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What are the Various Treatment Options for Glaucoma?

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Glaucoma is a disease provoked by the buildup of intraocular pressure (IOP) within the eye. The buildup damages the eye’s optic nerve, leading to vision loss.

Glaucoma is chronic and doesn’t present symptoms. By the time you notice changes in your vision, the optic nerve may have already been damaged. The risk factors of glaucoma include:

  • Having a relative with the disease
  • Being 40 years and above
  • Having a history of eye trauma
  • Race (African American or Latino/Hispanic descent)
  • Having corneas that are thinner than normal
  • Your eye pressure is very high

There are varied types of glaucoma, but the most common type is open-angle glaucoma. Other types include low or normal-tension glaucoma, angle-closure glaucoma, and congenital glaucoma.

Secondary glaucoma can result from medical complications, advanced cataracts, eye surgery complications, eye tumors, eye injuries, or eye inflammation (uveitis).

Pigmentary glaucoma is caused by slow fluid drainage resulting from the meshwork’s blockage due to the iris’s flake-off. The severe form of glaucoma known as neovascular glaucoma develops from diabetes.

Glaucoma has no cure, but its progression can be stopped when closely monitored. Detecting and treating the disease early can help lower the IOP and prevent vision loss.

Here are three treatment options for glaucoma:

  • iStent treatment uses stents to create access to vessel flows. This lowers the pressure in the eye. It opens clogged blood vessels by permanently opening the blockage to improve the natural outflow of the eye.
  • Kahook Dual Blade® (KDB): uses precise incisions to release intraocular pressure and treat glaucoma using a high-tech blade and may performed during cataract surgery when needed.
  • Selective Laser Trabeculoplasty (SLT): SLT is a laser treatment that helps the eye to drain fluid and minimize the IOP. It is a painless procedure with high rates of success.

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Diabetic Retinopathy: What are the Risks?

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Diabetic retinopathy is a diabetes complication of the eyes. It’s caused by elevated blood sugar levels, which damage the blood vessels connected to the light-sensitive tissues of the retina.
 
The retina forms the light-sensitive layer found at the back of your eye. It is responsible for turning light into electrical signals, which in turn reach the brain and form the images you often see.
 
Without constant blood supply from the blood vessels, you’ll experience complications in your sight. High blood sugar level damages blood vessels in different stages, including:
 

  • Background retinopathy -Where tiny bulges form in your blood vessels and cause bleeding. This may not affect your eyesight.
  • Pre-proliferative retinopathy – Severe and causes significant bleeding of the blood vessels into your eye.
  • Proliferative retinopathy – When new blood vessels and scar tissue become very weak and bleed, developing on your retina and causing vision loss.

 
Diabetic retinopathy, if not diagnosed and treated early, can lead to blindness. However, it can take years for the disease to threaten your sight.
 
You’re at a higher risk of diabetic retinopathy if you:
 

  • Have suffered from diabetes for many years. If you’ve had type 1 or 2 diabetes for more than ten years, you’ll likely to develop diabetic retinopathy.
  • Have persistent high sugar levels. Elevated glycated hemoglobin levels can increase your risk of developing this disease.
  • Are a smoker. Smoking causes blood vessel disorders.
  • Have high blood pressure. This condition causes hypertensive retinopathy. Combined with raised blood sugar levels, high blood pressure increases your diabetic retinopathy risk.
  • Have gestational diabetes. If you are pregnant with gestational diabetes, your risk for diabetic retinopathy is high.
  • Other conditions include high cholesterol levels.

 
To reduce the risk for diabetic retinopathy, you have to:
 

  • Control your cholesterol, blood sugar, and blood pressure levels
  • Go for diabetic eye screening
  • Have your diabetic retinopathy treated early
  • Take your diabetes medication
  • Eat a healthy, well-balanced diet, keep your weight in check by exercising
  • Quit smoking

 Screening is crucial because diabetic retinopathy doesn’t show symptoms in its early stages. It’s better to detect this condition early and prevent vision loss.

