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Glaucoma Treatment

With locations in Bradenton, Sarasota, Ellenton, Sun City Center & Venice, FL

Early detection is the key to stopping the progress of glaucoma. 

Click here or call 1-866-865-2020 for an appointment for a comprehensive eye examination.

There is no cure for glaucoma, however, today’s medications or surgery can control and prevent further vision loss. The appropriate treatment depends upon the type of glaucoma and usually is aimed at lowering the intraocular pressure in the eye. This can be done either by lowering the production of fluid or by increasing the outflow of fluid from the eye. If you are experiencing glaucoma symptoms, we urge you to come in and speak to one of our professionals.

Some of the treatment options are:

  • Topical medication (eye drops)
  • Systemic medication (pills) in cases where rapid reduction in pressure is needed
  • Selective Laser Trabeculoplasty (SLT)
  • Laser Iridotomy (for narrow angles or angle-closure glaucoma)
  • Durysta Implant
  • iStent Inject surgery
  • Hydrus Microstent
  • ECP (Endoscopic CylcoPhotocoagulation) or Diode Laser
  • Goniotomy
  • Omni Procedure
  • XEN Gel Stent surgery
  • Trabeculectomy or filtering surgery
  • Tube Shunt Procedure
  • Diode Micropulse Laser Cyclophotocoagulation

Eye Drops

Glaucoma drops are often the first treatment for lowering the pressure in the eyes because they are very effective as long as they are used as prescribed. Your doctor may even use a combination of drop types to get the best results. Usually, they must be used several times a day so patients need to create a routine schedule that they can keep. We find that patients are using smartphone technology to set alarms to remind them when it is time for their drops. These drops work quite well at keeping the pressure in the eye low but they can be expensive.

Selective Laser Trabeculoplasty (SLT)

For patients who can’t afford eye drops, have difficulty instilling them, have side effects from the drops, or prefer not to use them for various lifestyle reasons, Selective Laser Trabeculoplasty (SLT) may be another option. SLT is a fast, effective, and painless advancement in the treatment of primary open-angle glaucoma. It can reduce the need and expense of eye drop medication that glaucoma patients usually need. The Eye Associates is proud to have been the first practice in Manatee County to offer this advanced treatment to our glaucoma patients.

Dr. Robert Friedman, The Eye Associates’ Fellowship Trained Glaucoma Specialist explains, “SLT is a ‘cold’ laser that works by using a specific wavelength to selectively target pigmented cells clogging the drainage chamber, thereby increasing fluid outflow and lowering the pressure in the eye. Because the short pulse of the laser does not allow time for heat to spread to other cells, SLT does not cause adverse scarring and damage to other tissues the way older laser treatments did.”

SLT is usually performed in a specially equipped laser room at our office, and it only takes about 1 minute. Before the procedure, only drops are needed to numb your eye; no injections or needles are used. The laser applications are made through a slit lamp microscope, similar to the one used for eye examinations. Your doctor will hold up a special lens to your eye as a high-energy beam of light is aimed at the lens and reflected onto the meshwork drainage system at the angle of the eye. You will not feel any pain during the procedure.

To monitor the eye pressure, you will need to plan on coming in for a few follow-up visits. It may take several weeks to see the full pressure-lowering effect of this procedure. Many patients are eventually able to discontinue the use of some or all of their medications if they were using them before the laser.

Laser Iridotomy

Laser Iridotomy is necessary for certain types of narrow angles and angle-closure glaucoma. It is an office-based procedure using topical anesthesia where a laser is used to make a small opening in the iris to help open up the angle. Both eyes are generally done and success is nearly 100%.

Durysta Implant

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The Durysta implant is the first biodegradable medication for Glaucoma that is slowly released in the eye that provides constant medication to the eye to help lower the intraocular pressure associated with Glaucoma. Durysta is introduced into the eye as the patient is sitting at the slit lamp in the office after they have been treated with antibiotics and betadine solution, it is a completely painless in-office procedure. The implant once inserted settles at the bottom of the front part of the eye and will stay there for the next 6 months and many patients can experience the effects from the medication for up to two years.

iStent Inject Surgery

iStent inject comes with two stents and is composed of implant-grade titanium and is 360 μm in length and 230 μm in width with one central inlet and multiple outlets designed to provide multidirectional flow through Schlemm’s canal. The stents are inserted during cataract surgery to help decrease eye pressure in patients with open-angle glaucoma. This allows a permanent internal drain of the fluids to reduce the high pressures in the eye. This treatment is recommended in mild to moderate glaucoma.

Hydrus Microstent

Hydrus Microstent is inserted during cataract surgery to increase the drainage of fluid from the eye reducing interocular pressure.

Click this link for more about Hydrus Microstent

ECP (Endoscopic CylcoPhotocoagulation) or Diode Laser

ECP, sometimes called EndoLaser, is a glaucoma laser procedure that can be done on its own as an outpatient procedure, or in combination with cataract surgery. Instead of focusing on the eye’s drainage system, ECP works by reducing the amount of fluid the eye makes. Using a laser to treat the ciliary body, the pressure in the eye is lowered. ECP is a non-invasive, low-risk procedure, that is relatively easy to perform. It has proven to be effective in treating patients with glaucoma. The earlier pressure is lowered, the more likely patients can avoid possible optic disc damage. Also, another benefit of this laser procedure is that it may allow patients to reduce or eliminate their reliance on expensive eye drops.

Diode laser is another laser technology used to reduce pressure by treating the ciliary body. It is often recommended in the late stages of glaucoma, but some patients are opting for this treatment earlier in the course of their disease.

XEN Gel Stent surgery
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The XEN® Gel Stent is a surgical implant designed to lower high eye pressure in open-angle glaucoma patients where previous surgical treatment has failed and/or medications alone were insufficient (also known as refractory glaucoma).

Click this link for more about XEN Gel Stent

Omni Procedure

The OMNI® Surgical System is indicated for canaloplasty (microcatheterization and transluminal viscodilation of Schlemm’s canal) followed by trabeculotomy (cutting of trabecular meshwork) to reduce intraocular pressure in adult patients with primary open-angle glaucoma.

Trabeculectomy

Trabeculectomy also known as filtering surgery is an outpatient procedure performed under topical anesthesia to create a new drainage channel in the eye. Fluid from inside the eye travels to the tissue lining the outside of the eye forming a little bubble known as a filtering bleb. The body absorbs the fluid and the pressure is reduced. The procedure, which can also be performed at the same time as cataract surgery, is indicated in moderate to severe glaucoma with the goal of lowering the pressure sufficiently to prevent further optic nerve damage and vision loss. Many patients do not need to use glaucoma drops after this procedure.

The Eye Associates is committed to the treatment of glaucoma. A comprehensive eye exam will determine which type of glaucoma you have and the recommended treatment options.

We are also involved with various glaucoma clinical research studies and welcome patients who are interested in advanced and cutting-edge medical and surgical treatment options to contact our office.

Click here or call 1-866-865-2020 for more information on studies or if you’d like to make an appointment for a comprehensive eye examination.