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Glaucoma Glaucoma

Glaucoma Treatment in London

Glaucoma is a disease of the optic nerve, which plays a vital role in good vision. Glaucoma is a top cause of blindness in people over 60, and the damage often results or associated from high pressure in the eyes. Glaucoma usually has no warning signs and gradually affects people, making early diagnosis important. If you experience signs of glaucoma, don't hesitate to reach out to Optimal Vision for a consultation with a skilled glaucoma specialist. Call us on 020 7183 3725 or book your appointment online today.

Diagnosis of glaucoma

The glaucoma specialist doctor will perform a thorough eye exam and review your medical history. They may also recommend several tests such as:

  • Pachymetry for measuring the corneal thickness
  • Visual field test for checking the area of vision loss to evaluate your nerve function.
  • Tonometry for measuring intraocular pressure
  • Gonioscopy for inspection of the drainage angle
  • Imaging tests and dilated eye exam to test for optical nerve damage

Treatment of glaucoma

Damages from glaucoma are irreversible, but regular check-ups and treatments can prevent or slow down vision loss, especially when the diagnosis is in the condition’s early stages.

Glaucoma treatment involves reducing eye pressure, also called intraocular pressure. Depending on the diagnosis, treatment options may include oral medications, prescription eye drops, Glaucoma surgery, laser treatment, or a combination of these treatments. 

Eye drops of glaucoma

Most glaucoma treatments start with prescription eye drops. The eye drops help reduce eye pressure by enhancing fluid drainage from the eyes or reducing the amount of fluid eyes produce.

Depending on how low the eye pressure targeted, the glaucoma consultant may prescribe one of the following eye drops.

  • Prostaglandins

They increase the outflow of eye fluid (aqueous humour), which reduces eye pressure. The medications in this group include travoprost (Travatan ), latanoprost (Xalaran or Monopost), latanoprostene bunod (Vyzulta), tafluprost (Zioptan) and bimatoprost (Lumigan).

The possible side effects are darkening of the iris, stinging in the eyes, mild redness, blurred vision, and darkening of the pigment on the eyelid skin or eyelashes. Prostaglandins require daily usage.

  • Beta-blockers

Beta-blockers reduce fluid production in the eye, decreasing eye pressure. They include betaxolol (Betopic) and timolol (Istalol, Betimol, Timoptic).

The side effects include slow heart rate, fatigue, breathing difficulty, and low blood pressure. Beta-blockers are a class of medication prescribed one to two times daily, depending on the condition.

  • Alpha-adrenergic agonists

These medications reduce aqueous humour production and increase the outflow of eye fluid. Examples include brimonidine (Qoliana, Alphagan) and apraclonidine (lopidine). Some side effect of this group of medication includes high blood pressure, red, swollen, or itchy eyes, fatigue, and dry mouth.

They are usually prescribed for twice-daily use and three-times daily use in some cases.

  • Carbonic anhydrase inhibitors

They reduce fluid production in the eye. The examples are brinzolamide (Azopt) and dorzolamide (Trusopt). Common side effects of this class of medication include frequent urination, metallic taste, and tingling in the toes and fingers.

Doctors prescribe them for two or three times daily use.

  • Rho-kinase inhibitors

These inhibitors reduce eye pressure by suppressing the rho kinase enzymes that control fluid increase. These medications are available as netarsudil (Rhopressa) and are prescribed for single-use daily. Its side effects are eye discomfort, deposits forming in the cornea, and eye redness.

  • Cholinergic or motion agents

They increase fluid outflow from the eye. Examples include pilocarpine (Carpine Isopto). Side effects are possible dim or blurred vision, headache, constriction of the pupils, and eye ache.

Doctors prescribe this class of medication for up to four times use daily. Due to the possible side effects and required frequency of use, most doctors no longer prescribe these medications.

Some of these eye drops get absorbed into the bloodstream, leading to side effects that are unrelated to the eyes. To reduce the risk of absorption, ensure you close your eyes for a minute or two after putting the drops into your eyes. You can also press the sides of your ears, near the nose, lightly to close the tear duct, then wipe out unused drops from the eyelid.

Oral medications of glaucoma

If eyedrops do not reduce your eye pressure to the required level, the doctor may prescribe oral medication. In most cases, doctors prescribe carbonic anhydrase inhibitors. The possible side effects include kidney stones, stomach upset, depression, and tingling in the toes and fingers.

Surgery and other therapies of glaucoma

Treatments for glaucoma also include laser therapy and other surgical procedures. The following are common options for improving fluid drainage in the eye and reducing eye pressure.

