Glaucoma is a chronic disease that requires life-long treatment and monitoring. Although there is no cure for glaucoma, it can be adequately managed with medication, laser or surgical treatment most of the time. 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 MEDICATION
There are different types of medication in glaucoma treatment. They reduce eye pressure by reducing the fluid production in the eye, or increasing the fluid drainage. Eyedrops are most commonly used and can be used long-term. They need to be instilled daily. Oral or intravenous medication are usually used for a short period of time to quickly lower the eye pressure.
2 / LASER TREATMENT
There are different types of laser treatment used in glaucoma.
Selective laser trabeculoplasty (SLT) causes changes in the drainage pathway and increases the fluid drainage in eyes with open angle glaucoma.
Laser peripheral iridotomy (LPI) can widen the drainage angles in eyes with narrow or closed angles to facilitate fluid drainage.
Transscleral cyclophotocoagulation (TCP) and micropulse transscleral cyclophotocoagulation (MPTCP) can reduce fluid production and increase fluid drainage in the eye.
3 / Conventional glaucoma surgery
Trabeculectomy creates a new drainage channel in the white wall (sclera) of the eye, and provides an alternative route for the fluid within the eye to drain out. It is a major eye operation, and may be associated with serious complications. Intensive post-operative care is often required in the first few months.
Glaucoma drainage implant or tube surgery is another type of conventional glaucoma surgery. It involves implanting a drainage device to lower the eye pressure. It is a major eye operation, and may be associated with serious complications.
4 / MINIMALLY INVASIVE GLAUCOMA SURGERY
In recent years, a new group of surgical procedures known as minimally invasive glaucoma surgery (MIGS) have emerged. These procedures involve inserting a microstent or drainage shunt to increase fluid drainage from the eye and lower the eye pressure. Compared with conventional glaucoma surgery, they are less invasive, have a higher safety profile, and allow faster recovery. They can be performed together with cataract surgery, or as a standalone procedure.
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.
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.