Unfortunately there is no no curative treatment. Visual acuity lost due to glaucoma cannot be regained. The aim of the treatment is therefore to prevent or SLOW DOWN the subsequent damage. To do this, in many cases, it will be a matter of reducing the pressure inside the eye by improving the circulation of the aqueous humor.

THEophthalmologist, the eye care physician, will establish a treatment plan and monitor vision regularly. Possible interventions include eye drops, oral medications, laser treatment, and, if needed, surgery. In many cases, medication must be taken for life.

If the cause of glaucoma is identifiable, it will be important to treat it. Furthermore, corticosteroid therapy administered to the eyes is contraindicated in people with glaucoma. It is therefore advisable not to start or stop this type of treatment. In some cases, their use cannot be avoided. It is then necessary to obtain a very good follow-up with an ophthalmologist.

For open angle glaucoma

Eye drops (eye drops)

They reduce the pressure in the eye. Drops are prescribed frequently because they cause fewer side effects than medicines taken by mouth.

Several types of eye drops are used. Some of the most common are beta blockers, the alpha-adrenergic agents, the prostaglandin analogues, the carbonic anhydrase inhibitors and miotics. The majority of these drugs work by both reducing the production of aqueous humor in the eye and increasing its excretion.

The side effects vary from one type of gout to another. This could be, for example, a dry mouth, low blood pressure, low heart rate, eye irritation, redness around the eyes, or fatigue. It is best to inform your doctor of any side effects that occur, if any.

It is important to follow the dosage carefully. This treatment is very effective, provided it is followed daily and for life.

Oral medications

If the drops do not sufficiently reduce intraocular pressure, which is rare, oral medication may be prescribed (for example, carbonic anhydrase inhibitors). However, these drugs cause side effects more often and more pronounced than eye drops.

Laser treatment

This intervention, called trabeculoplasty, is more and more common. It may even be offered before the use of eye drops. It can also be done if the glaucoma gets worse despite treatment or if the medication is poorly tolerated.

This laser treatment aims to help the circulation of aqueous humor in the eye. The intervention is painless and quick: it is performed in one or two 2-minute sessions. A laser beam is directed at the trabeculum (see the diagram of the internal structures of the eye above). It is not clear why it decreases the pressure.

Even if a laser procedure is performed, drug treatment (most often eye drops) must still be followed for life.

Classic surgery

This eye surgery is called trabeculectomy. The intervention aims to create a new way of evacuation of the aqueous humor, by removing a small segment of trabeculum. Pipe laying is frequent. The tube directs the aqueous humor into a reservoir behind the eye. About 80% of people who have this surgery no longer need eye drops afterward.

Other types of surgeries are in experimentation. Eventually, they could replace trabeculectomy. However, it will take several more years before we can determine their effectiveness. Examples include Canalostomy, Ex-Press®, Canaloplasty, Gold Implant, Glaukos iStent®, and Trabeculotome.

For narrow-angle glaucoma

Un emergency treatment is required. We use several pharmaceuticals to quickly reduce intraocular pressure.

Once the pressure is lowered, the ideal is to open a passageway through the iris, using a ray at the laser. This intervention is callediridotomie ring road. This treatment allows the flow of aqueous humor, in order to avoid recurrence. Anesthetic drops are first applied to the eye, as is a contact lens (removed after the treatment). After the treatment, anti-inflammatory drops are prescribed and must be applied to the eye for a few days. Other treatments may be needed.

For congenital glaucoma

Only the surgery can correct this type of glaucoma. It is practiced from the first weeks of life.