Currently, there is no cure for glaucoma. Treatment of this degenerative disease focuses on keeping the intraocular pressure (IOP) low in order to prevent further damage and harming of the optic nerve. We also focus on helping the optic nerve increase its blood flow (neuroprotection).
Advanced glaucoma treatment at Barossa Eye Clinic falls under four distinct, usually escalating, categories:
Eye drops are the most common form of medication for glaucoma. For most, eye drops are applied one to four times a day on a regular schedule. Five types of eye drops are used in modern ophthalmology:
While these drops are effective, they may not work for everyone. In addition, a strict eye drop regimen may affect one’s quality of life as eye drops need to be taken as often as every six hours. Sometimes these drops may cause an allergic reaction. If your eyes become red and puffy, stop the drops and contact an eye doctor as soon as possible.
Drops can also cause local side effects such as burning, stinging, tearing, itching, or redness in the eye. One example of a common side effect is that beta blocker eye drops, such as Timolol, can lower blood pressure at the same time as they lower intra-ocular pressure. These side effects can be minimized by carefully following instructions for using eye drops, including placing a finger on the inside corner of the eye for two or three minutes to prevent the eye drops from entering the nasal ducts.
At the Barossa Eye Clinic, we perform a variety of glaucoma laser treatments to help our patients manage their condition. These procedures include:
Our in-office Selective Laser Trabeculoplasty (SLT) laser can help rid glaucoma patients of their dependence on a strict eye drop regimen by reducing their ocular pressure. SLT is a safe and simple in-office laser treatment that effectively reduces the pressure in the eye for most patients with glaucoma for a temporary period of time (up to two years). Advanced laser application targets specific cells of the eye—those containing melanin, a natural pigment. This allows for only these cells to be affected, leaving surrounding tissue intact. As a result, your body’s own healing response helps lower the pressure in your eye.
The YAG laser is also used to perform LPI or Laser Peripheral Iridotomy, a procedure for narrow-angle glaucoma treatment. Narrow-angle glaucoma occurs when the angle between the iris and the cornea in the eye is too small. This causes the iris to block fluid drainage, increasing inner eye pressure. LPI makes a small hole in the iris, allowing it to fall back from the fluid channel and helping the fluid drain out of the eye. The laser procedure itself causes little sensation. Side effects, if any, may include transient blurring of vision, mild inflammation, temporary elevation of IOP and, less commonly, minimal bleeding at the treatment site. Eye drops are used immediately prior to treatment and for several days thereafter to control inflammation and minimize IOP rise. The small potential for side effects of laser treatment is far outweighed by the serious consequence of angle closure glaucoma if narrow anterior chamber angles are left untreated.
Endoscopic Cyclo Photocoagulation or ECP, is an exciting new development in the management of most types of glaucoma. ECP is performed on an outpatient basis. The ECP procedure consists of using laser light to cauterize part of the ciliary body, which results in less fluid and lower intra-ocular pressure. This reduces fluid production that in turn, reduces intraocular pressure. Endoscopic Cyclo Photocoagulation (ECP) is often performed on patients at the time of cataract surgery. It can also be performed on those patients who had SLT procedures, glaucoma filtration surgery, or other surgical procedures that were not successful at controlling intra-ocular pressure.
Endoscopic Cyclo Photocoagulation (ECP) is a surgical approach that employs light endoscopy and visualized laser application. The ciliary body (which produces aqueous humour) is viewed by the surgeon through the endoscope in real time. The target tissues are easily and accurately identified utilizing endoscopy. This allows discrete treatment of the targeted ciliary processes with clear laser ablation and minimized trauma to peripheral (non targeted) tissues
Glaucoma surgery includes a number of procedures designed to lower the IOP by improving the outflow of fluid from the eye. These procedures are sometimes performed solo and sometimes in combination with cataract surgery:
At the Barossa Eye Clinic, we use a variety of the latest, most cutting-edge technologies to diagnose glaucoma for our patients.
Visual field testing is an important tool in the diagnosis and management of glaucoma. It is used to:
The Humphreys Visual Field Analyzer is a user friendly, exact diagnostic machine which helps to monitor and record a patient’s visual field. It is the recognized standard of care for early diagnosis and management of ocular diseases resulting in visual field loss.WHY WE USE THE HUMPHREY FIELD ANALYZER:
Ocular blood flow analysis using non-invasive imaging provides valuable information about the dynamics of the eye’s vascular network. With this data, we can detect new cases earlier and improve our ability to monitor and manage our current glaucoma patients – especially from a neuro-protective point of view. Management and detection of other circulatory abnormalities involving diabetes, retinal and carotid disorders.
This device has become our gold standard for measuring structural changes of the optic nerve head and macula area. These highly reproducible accurate measurements help document progression which helps guide our treatment algorithm for each patient individually.