Glaucoma

Argon laser trabeculoplasty, or ALT

Argon laser trabeculoplasty, or ALT, is a treatment for open angle glaucoma.

Open angle glaucoma occurs because the pressure in the eye increases. Eye pressure is normally regulated by fluid flow out of the eye. Fluid drains out of the eye from the trabecular meshwork. Overproduction or insufficient drainage causes an imbalance in the eye’s ability to regulate pressure. Most patients with open angle glaucoma must use eye drops daily to lower eye pressure.

ALT is an outpatient procedure.

Using a special lens to aim the laser, your doctor will fire the laser into the drainage area. With each pulse, the laser will open up the drainage system.

Drop Compliance

Open angle glaucoma causes a gradual and irreversible reduction in vision.

Glaucoma affects the inside of the eye at a structure called the optic nerve. Early changes to the optic nerve can only be detected using specialised tests, as early glaucoma does not cause any symptoms of pain or vision loss.

The first line of defence is the regular and timely use of special eye drops that have the effect of lowering eye pressure. The drops work by either reducing the amount of fluid produced, or increasing the fluid outflow.

Your practitioner may prescribe one or more drops to effectively control eye pressure.

It is essential to adhere to the recommended use of the drops in order to minimise sight loss.

Iridotomy

 

Laser Peripheral Iridotomy, or LPU, is a procedure used to lower eye pressure in patients who either have angle closure glaucoma, or are at risk of angle closure.

Using a YAG laser, your doctor will focus the laser at the top of the iris. The laser creates an opening in the iris. The opening allows aqueous fluid to drain out of the eye and therefore lower eye pressure.

In approximately one third of cases, the opening may close. In these cases, retreatment will be required.

A small amount of bleeding from the iris is quite common and usually stops in less than a minute.

Risk Factors

Open angle glaucoma is one of the most common causes of blindness, where the field of vision slowly reduces without warning.

However, some people are at greater risk. The over 60s have a 6-times greater risk. There is a four-to-nine times greater risk if your parent or sibling has the condition. If you are of African or Hispanic descent, there is a six-eight times greater risk compared to Caucasians. The risk also increases if you take high dosage steroids or inhalers, or have diabetes. Even high myopia is a risk factor. Research has shown that patients with thin corneas have a higher risk of glaucoma.

Your practitioner is ideally placed to detect glaucoma. Usually this involves measuring eye pressure, performing a visual fields test in order to take a snap shot of your field of vision, and examining the optic nerve using a special light.

You may be advised to complete a more specialised test, such as OCT, to improve diagnosis.

In addition to drops, treatments such as SLT or trabecular stents may also be advised to lower eye pressure.

SLT

Selective laser trabeculoplasty, or SLT, is a treatment for open angle glaucoma. Open angle glaucoma occurs because the pressure in the eye increases.

Eye pressure is normally regulated by fluid flow out of the eye. Fluid drains out of the eye from the trabecular meshwork.

Overproduction or insufficient drainage causes an imbalance in the eye’s ability to regulate pressure. This results in an increase in eye pressure.

Most patients with open angle glaucoma must use eye drops daily to lower eye pressure.

SLT is an outpatient procedure.

Using a special lens, your doctor will fire the laser into the drainage area. With each pulse, the laser will open up the drainage system. Unlike SLT treatment, conventional argon laser treatments cause thermal damage to the drainage system.

In many cases, SLT treatment may help reduce the need for glaucoma drops.

Trabecular Stent

Raised eye pressure in open angle glaucoma is usually controlled using drops to lower the eye’s pressure. Patient compliance and the ability of drops to lower eye pressure are related to successful glaucoma control.

One option is to have a glaucoma stent inserted – often as a part of routine cataract surgery. The stent is placed at a location where aqueous fluid normally drains out of the eye. The procedure to inset the stent is quick and relatively straight flowered. Once inserted, the stent should increase the outflow of aqueous fluid thereby lowering eye pressure. Stent surgery will not always eliminate the need for eye drops. However, for the majority of people, eye pressure will be reduce to a level where glaucoma drops are no longer required.

The good news is that dry eyes can be treated. 

If you are experiencing problems,

we are only too happy to help so call us and make an appointment.

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