Refractive Surgery is a procedure that restores near, intermediate, and far vision with an implantable lens.

A clear, watery fluid called the aqueous fluid filtrates the blood that fills the chambers of the eye. This is a source of nourishment because it eliminates waste and cleans the eye. The process of the aqueous fluid flowing in and out creates a pressure that is called the intraocular pressure and the inflow versus the outflow of aqueous fluid is measured. When people have glaucoma, the inflow and outflow of this pressure is not working properly and can be categorized as open-angle glaucoma or closed angle glaucoma. With open angle glaucoma, peripheral vision tends to be affected first and if not treated, it can result in a loss of vision.

Glaucoma is a disease that can cause permanent vision loss. The way to prevent glaucoma-related vision loss is early detection. Since glaucoma usually shows no symptoms, patients could lose vision without even knowing anything was wrong. That is why we encourage our patients to attend their annual eye examinations. Since vision lost to glaucoma cannot be restored, glaucoma treatments are aimed at stopping further vision loss. This is usually done by decreasing intraocular pressure (IOP). Elevated IOP, often called ocular hypertension, is the main cause of glaucoma.

There are many different avenues your doctor can take to accomplish this. Prior to your treatment, your doctor will need to determine which method is best for you. Often times, multiple treatment methods are combined. It may take some trial and error to find the most effective treatment for you.

Medications

There are several types of medications used for glaucoma patients. Whichever your doctor chooses will be based on your health and specific type of glaucoma.

Alpha Adrenergic Agonists

This type of medication reduces both fluid productions and increases the outflow of fluid. This means that fluid will no longer build up in your eye, causing elevated IOP.

Brands that use this type of medication include:

• Alphagan®
• Iopidine®
• Propine®

Beta Blockers

This type of medication lowers IOP by reducing the fluid production and decreasing the rate at which the fluid flows into the eye.

Examples of this medication include:

• Betagan®
• Ocupress®
• Betoptic®

Prostaglandin Analogs

This medication reduces eye pressure by increasing the flow of fluid out of the eye.

Examples include:

• Lumigan®
• Zioptan™
• Xalatan®

Laser Surgery

When medication alone is not enough to prevent vision loss, laser surgery can be used. Laser surgery is commonly used to lower eye pressure. However, the length of time that pressure is lowered depends on the age of the patient, the type of glaucoma, and overall health. In a lot of cases, medication may still be necessary after laser surgery to keep IOP at a safe level.  Laser surgery for glaucoma will be performed on an outpatient basis. Your surgeon will numb your eye. Depending on the type of surgery, your surgeon will direct a laser toward the trabecular meshwork, iris, ciliary body and/or retina.

Common laser glaucoma surgeries include:

• Trabeculoplasty
• Laser Peripheral Iridotomy (LPI)
• Scatter Panretinal Photocoagulation

Surgery

Non-laser surgery is also used to treat glaucoma.

Types of glaucoma surgeries include:

• Trabeculectomy
• Peripheral Iridectomy
• Implant Devices