Glaucoma Treatment 

Discussing glaucoma treatment in the clinic 

Mr Dean is a glaucoma and cataract specialist and has performed over a thousand laser and hundreds of surgeries for glaucoma. We aim to be with you for the long journey, whilst offering the highest quality service and outcomes. 
When coming to the clinic for the initial first consultation it is best not to drive as we may need to place pupil-dilating drops in your eye to enable a thorough exam. Mr Dean will talk through all eye health and general health questions before examining your eyes. We will also perform a field of vision test, which takes about 7 minutes for each eye. It may appear slightly daunting looking at sim flashing lights in a bowl, but it is usually a straightforward test. 

Eye Drops to treat glaucoma 

The main goal of treatment for ocular hypertension or glaucoma is to lower the pressure in the eyes. Initially, if laser treatment (SLT) is not an option, regular daily eye drops are a very good way to start lowering the pressure. There are four main types of eye drops to lower the pressure. Some increase the drainage of aqueous fluid from the eye to lower the pressure, some decrease the production of the aqueous fluid to lower the pressure. We will discuss options available. Often one drop in both eyes last thing at night is a good first option. 

Laser treatments to treat glaucoma 

Recent studies have shown that selective laser trabeculoplasty (SLT) is an excellent way to lower pressure without the need for drops. This ‘cold’ laser treatment may last for many months or years. It can also be repeated if necessary. 
In angle-closure glaucoma, a YAG laser peripheral iridotomy uses an infrared laser to make a small hole to allow drainage and prevent a future pressure spike. Recently a study has shown that early cataract surgery may indeed be a better option for angle closure. 
Mr Dean will talk you through all options and address any queries you might have. 

Surgery to treat glaucoma 

If medications or laser are unable to control the pressure, or the glaucoma is still progressing – surgery may be the best option. The ultimate glaucoma surgery is a trabeculectomy with Mitomycin C (a medication used at the time of surgery to help it work). This operation creates a small valve in the surface of the eye to allow slow draining of aqueous and a low pressure. 
Other options are cataract surgery, with or without a minimally invasive glaucoma surgery (MIGS) stent implant, or MIGS on its own. In rare and very specific circumstances a glaucoma drainage tube may be used. 
As with drops or laser or any aspect of your glaucoma condition and treatment, Mr Dean will be very happy to talk through all aspects with you. 
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