Glaucoma Treatment | Eye Drops Baltimore

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Glaucoma is a chronic disease; the eye drops only work to prevent progression if taken on a regular and consistent basis
Approximately 60% of patients do not take their glaucoma medications as prescribed or refill them continuously
Telling us accurately about your drop use is what is important to us, a "good patient" is one who can provide truthful information about use and issues with drops; this information can then be used to tailor what works best for the specific patient. All patients miss drops occasionally; perfection is not expected.
Many patients have cycling or "on-off" behavior with eye drops, and are best shortly before their next appointment. This can be very damaging. The intraocular pressure can measure at goal in the office because of recent use, but may well be causing damage between visits when not being used regularly as the pressure rises when the drops wear off. This confuses the doctor as to why the patient may be getting worse when the intraocular pressure appears good on the day of the office visit
Why and when drops are missed will help us choose the best care for you. For example, some patients can fit drops into their schedule better in the AM or the PM. We can also help tailor your schedule to match a specific activity in your routine, such as AM coffee or toothbrushing.

If cost is a reason that drops do not get in regularly; please do not be uncomfortable telling us. Patients may be eligible for benefit packages from the pharmaceutical companies or in some cases, the chosen eye drops can be switched to more affordable ones
If getting the drops into the eye is difficult, please tell us. Consider having a family member help if possible
Glaucoma care is a team approach; preventing more damage only works if the patient keeps up their part at home/in-between visits
If you think the eye drops are causing you side effects, please tell us and we can discuss changing your regimen
Remember to pack your drops when traveling and keep in carry-on baggage
Wait 5 minutes between putting in different eye drops
Close eyes firmly for at least 30 seconds after putting in eye drops

Eye Check

Laser Iridotomy - in the upper part of the iris (colored part of the eye) under the eyelid to treat narrow angles and angle-closure. View Handout.
ALT- uses an argon laser to mechanically open up the drainage spaces in the trabecular meshwork
SLT- uses a frequency-doubled YAG laser to open up the drainage spaces in the trabecular meshwork by using the body's own immune cells to remove the debris in the trabecular meshwork (more info)
Diode cyclophotocoagulation (View Information)-uses a diode laser to reduce the fluid production of the eye; most commonly used in eyes with poor vision

Minimally Invasive Glaucoma Surgery (MIGS)
Trabeculectomy (View Diagram)
Also called filtering surgery
The most common form of surgery for glaucoma, highly successful in routine patients
Outpatient, done under local anesthesia
Creates a new drain out of the wall of the eye under the upper lid, covered by the conjunctiva (skin of the eye), bypassing the existing clogged drainage system
No foreign material is implanted
May not last a lifetime and may need to be supplemented with eye drops or to be repeated in the future
Your doctor can discuss your individual risks and benefits with you
Video
Combined cataract extraction and trabeculectomy