Glaucoma Treatment

Glaucoma is a chronic disease that requires life-long treatment and monitoring. Although there is no cure for glaucoma, it can usually be adequately managed with medication or surgical treatment. The medication available today can treat glaucoma more successfully, requiring fewer individuals to undergo surgery. The aim of glaucoma treatment is to reduce the eye pressure to a safe level, to preserve the remaining vision.

Only a Glaucoma Specialist can establish the adequacy of glaucoma control, and regular follow-up is required to ensure that the glaucoma control is at its optimum.

Glaucoma treatment options include glaucoma medication, laser, surgery or a combination of these treatment options.

1 / GLAUCOMA MEDICATIONS

Glaucoma eyedrops are commonly used, and can be used long-term. They need to be instilled daily as they bring down the eye pressure by reducing the fluid production in the eye, or increasing the fluid drainage from the eye.

2 / LASER TREATMENT

Certain forms of glaucoma, particularly angle-closure glaucoma, can benefit from laser treatment (iridotomy) to open up the angles. Here, a laser is used to create a small opening in the iris (the coloured portion of the eye) to allow fluid to drain. It is a simple out-patient treatment that takes only a few minutes to get done. As a precautionary step, the procedure is done for both eyes.

Selective laser trabeculoplasty can increase the fluid drainage from the eye in those with open angle glaucoma.

Trans-scleral cyclophotocoagulation reduces the fluid production in the eye.

3 / GLAUCOMA SURGERY

When medication is inadequate for glaucoma control, especially for those with advanced glaucoma, surgical treatment may be required. In trabeculectomy with anti-metabolites, a traditional glaucoma surgery, a bypass channel is created to allow fluid to exit the eye in order to lower internal eye pressure. It is a major eye operation, and may be associated with serious complications.

An external glaucoma tube implant involves inserting a tube into the eye, to allow fluid to drain out, hence reducing the eye pressure. It may be recommended for those who have had previous trabeculectomies that failed or who have complex glaucoma conditions. These are major procedures with significant risks and complications, therefore they are mostly recommended for those with uncontrolled glaucoma.

4 / MINIMALLY INVASIVE GLAUCOMA SURGERY

Glaucoma surgical treatments have been developed to help those with mild to moderate glaucoma control their eye pressure. Due to the risks involved with traditional glaucoma surgery, the minimally invasive glaucoma system (MIGS) is a favourable surgical alternative, which involves inserting a small device into the eye to increase fluid drainage. This technique is less invasive, has a higher safety profile with fewer issues, and has a faster recovery period. However, there is a trade-off in the degree of pressure lowering control with increased safety, which is why it is recommended for individuals with mild to moderate glaucoma and not suited for severe cases.

Prevention

Implement simple self-care practices to help prevent or slow down the progression of glaucoma.

1. Regular eye screening and monitoring: Comprehensive eye examinations can aid in the early diagnosis of glaucoma. It is recommended that adults over the age of 45 have their eyes checked regularly for glaucoma.

2. Use eyedrops as directed: The majority of those with glaucoma is given medication to treat the disease. The risk of progressive nerve damage is considerably minimised with the regular use of glaucoma eyedrops.

Determine the Best Possible Treatment With Early Glaucoma Screening

During the early stages of glaucoma, most people have only minor symptoms and are unaware of it until it has progressively developed into its advanced stages. Glaucoma eye screening is extremely important in detecting the condition early and initiating the best possible treatment.

Dr-Annabel-Chew-photo-web-s

Our Glaucoma Specialist
Dr Annabel Chew

Dr Annabel Chew is the Senior Consultant Ophthalmologist at Lang Eye Centre.

She was formerly a Senior Consultant of the Glaucoma Department at the Singapore National Eye Centre (SNEC), and is currently a Visiting Consultant at SNEC. She completed her medical training with the Faculty of Medicine, National University of Singapore (NUS) in 2005. She completed her Ophthalmology residency training in Singapore and was awarded the Ministry of Health Training Award in 2010 for her specialist training. She obtained her Master of Medicine (Ophthalmology) from NUS in 2011, and her specialist accreditation in Ophthalmology. She qualified as a Fellow of the Academy of Medicine, Singapore (FAMS), and a Fellow of the Royal College of Surgeons of Edinburgh, and successfully completed her glaucoma sub-specialty fellowship training at SNEC.

Dr Chew specialises in cataract surgery and the treatment of general ophthalmology conditions including retinal and corneal diseases. She sub-specialises in glaucoma and has experience in managing patients with complex glaucoma. Her clinical interests include glaucoma lasers, trabeculectomy, tube shunt surgery, minimally invasive glaucoma surgery, cataract surgery, and implantation of toric and multifocal lenses for the correction of myopia, astigmatism and presbyopia.

Dr Chew was the Clinical Director of the Primary Eyecare Clinic and Community Eyecare clinic at SNEC. She was also the lead for community eye investigation units in the Regional Eye Service. She was instrumental in setting up the Glaucoma Observation Clinic (GLOC) at SNEC, and had overseen the planning and implementation of GLOC services at SNEC satellite sites.