Answers provided by Dr. Mitchell Gossman, M.D., ophthalmologist at Eye Associates of Central Minnesota, St. Cloud
I’ve been told that I have glaucoma. How can the pressure be kept under control?
Glaucoma is a disease where loss of vision takes place due to damage to the optic nerve, usually starting in the peripheral vision, and in most cases this is associated with elevated pressure in the eye. In some cases, the pressure is in fact normal, but the patient’s optic nerve is sensitive to even normal pressures. The goal of treatment in all cases is to get the pressure to a safer level. What is a safe level? This depends on the situation, such as the starting pressure, the degree of vision loss that has taken place already, and even the patient’s age.
Pressure can be lowered with eyedrops. The eye is kept pressurized in order to maintain its shape, among other reasons, and this is accomplished by fluid being continuously produce to pressurize the eye. This fluid also exits the eye at the same rate. The pressure can be lowered by decreasing the production of fluid or increasing the outflow of fluid. There are many medications available, and some of these can be used in different combinations.
Laser procedures can be performed in the office or the operating room to decrease fluid production or encourage outflow of fluid as well.
There are some oral medications that can be used also, but usually these are used in the short term.
There are a number of surgical procedures, performed in the operating room, that can lower pressures. Some of these are major eye surgeries, which might be used only if more conservative treatments have failed.
There are many procedures that can be performed at the same time as cataracts surgery, which are called Minimally Invasive Glaucoma Surgery (MIGS for short).
How do you decide which method of lowering pressure is the best?
This can be a complex decision based upon the pressure at that time, how much vision has been lost, and the rate at which vision has been lost. Generally, it’s best to use the most conservative method of lowering pressure, such as eyedrops or lasers, with the fewest side-effects, before performing invasive surgery, unless there’s an imminent threat of rapid loss of vision. Your doctor should discuss the best way based upon the information at hand. The goal is to do everything possible to ensure keeping functional vision for life.
Find Out More
Dr. Mitchell Gossman and Dr. Andrea Joplin, ophthalmologists at Eye Associates of Central Minnesota, can diagnose and treat cataracts. The office is located at 628 Roosevelt Road, Suite 101, in St. Cloud. To make an appointment or to learn more, call 320-774-3789 or email info@eaofcm.com.
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