Glaucoma Treatments Other Than Eye Drops

by Dec 5, 2023

Glaucoma is a chronic eye condition characterized by increased intraocular pressure (IOP) that can lead to optic nerve damage and vision loss if left untreated. Eye drops are typically the first-line treatment for glaucoma, as they can effectively lower IOP and slow down the progression of the disease. However, in some cases, eye drops may not control the condition sufficiently. When this occurs, various alternative interventions can be explored to manage glaucoma effectively. Let’s delve into some options available when eye drops stop working to treat glaucoma.


Additional Eye Drops

If a patient is experiencing an insufficient reduction in IOP despite consistently using glaucoma eye drops, their eye care professional may consider adding additional eye drops to their treatment regimen. Various classes of glaucoma eye drops are available, such as prostaglandin analogs, beta blockers, carbonic anhydrase inhibitors, and alpha-2 agonists. Combining different eye drops with distinct mechanisms of action can help enhance the effectiveness of IOP reduction. However, it’s important to note that adding more eye drops can increase the complexity of the treatment regimen and may require close monitoring for potential side effects.


Laser Treatments

Laser therapy is another option for managing glaucoma when eye drops are no longer sufficient. There are different laser procedures available, including:

Laser trabeculoplasty: This procedure involves using a laser to enhance the drainage of fluid from the eye by improving the function of the trabecular meshwork. It can be performed as selective laser trabeculoplasty (SLT) or argon laser trabeculoplasty (ALT). SLT is typically the preferred option as it is associated with fewer complications and can be repeated if necessary.

Laser peripheral iridotomy: This procedure creates a small hole in the peripheral iris to improve the flow of fluid within the eye, particularly in conditions like narrow-angle glaucoma. It helps to relieve any blockages that may be contributing to increased IOP.

Laser treatments are generally safe and minimally invasive, and they can be effective in lowering IOP. However, the duration of the effects may vary, and patients may require additional treatments or further interventions after some time.


Surgical Interventions

When eye drops and laser treatments fail to control glaucoma adequately, surgical interventions may be recommended. These surgical procedures aim to create alternative pathways for the drainage of fluid from the eye or reduce fluid production effectively. Some surgical options include:

Trabeculectomy: This procedure involves creating a new drainage channel by removing a small portion of the trabecular meshwork and creating a small reservoir-like space under the conjunctiva to collect fluid. This allows fluid to drain out of the eye, reducing IOP.

Glaucoma drainage implants: These are small devices implanted in the eye to provide an alternative route for fluid drainage. They are typically used when trabeculectomy is not feasible or unsuccessful.

Minimally invasive glaucoma surgery (MIGS): MIGS encompasses a range of minimally invasive procedures that aim to enhance the outflow of fluid from the eye or reduce fluid production. These procedures are typically less invasive than traditional surgeries and have a faster recovery time.

Surgical interventions significantly lower IOP and can be highly effective for patients without adequate control with eye drops or laser treatments. However, it’s important to note that surgery carries potential risks, including infection, bleeding, and vision changes and should be thoroughly discussed with an eye care professional.



Dr. Nathan Abraham and the staff of the Abraham Eye Center specialize in cataract surgery, LASIK, PRK, and various corneal surgeries. Call our ophthalmologist in Valencia, CA today at 661-977-7377 or schedule an appointment online if you are interested in learning more about glaucoma. Our eye doctor provides only the highest quality eye care and surgical services amongst eye doctors in the Valencia California area.

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