I recently wrote about the risk factors for glaucoma and the importance of early detection.
This week, I want to address treatment. It is important to remember that treatment can help to save vision, but it cannot restore lost vision.
It is very important to have tests regularly, as recommended by your physician, if you are 60 or older, and sooner if you have risk factors such as being African-American or have a family history of glaucoma.
Many people are familiar with eye drops that are used to treat glaucoma, often in its early stages.
Following is a lost of some of the medications applied through eye drops.
Beta blockers: These medicines reduce the production of some fluid in the eye. Common ones are Betagan, Timoptic, and Betoptic.
Alpha-adrenergic agents: These also reduce the production of eye fluids. Common ones are Lopidine and Alphagan.
Carbonic anhydrates inhibitors: These also reduce the amount of eye fluids. This may also be taken orally. Common ones are Trusopt and Azopt.
Prostaglandin analogue: These increase the outflow of eye fluids. Xalantan and Travantan are common medications of this type. They are often given with medications that reduce the production of the fluids.
Miotics: Increase the outflow of eye fluids. Common ones are Isopto, Carpine and Pilocar.
It is important to remember that these medications may have side effects affecting the eyes and other parts of the body.
They are powerful medicines. It is very important to follow your physician's instructions carefully. If you have more than one medication, keep a chart to make sure that you take each one as scheduled.
Check them off each day as you apply them.
Surgical options
There are several surgical procedures that may help if medications do not work, or if they lose their effectiveness.
Ronald Frenkel of the East Florida Eye Institute in Stuart is a voluntary associate professor of ophthalmology at the Bascom Palmer Eye Institute at the University of Miami School of Medicine. He says there are several procedures that may be tried, often in conjunction with medication.
Also, Dr. Frenkel says because there are different types of glaucoma, the same treatment may have different goals.
Laser surgery: Slightly increases the outflow of fluid from the eye in open-angle glaucoma and eliminates fluid blockage in angle-closure glaucoma. There are different types of laser surgery; your ophthalmologist can discuss which procedure would be appropriate in your case.
Trabeculectomy: If medication and laser surgery do not work, an operation called a trabeculectomy may be performed in a hospital or outpatient surgery center.
The surgeon creates an opening that allows the aqueous humor to flow freely. This results in lower eye pressure.
After surgery, the patient will require antibiotics and anti-inflammatory eye drops to prevent infection and scarring.
Remember, too, that glaucoma surgery may preserve vision, but it cannot restore vision that is already lost.
Dr. Frenkel says that the greatest problem in managing glaucoma is that patients do not use their medications as directed.
"Careful adherence to the prescribed drop regime is one of the most successful ways a glaucoma patient can improve their outcome and reduce their chance of losing sight from the silent thief of sight," he said.
Information for this column comes from several sources.
To get more information, visit the Web site of the Mayo Clinic, www.mayoclinic.com or the Web site of the National Eye Institute at www.nei.nih.gov.
You can contact The Glaucoma Foundation at (800) 452-8266 or www.glaucomafoundation.org.
Note: The Indrio Relay for Life, raising money for the American Cancer Society, will take place April 13-14 at Lakewood Elementary School on Indrio Road. The Fort Pierce Relay, which was recently rained out, will be there as well. Call Veronica Torres for more information at (772) 528-7805.
Shelley Koppel is the former editor of "Today's HealthCare" magazine and a member of the National Association of Science Writers. Send questions by e-mail to skoppel@bellsouth.net.