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What is the Recommended Age for LASIK Eye Surgery?

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People can experience impaired eyesight at any age, but when is it right to undergo LASIK eye surgery?
 
The American Academy of Ophthalmology observed that over 90% of people who have LASIK vision correction surgery could see without contact lenses or glasses.
 
However, you are required to meet a few qualifications before being considered for LASIK. These include being in good health and having a record of a stable prescription for your eyes for a year. Specialists also prefer that you be free of eye diseases when considering LASIK.
 
But the big question remains: What are the age qualifications for this operation?
 
According to the FDA, LASIK surgery can be performed on patients who are 18 years and above. At 18 years, your eyes are deemed ocularly mature. That’s why it’s necessary to evaluate your eyes before conducting LASIK.
 
The American Academy of Ophthalmology recommends having LASIK at 21 years and above. This is when your major eye changes are complete. Most LASIK eye specialists prefer performing surgery on patients in their mid-twenties up to their forties. By this age, their prescription is already stabilized.
 
Presbyopia starts developing in the forties, making it difficult to see objects up close. Even if you undergo refractive surgery, you may still need glasses. A monovision treatment may be needed before considering LASIK.
 
Considerations for this age include being in good health, being a non-smoker, and having no history of glaucoma, diabetes, or corneal disorders.
 
During your fifties, you may already show signs of advanced presbyopia. With monovision, the vision in your dominant eye is corrected for distance vision, while your other eye is intentionally left somewhat nearsighted to allow you to see close objects. Both eyes still work together, allowing you to see clearly at any distance.
 
There’s no age limit for LASIK, though. But older patients need to double-check if their eye problems are caused by cataracts or other diseases. If you have cataracts, you’ll have to undergo surgical treatment first.
 
Overall, your stability, measurements, and medical and ocular history determine your eligibility for LASIK surgery. Discuss your health condition, risks, and benefits with your eye doctor to determine the best procedure for your eyes.

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Does Refractive Surgery Improve Vision?

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Refractive vision problems include astigmatism, farsightedness, or nearsightedness. Treatment for these conditions is refractive surgery.

Refractive surgery includes a variety of surgical treatments that help to improve the eye’s refractive state to reduce dependence on contact lenses or glasses. The procedures help to correct vision by allowing the proper direction of light to the retina.

Refractive surgery options include:

  • Refractive lens exchange: A surgical procedure that can be used alongside LASIK surgery to replace the eye’s natural lens with intraocular (artificial lens).
  • Photorefractive keratomy: A surgery that removes the epithelium (outer layer of the cornea).
  • Laser in-situ keratomileus (LASIK): A type of surgery where the surgeon creates a thin flap in the cornea to correct a refractive problem.

The main objective of the refractive procedure is to minimize contact lenses or glasses dependence. Before undergoing the procedure, you should consult an ophthalmologist and consider the benefits and risks.

Candidates for refractive surgery include people with healthy eyes who want to eliminate the need for contact lenses or glasses and those with refractive errors that need correcting.

You cannot undergo refractive surgery if:

  • Your corneas are cone-shaped (keratoconus)
  • You have a severe dry eye
  • You’ve had your contact lens prescription changed in the past year
  • You have a recurrent infection of herpes simplex that involves the cornea
  • You have a condition like connective tissue disease, which impairs wound healing
  • You’re currently taking drugs like amiodarone or isotretinoin
  • You’re under 18 years

Your eye doctor will determine your refractive error by examining your cornea. They’ll check you using topography, pachymetry, and tomography.

Refractive surgery improves vision significantly. Reshaping the cornea through refractive surgery has had a success rate of over 90%. Photorefractive keratomy, for instance, has shown 95% success with people achieving 20/20 vision without the support of corrective lenses. Refractive lens exchange has yielded over 88% success with a visual acuity of 20/40.

Refractive surgery offers convenience, especially to people with contact lens intolerance. In most cases, it eliminates the need to wear contact lenses or glasses.

