How is glaucoma treated?

Glaucoma is a common ophthalmic disease primarily characterized by optic nerve damage and visual field loss, usually associated with elevated intraocular pressure. Treatments for glaucoma include:

1. Medication therapy: Drug categories include prostaglandin analogs, beta-blockers, alpha-2 agonists, and carbonic anhydrase inhibitors, some of which reduce aqueous humor production and others increase aqueous humor drainage. During acute glaucoma attacks, medications such as pilocarpine eye drops, timolol eye drops, intravenous mannitol, brinzolamide eye drops, and brinzolamide/brimonidine eye drops may also be used to control intraocular pressure. Oral pressure-lowering medications, such as acetazolamide tablets and betaxolol hydrochloride tablets, may be considered when eye drops are ineffective.

2. Laser therapy: Used for both angle-closure and open-angle glaucoma. Common laser treatments include laser peripheral iridotomy, used to treat angle-closure glaucoma by creating a hole in the iris to increase the aqueous outflow pathway, and laser trabeculoplasty, used to treat open-angle glaucoma by stimulating the trabecular meshwork to improve aqueous drainage.

3. Surgical therapy: When medication and laser treatments fail to effectively control intraocular pressure, surgical intervention may be necessary. Surgical options include trabeculectomy, which creates a new outflow pathway for aqueous humor to lower intraocular pressure; and goniotomy with implantation of a small device to assist aqueous drainage. For patients with coexisting cataracts, combined cataract-glaucoma surgery may be selected. When glaucoma causes optic nerve damage, stem cell therapy may be an option to help preserve optic nerve function.

Treating glaucoma is a long-term process requiring regular follow-up visits by the patient to monitor intraocular pressure and optic nerve condition, and timely adjustment of treatment plans.

For individuals with a family history of glaucoma or other high-risk factors, regular ophthalmic examinations are recommended for early detection and treatment.