Glaucoma is a serious eye condition that often progresses without being noticed. Because its symptoms can be so subtle at first, many people fail to realise that they have a problem until the later stages.
The problem is that glaucoma can cause irreversible vision loss. There is also currently no cure for the condition.
Fortunately, there are methods for managing it. In fact, management is generally the chief aim in most options for glaucoma treatment in Singapore.
How Does Glaucoma Harm Vision?
Glaucoma causes vision loss through progressive damage to the optic nerve, which sends the signals from our eyes that are translated into vision by our brains.
The damage to the optic nerve is typically linked to higher-than-normal intraocular pressure or IOP (pressure in the eye). It may be caused by a variety of factors, most commonly by a drainage failure in the eye.
Eye fluid, called aqueous humour, can build up instead of draining away. The dammed-up fluid raises pressure in the eye and compresses the optic nerve. Any damage to the nerve is irreversible.
As we age, the efficiency of the eye fluid drainage may decrease, which is why glaucoma is more common among older individuals. In Singapore alone, studies peg the census-adjusted prevalence rate at 5.1% in those aged 60 and above.
How Do Eye Specialists Manage Glaucoma?
Because glaucoma’s damage is often due to IOP, glaucoma management focuses on bringing down the pressure within the eye.
After a glaucoma diagnosis, ophthalmologists focus on keeping intraocular pressure (IOP) within a safe range to protect the patient’s remaining vision. Note that treatments are often tiered, with less invasive strategies always being the first-line options.
1. Medications and Eye Drops
These are among the most common initial treatments for glaucoma in Singapore. These medications and eye drops typically do at least one of these things:
- Reduce the production of aqueous humour or eye fluid.
- Improve the outflow or drainage of aqueous humour from the eye.
Some examples of eye drops used for this purpose are prostaglandin analogues and beta-blockers. Note that consistency is vital. Without that, the medication cannot maintain eye pressure at a stable level.
2. Laser Procedures
If eye drops are insufficient, patients are often offered laser treatments for glaucoma. These are only minimally invasive and generally aim to improve the drainage of fluid from the eye.
A common procedure used for this is SLT or Selective Laser Trabeculoplasty. It uses a low-energy laser to target the drainage tissue, allowing fluid to pass through more effectively.
Another option is a Laser Peripheral Iridotomy or LPI. This procedure involves creating a small opening in the iris of the eye. It relieves the blockage and allows aqueous humour to drain more quickly.
3. Surgical Procedures
These interventions are only used when other, less invasive ones have failed to control the condition. One of the most common procedures used here is trabeculectomy.
This is where the surgeon creates a new drainage channel in the sclera or white of the eye. Built-up fluid can drain from that new channel. To keep the new channel open and functioning properly, the patient typically takes anti-scarring medication afterwards.
Which Glaucoma Treatment Is Best for Me?
The most suitable glaucoma treatment for each patient should be determined by a licensed professional, e.g, an eye doctor. Such doctors can also only make recommendations after proper consultations.
The eye doctor will perform a series of tests and assessments to evaluate your condition, then determine which treatment option best suits your needs.
