May 18, 2022
Contributing Author: Elana Rosenberg, M.D.
Glaucoma is a collection of diseases that irreparably damages the eye’s optic nerve, which is responsible for our visual information from the eyes to the brain. Intraocular pressure (IOP) is often associated with discussions on glaucoma as it is the most important risk factor for disease development, particularly as it is the only modifiable one. Elevated intraocular pressure within the eye is the result of an imbalance between the fluid produced within the eye and the fluid that normally drains out of the eye. Over time, this increased intraocular pressure can damage the optic nerve, leading to characteristic patterns of vision loss or even total blindness. Although there is no cure for glaucoma, early detection and treatment is essential as it can help preserve your visual field, which is the goal of all glaucoma therapies.
First line glaucoma treatments usually include prescription eye drops to help lower the pressure inside the eye. Laser procedures are another way to safely & effectively lower eye pressure, and they can be done either alone or in combination with the use of eye drops, collectively working to further lower the pressure inside the eye depending on disease severity. In the more complex cases of glaucoma, oral medications or surgical interventions may also be necessary.
According to the Glaucoma Research Foundation (GRF), laser treatments are the most prevalent treatment for glaucoma when primary treatment fails. In some cases, laser procedures are the first-line treatment, depending on the type of glaucoma and its severity. Laser treatment for glaucoma works by helping the aqueous fluid in the eye drain and, thus, reducing eye pressure. The procedures can be done in your doctor’s office or at an outpatient surgery center. Your ophthalmologist will determine the right treatment option for you.
Lasers emit a focused beam of light on the area of interest, depending on the type of laser treatment. This laser energy helps remodel the drainage system of the eye allowing for improved outflow.
Laser procedures typically performed in the office and without the need for sedation. The procedure begins with application of a local anesthetic drop to numb the eyes in order to ease the patients discomfort throughout the procedure. Then, your doctor will aim the laser into the eye using a special lens. You may see flashes of bright green or red light during treatment.
Given the fact that glaucoma is generally a bilateral disease process, your doctor will often perform the laser procedures on both eyes, with a few days or weeks in between the treatments.
There are several types of laser treatments for glaucoma. The right treatment plan depends on the form of glaucoma and its severity.
The most common forms of laser treatment for glaucoma include:
Your doctor will advise you on which type of laser treatment is most suitable for you, as well as its risks and benefits, before proceeding with the procedure.
Light sensitivity and soreness are the most common side effects of laser treatment for glaucoma. While not necessary, your doctor may prescribe drops to alleviate any soreness.
According to the National Eye Institute (NEI), recovery from glaucoma treatment is almost immediate. The treatments are relatively quick, and patients can resume normal activities upon the leaving the office. You may experience mild irritation and blurry vision soon after the treatment. Most patients are able to drive themselves home from the procedure. As there is no cure for glaucoma, patients still need to follow-up with an eye care provider after these laser treatments to ensure proper pressure control.
Laser treatment is conducted more often than conventional surgery for glaucoma due to its many benefits, such as lower risk of complications, greater safety profile, and ability to be performed at the doctor’s office as opposed to the hospital.
However, there are also a few risks to laser treatments that must be considered before undergoing the treatment. Some people may experience a short-term spike in eye pressure within one to four hours of the procedures. Your doctor may give you topical hypotensive medications before and after the procedure to prevent/lessen this risk. Furthermore, patients who specifically undergo cyclophotocoagulation laser treatment are at higher risk for persistent inflammation and abnormally low eye pressure.
Other risks of laser treatment for glaucoma include:
In more complex glaucoma cases, treatments can sometimes result in cataract formation. However, the potential benefits of lowering the eye pressure usually outweigh any possible risks.
Although glaucoma laser treatments help to reduce eye pressure, the length of time the eye pressure remains low depends on the type and severity of glaucoma, the laser treatment performed, the patient’s age, race, as well as other factors. If determined to be effective, certain laser procedures (i.e. SLT/cyclophotocoagulation), may be repeated to continuously manage the patient’s glaucoma.
The cost of laser treatment for glaucoma can range from $1,000 to $2,000. In many cases, the insurance will cover a portion to all of this procedure as it is medically necessary. Out of pocket cost will vary from patient to patient depending on the insurance coverage and deductible. You can discuss this further with your doctor and office staff. Laser treatments tend to be less expensive treatment options since they can usually be performed in the ophthalmologist’s office as opposed to hospitals.
Given the fact that glaucoma is not a curable condition, disease progression is still possible in spite of eye drop use and/or laser treatments. In these cases, surgical intervention may be necessary to further lower the eye pressure and better control the disease state. Although glaucoma surgery is not a cure for glaucoma and cannot undo the vision loss from the disease, it can help slow or delay progression of the disease.
According to the National Eye Institute (NEI), the types of glaucoma surgery used to reduce eye pressure include:
Before proceeding with any glaucoma surgery, it is important to carefully consider each one and discuss all options with your care team to ensure you’re having the right treatment.
Here at OOMC, our patient’s well-being is our priority. Our dedicated team of surgeons and staff always makes an effort to create a safe and secure environment where you can easily access care comfortably and confidently.
Contact one of our centers nearest to you for further information.
Corneal Associates of New Jersey
Kremer Eye Center
Ludwick Eye Center
Omni Eye Services
Phillips Eye Center