  • Laser therapy (SLT laser)

A laser treatment option for glaucoma is Selective Laser Trabeculoplasty. This procedure is painless and short and it helps in treating open-angle glaucoma and is an in-office procedure. The doctor will use a small laser towards the drainage system to increase the flow in the trabecular meshwork. It takes about a few weeks to notice the full effect of this treatment is easy and very effective but may need to be repeated every few years. Many prefer this method rather than daily use of eye drops.

  • Filtering surgery

The surgeon can carry out a trabeculectomy to create an opening in the sclera (the white part of the eye) and remove part of the trabecular meshwork.

  • Drainage tubes

The surgeon will insert a small tube shunt in the eye to remove excess fluid and reduce the pressure in the tube.

  • Minimally invasive glaucoma surgery (MIGS)

MIGS requires less postoperative care and fewer risks than installing a drainage device and trabeculectomy. Several MIGS techniques are available, and the doctor will recommend the right procedure.

After glaucoma surgery, you need to visit the doctor for follow-up examinations. Some people may need additional procedures if the eye pressure rises again or other eye changes occur.

Treatment for acute angle-closure glaucoma

Acute angle-closure glaucoma requires emergency medical care. If you receive a diagnosis of acute angle-closure glaucoma, you will need urgent treatment to reduce eye pressure. The treatment usually includes laser and medications or other surgical treatments.

Your eye doctor may recommend a procedure known as laser peripheral iridotomy to create a small hole in the iris using a laser. The hole allows eye fluid to flow through, reducing eye pressure. Cataract or lens surgery and removal can open the narrow angles and avoid future closure.

Home remedies and lifestyle changes of glaucoma

The following tips will help control high eye pressure or enhance eye health.

  • Eat healthy foods

Eating healthy foods will maintain your health but may not prevent worsening the condition. Different nutrients and vitamins are essential for eye health. These nutrients include antioxidants, selenium, copper, vitamin A, C, and E.

  • Exercise

Exercising regularly may reduce eye pressure in people with open-angle glaucoma. Ensure you talk to your doctor to determine the right exercise program.

  • Reduce caffeine intake

Increased intake of beverages with caffeine can increase eye pressure.

  • Take fluids regularly

Drink moderate amounts of fluids at given periods during the day. Taking a quart or more liquid at once may temporarily increase your eye pressure.

  • Take your prescribed medications

Using prescribed eye drops and other medication increases the chances of successful treatment. If you do not use your eye drops as prescribed, the damage to the optic nerve may worsen.

Alternative medicine of glaucoma

Alternative medicine may improve your overall health but is not proven to effectively treat glaucoma. Ensure you talk to your doctor about the possible risks and benefits of the following.

  • Herbal remedies

Some herbal supplements like bilberry extract claim to treat glaucoma. However, avoid using herbal supplements as a replacement for proven therapies. The effect is not unclear.

  • Relaxation techniques

Stress may induce an attack of acute angle-closure glaucoma. If you have a high risk of this condition, explore healthy ways to manage stress.

How to prepare for your appointment

If you experience symptoms of glaucoma, you will need to schedule an appointment with your doctor. Before your appointment, make a list of the following.

  • Your symptoms and how long you’ve had them
  • All supplements, vitamins, and medications you take, including their doses
  • Any known eye condition or problems
  • Family members diagnosed with glaucoma and the severity of their condition
  • Previous glaucoma testing, if any
  • Questions for the doctor

You can ask your doctor the following questions to understand your condition.

  • What tests do I need for a diagnosis?
  • Are my symptoms consistent with glaucoma?
  • Do I need to avoid certain activities?
  • What treatment approach is suitable
  • What are my alternatives to the primary treatment approach?
  • What self-care measures may alleviate my symptoms?
  • Do I need to see a specialist?
  • How often will I need follow-up visits?
  • How can I manage this condition with other health issues?

What you should expect from the glaucoma doctor

If you see a doctor for possible glaucoma, the glaucoma doctor is likely to ask you the following questions.

  • Do you experience concerning symptoms?
  • Have you experienced vision problems or eye discomfort?
  • Are you using any eye drops?
  • Do you have a family history of eye conditions, including glaucoma?
  • Are you taking any supplements or vitamins?
  • Have you had a diagnosis for any medical condition?

If you experience glaucoma symptoms, visit Optimal Vision today to consult with an experienced glaucoma specialist, or call 020 7183 3725 to schedule the appointment.

Dr Amir Mani - Specialist refractive surgeon

One of the most experienced refractive surgeons in London

Dr Mani has performed more than 20,000 ophthalmic procedures, including LASIK, LASEK, PRK, Femto Cataract, RLE, Lens ICL and Phakic IOL Surgery

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