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Does LASIK Fix Your Eyes Permanently?

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LASIK surgery uses laser to reshape the corneal tissue and improve vision. The procedure permanently corrects vision. However, age and vision changes (astigmatism or presbyopia) may determine how long the LASIK surgery will last.

LASIK surgery is a permanent option for fixing vision. The procedure is very safe and quick. The recovery time is short, and you can have your vision back one day after surgery. Most can do away with contact lenses or glasses after surgery.

The ideal candidate for LASIK surgery is one who has had an eyeglass prescription for two years and above. They should also have a healthy cornea and eye. The surgery has minimal discomfort and is not painful.

Medical reviews state that laser-assisted in situ keratomileuses can correct vision for a long time. It treats myopia (nearsightedness), astigmatism, and hyperopia (farsightedness).

The procedure is permanent, except in rare cases when correction regresses to its initial condition. When this happens, the patient can undergo a corrective procedure.

As you age, the eye’s crystalline lens gets stiffer, causing a condition called presbyopia. Presbyopia makes it difficult for one to see nearsighted objects. Your vision may also change due to medical conditions like developing cataracts. This impacts the clarity of your vision, which may require additional surgery to enhance the vision.

When the eye ages naturally, it changes your vision even if you have LASIK surgery. The eye lens accommodation will begin to decline, prompting you to use reading glasses even after the LASIK procedure. For such cases, a patient can undergo a modified type of LASIK surgery known as monovision or blended vision. This treatment tricks the eyes into retaining their far and near vision. The procedure may be performed on one dominant eye.

Your eye doctor may recommend LASIK enhancement or correction surgery 10 years after your last LASIK procedure. The LASIK surgery enhancement procedure involves making small changes to reshape your cornea. This happens when your initial LASIK results begin to fade.

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Should Patients Simultaneously Undergo Cataract Surgery on Both Eyes?

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Cataracts often affect both eyes if they are age-related. Studies indicate that more people will be diagnosed with cataracts in one or both eyes by age 80.
 
Usually, surgery is performed to replace your clouded endogenic lens with artificial intraocular lens. For both eyes, bilateral surgery can be carried out simultaneously on the same day or a few weeks between surgeries.
 
In a recent Cochrane review, they discovered that performing cataract surgery on both eyes the same day or a few days apart produced the same results. However, same-day bilateral surgery could have some consequences.
 
The benefits and drawbacks of this approach include:
 
Benefits

  • Minimal clinic visits
  • Lower procedural costs
  • Faster vision recovery for both eyes

Drawbacks

  • There’s the risk of simultaneous postoperative complications in both eyes.
  • It’s impossible to utilize the same visual acuity on both operations.

If you have cataracts in both eyes, surgery is usually performed on one eye, and then a few weeks later, it’s performed on the second eye. This allows the first eye to recover and your vision to become normal before surgery is performed on the next eye.
 
Even though there may be some benefits, many cataract surgeons are reluctant to perform cataract surgery on both eyes simultaneously. The risk of eye infection and other serious complications from cataract surgery is very low. Nevertheless, if both eyes were to become infected or experience complications at the same time, the results could be visually overwhelming for a period and could possibly affect your vision permanently.
 
A benefit of performing cataract surgery on each eye with time in between allows you and your doctor to evaluate the visual outcome of the first surgery, which might effect choices made for the second surgery.
 
During your pre-operative eye exam, ask your eye doctor or cataract surgeon to discuss the pros and cons of all your cataract surgery options to determine the best choices for your particular needs.

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Foods to Eat or Avoid After Undergoing Eye Surgery

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Lasik surgery is performed to enhance your eyesight. To help with fast recovery and avoid surgery complications, you should follow the rules and instructions given to you after your surgery. But another thing to be mindful of is your diet after eye surgery.
 
Let’s look at the foods you can eat and avoid after LASIK surgery to help with your recovery.
 
