent years, there have been a number of developments in the surgical management of glaucoma using minimally invasive techniques that are performed in combination with cataract surgery or as standalone procedures. These devices, such as the iStent and the Hydrus stent, are performed in the operating room under local anesthesia. These implanted devices have a very high safety profile and improve the outflow of aqueous. After implantation, they are effective, in most instances, of reducing intraocular pressure and are often useful in reducing the number of eye drops needed to treat mild to moderate glaucoma.​

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