Diseases / Glaucoma

General Guidelines for Treating Glaucoma

Early treatment with medications, surgery, or both can nearly always maintain safe pressure of the aqueous humor,

thus preventing optic nerve damage and blindness. Once glaucoma has destroyed optic nerve fibers, no known treatment can reverse the damage.
Many people, however, have high IOP but no sign of nerve damage, and over 20 years, only about a third of these people will actually develop glaucoma. The drugs used to treat glaucoma have side effects that can be quite severe, and a major study is underway to determine just when or if such drugs should be initiated. If IOP is low or normal but tests report optic nerve damage and peripheral visual loss, doctors should check for other problems, including steroid use, anemia, and previous hemorrhage or severe low blood pressure, before starting any treatment for glaucoma.
Many of the drugs used for glaucoma interact with common medications. The patient should discuss these issues with both the regular physician and ophthalmologist. Most cases of glaucoma can be controlled with a single drug or drug combinations, but some patients may require or select surgery. About 70% of patients require new or extra medications within two years after the start of drug treatment compared to 56% of those who chose laser surgery, so an increasing number of patients are choosing surgery as a first option.