Glaucoma - Treatment Overview
Treatment for glaucoma focuses on preserving eyesight by slowing the damage to the nerve located in the back of the eye (optic nerve). In adults, treatment cannot restore eyesight that has already been lost as a result of glaucoma. But in certain children, some of the damage caused by congenital glaucoma can be reversed.
Most treatment for glaucoma is directed at lowering the pressure in the eyes (intraocular pressure, or IOP). Optic nerve damage can occur at any level of eye pressure, even within the normal range. Lowering the IOP often can help protect the optic nerve from further damage.
Understanding Black Eye -- Symptoms
The signs of a black eye include bruising and swelling of the eyelid and soft tissue around the injured eye, sometimes accompanied by broken blood vessels along the white of the eye, called a subconjunctival hemorrhage. The discoloration starts out deep purple or blue, then may turn green or yellow before disappearing, usually in about a week.
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Treatment options include medicines, laser treatments, and surgery. In the United States, treatment usually begins with medicines. When treatment with medicines does not successfully lower pressure in the eyes, laser or surgery treatments need to be considered. But in some instances it may be appropriate to use laser or surgical treatments first, particularly in moderate to severe cases. Studies indicate that treatment with medicine or surgery are both effective, but the risks and benefits may differ depending on the type of glaucoma, age, race, and other factors.4 If you have glaucoma, ask your doctor about all the possible treatment options and which treatments may be better for your particular condition.
Initial treatment
If you are diagnosed with glaucoma, a target eye pressure for each eye is established. The target is based on the amount of damage to the optic nerve and the pressure in the eyes (intraocular pressure, or IOP) at which the damage occurred. The target eye pressure level is approximately 20% to 30% less than the prior eye pressure. During treatment, the target eye pressure is adjusted as needed to prevent damage to the optic nerve.
If you have high IOP but no other signs of glaucoma, you will need to be checked regularly by an eye specialist (ophthalmologist). If the pressure is high enough, you may be treated with medicines to lower the pressure and prevent vision loss. But the decision to start treatment in the absence of optic nerve damage is a serious one, as it exposes you to the risks and expenses of long-term treatment.
Treatment for open-angle glaucoma may involve medicines (eyedrops) that lower the pressure inside the eye, laser treatment, or other surgery. In the United States, eyedrops that lower the IOP are usually tried first. Decreasing eye pressure in open-angle glaucoma slows the progression of the disease and helps prevent further vision loss. But other treatments (laser or surgery) may sometimes be considered as an initial form of treatment if you have moderate or severe open-angle glaucoma.
Closed-angle glaucoma can be an emergency situation (acute closed-angle glaucoma), because blockage of fluid in the eye causes a sudden increase in pressure, resulting in rapid damage to the optic nerve. Acute closed-angle glaucoma usually causes significant pain in the eye. Acute closed-angle glaucoma needs immediate care, including medications to lower IOP, monitoring of the drainage angle, and often surgery. If it is not treated immediately, blindness can develop rapidly.
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