The first line of glaucoma treatment is eye drops or pills that are designed to reduce intraocular pressure by regulating the production and drainage of fluid in the eye, called aqueous humor. High pressure spikes can damage the optic nerve resulting in irreversible vision loss. When these drops are no longer at sufficient at controling this pressure, your ophthalmologist may recommend more advanced treatment options that vary in invasiveness.
Open Angle/Steroid Responsive Glaucoma:
Open angle glaucoma occurs slowly over time resulting from long term high pressures that go undetected and untreated. It is a painless progression where peripheral vision occurs and is the second leading cause of blindness in the United States.
Closed Angle Glaucoma:
Closed or narrow angle glaucoma occurs very suddenly when the iris moves to block the normal flow of the drainage system of the eye. This causes a sudden buildup of pressure resulting in acute pain and decreased vision.
In acute angle closure glaucoma, the iris blocks the normal flow of eye fluid from the area where it is produced behind the iris to the trabecular meshwork in front of the iris, where the fluid drains from the eye. The treatment for acute angle closure glaucoma is to make a hole in the peripheral iris so the fluid can bypass the areas of blockage. Typically if a drainage hole is made in the iris before acute angle closure happens, it does not cause corneal problems. However, when the drainage hole (called an iridotomy) has to be made after the eye is inflamed from the onset of acute angle closure, there can be secondary decompensation of the cornea either immediately or even years later. This is particularly a problem in Asian eyes, where the space between the iris and cornea is often smaller. Being farsighted (hyperopia) can be a risk factor for this type of glaucoma.