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 Benjamin Eye Institute, 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.
SLT does not rely on medicines. Instead, it uses an advanced laser system to target only 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 to glaucoma treatment 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:
Penetrating glaucoma surgeries listed here are performed in a surgical center in an outpatient setting. They require close postoperative follow up and care.
At the Benjamin Eye Institute in Los Angeles, 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 Humphrey Field Analyzer is a wheelchair accessible, diagnostic tool used to examine 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.
This specialized software allows us to statistically interpret data from the visual field analyzer.
Visual field testing (VFT) and analysis with PeriData software allows Dr. Benjamin to utilize unique statistical methods for analyzing the visual field performance in patients with glaucoma.
Why we use PeriData:
Ocular blood flow analysis records 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.
Why we use Ocular Flow Analyzer:
The Heidelberg Retina Tomograph is an advanced diagnostic tool that can detect glaucoma at its earliest stages: up to eight years earlier than visual fields or photos.
Why we use the Heidelberg Retina Tomograph:
This laser, which is not powerful enough to harm the eye, is first focused on the surface of the optic nerve and captures the image. It is then focused on the layer just below the surface and captures that image. The HRT continues to take images of deeper and deeper layers until the desired depth has been reached. Finally, the instrument takes all these pictures and puts them together to form a three-dimensional image of the entire optic nerve.
