Laser Procedures for Glaucoma

Author: Khoa D. Hoang, M.D., See Clearly Vision

Currently, there are several types of laser procedures available to treat the various types of glaucoma. Based on the type of glaucoma, a corresponding laser treatment is indicated.

Laser peripheral iridotomy is an effective way to treat a type of glaucoma called Anatomical Narrow Angle. It is a type of glaucoma that can cause patients to experience an angle closure attack. The purpose of the angle is to allow ocular fluid to freely pass from the back of the eye to the front portion of the eye. When the angle is narrow, fluid builds up and will cause the angle to completely close. These attacks occur rapidly, resulting in ocular redness, pain in and around the eye, decreased vision, a headache that is not alleviated with pain medicine and nausea and vomiting. If not treated in a timely manner, the decreased vision can lead to permanent loss of vision. Occasionally, the attacks are chronic; happening repeatedly over a long period of time. In these situations symptoms are minimal and often times go unnoticed. Symptoms can include minor headaches that occur in dark environments, but are relieved when lights are on.

During an office visit, your eye care professional will assess the angle of your eye by gonioscopy. If the angles are narrow, it may be beneficial for you to undergo an LPI. The purpose of the laser is to allow fluid to have an alternate pathway from the back of the eye. The laser is a short outpatient procedure that can prevent the attacks and therefore preserve the current visual acuity.

Selective laser trabeculoplasty is another way of lowering eye pressure in eyes that have open angles. This type of glaucoma will result in high pressure caused by an overproduction of ocular fluid, or the filtration portion of the eye is working slowly. Traditionally, eye drops have been used as the initial treatment for open-angle glaucoma. Their function is to reduce the amount of fluid being produced, or to increase fluid outflow. If multiple drops don’t maintain an adequate eye pressure, a laser can be used. However, with the advancement of laser technology, selective laser trabeculoplasty is a viable first step for many patients. During the procedure, a laser is used to stimulate the drainage system of the eye thereby lowering eye pressure by reducing the amount of fluid in the eye. It is a great way to control ocular pressure without the use of daily medications and is especially beneficial for patients who have trouble instilling eye drops.

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