CONTRIBUTED CONTENT — In a healthy eye, nourishing fluids flow through the eye and exit in a continuous stream, but when a person has glaucoma, the fluid is blocked from exiting through its natural channels, which causes a buildup of pressure in the eye.
At Richens Eye Center, we know that over time, this intraocular pressure damages the optic nerve, causing vision loss. Most forms of glaucoma don’t exhibit any symptoms until the patient already has permanent vision damage.
Glaucoma is sneaky, because it’s painless and is usually only detected by a screening or annual eye exam. Like high blood pressure, it becomes more common with age, hence the recommendation that even healthy folks over 65 have an annual eye exam. People with high blood pressure, heart disease, diabetes and a family history of glaucoma are at particular risk.
January is National Glaucoma Awareness Month. Glaucoma is just one reason why regular, thorough eye exams are so critical – especially if you’ve been told you’re at risk for glaucoma. Left uncontrolled, glaucoma can cause severe loss of vision or blindness. It’s the second-leading cause of blindness across all age groups in the United States. Thankfully, glaucoma is a treatable condition.
Eye drops and oral medications
Glaucoma is commonly treated with daily eye drops and/or oral medications. Some patients must use up to three different types of glaucoma medications, which aren’t a cure but are designed to reduce intraocular pressure and slow disease progression. The medications work well with regular monitoring from a qualified eye doctor. These medications must be used for the rest of the patient’s life.
As you might imagine, daily pills and eye drops can become a hassle. Many patients forget them or have issues with arthritis or dexterity in their fingers that make eye drops difficult to use. Copays add up too. Thankfully, these aren’t the only treatments available.
For patients with open-angle glaucoma, an implantable, sustained-release medication called Durysta can eliminate the need for eye drops. After numbing medicine, a tiny needle is used to place the medication. As it slowly dissolves, it relieves intraocular pressure by about 30% for 12 weeks or even longer. Durysta is covered by most insurance plans.
Microstent glaucoma surgery
With minimally invasive glaucoma surgery, pressure can be decreased to help prevent further vision loss. These procedures may reduce or eliminate the need for daily eye drops, but any changes to your medication will be determined by your doctor after surgery.
One type of minimally invasive glaucoma surgery involves the insertion of microscopic devices called microstents. For example, the iSent made by Glaukos is the world’s smallest medical device.
Microstents are inserted at the edge of the iris through a tiny incision and remain in the eye permanently. They reduce intraocular pressure by allowing fluids to access natural drainage channels or bypassing blockages to those channels. As fluids escape the eye, the reduction in pressure may prevent further damage to the optic nerve.
For patients with cataracts, microstents can be inserted during cataract surgery through the same incision with no additional anesthetic needed. This may be welcome news for cataract patients who also have glaucoma.
AB Interno Canaloplasty
Another type of glaucoma surgery is called AB Interno Canaloplasty. This procedure works to restore the eye’s natural fluid outflow. Rather than an implanted device, this procedure is based on the same principle as angioplasty, where a thin tube is used to restore blood flow in an artery.
In AB Interno Canaloplasty, a microcatheter is inserted through a tiny incision and advanced all the way through the eye’s natural drainage canal. Sterile viscoelastic gel is injected to dilate the canal to two or three times its normal size, creating a “flush” designed to help fluids drain properly. The catheter is then removed. Like microstent surgery, AB Interno Canaloplasty can also be performed during cataract surgery.
Great news for glaucoma patients
If you have glaucoma and would like to reduce or eliminate daily eye drops, these minimally invasive procedures are available from our experienced surgeons at Richens Eye Center. We can assess your condition and determine if glaucoma surgery is right for you.
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