Foods to Eat
 
Proteins: Foods rich in protein can benefit your eyes and the whole body. They rejuvenate body cells, blood vessels, and veins to improve recovery. The best protein foods to eat after your eye surgery include organic chicken, eggs, salmon, dairy products, seeds, and nuts.
 
Vitamins: Vitamin foods (vitamin C specifically) are great for eye health. They help to slow down eye aging, reduce any risks of developing eye cataracts, and speed up recovery. The best vitamin C fruits to consume are citrus fruits, green leafy vegetables, carrots, red bell peppers, milk, tomatoes, and berries.
 
Carbohydrates: Carbohydrate foods supply energy to the body and promote healing. Excellent foods to eat after surgery are whole wheat foods, quinoa, oats, buckwheat, and bananas.
 
Healthy Fats: Healthy fats are essential to healing as they aid the body in absorbing vitamins and other nutrients. Foods like sweet potatoes, whole eggs, avocado, nuts, and seeds are enriched with healthy fats.
 
Foods You Should Avoid
 
Sugar-Rich Foods: The first thing you should do after your eye surgery is to reduce your sugar consumption. High sugar foods can elevate your blood pressure. These include high-sugar fruits, honey, packed juices, candies, cakes, pastries, etc.
 
Deep Fried Foods: Fried foods accumulate a lot of unhealthy oils. When fried, the nutrients are killed, leaving only empty shells that are useless and unhealthy for the body.
 
High Sodium and Processed Foods: Salty foods also trigger high blood pressure and other health issues that can complicate your eye recovery. As much as possible, steer clear of pickles, canned foods, ultra-processed foods, and preserved foods like chips, burgers, pizza, etc.
 
Always eat nutritious food to ensure quick and complication-free eye recovery.

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A Quick and Painless Alternative to Wearing Spectacles

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Laser eye surgery is a form of refractive surgery performed to correct hyperopia, astigmatism, and myopia. These are spectacle errors found in people with uncorrected or impaired vision.
 
By 2011, more than 11 million patients had undergone laser eye surgery in the U.S.; by 2009, over 28 million surgeries had been performed globally.
 
An ophthalmologist performs laser eye surgery using a microkeratome or laser to reshape the cornea and improve the patient’s visual acuity. Most patients who undergo the procedure receive a permanent alternative to wearing contact lenses or eyeglasses.
 
The procedure involves three main steps where:

  • The ophthalmologist creates a lean flap in the cornea’s surface layer and sets it on the side.
  • They’ll then reshape the bare area using precisely targeted laser pulses. The laser is guided by sophisticated algorithms to remove tiny corneal tissue amounts from various positions of the cornea that were pre-determined. This will correct the overall curvature of the cornea.
  • Once done, the flap will be put back into its initial position, re-attaching onto the eye’s as it heals.

This procedure has helped correct many patients’ far and near-sightedness, enabling them to see clearly (20/20) without wearing spectacles.

It is a quick and painless surgical procedure that takes about 10 to 20 minutes. A numbing drop is administered to lessen the pain. Vision recovery is often rapid, with patients reporting vision acuity within 24 hours.
 
Through a technique known as mono-vision, laser eye surgery can minimize the need for contact lenses in patients aged 40 and above who use bifocals.
 
Candidates for this type of surgery are those over 18 years with healthy eyes and adequate thickness in their cornea. Corneal disease, chronic dry eye, and other abnormalities can disqualify one from the surgery.

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What Is a Tecnis Multifocal Lens Implant?

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The Tecnis multifocal lens implant is a cataract surgery involving the removal of the eye’s natural lens. The lens is then replaced with a clearer artificial lens implant (IOL).
 
By ‘multifocal, it means that the implanted lens is designed to produce a clearer vision for both near and distant visions without the glasses. This is different from a monofocal IOL, which is designed for specific visions without a clear range of focus.
 
Tecnis multifocal IOL sets the patient free from using contact lenses.
 It uses wavefront technology. The technology corrects visual distortion (optical aberrations) that may cause halos, glare, and low visual quality.
 
Tecnis is a diffractive lens that comes with concentric rings of distinct power. The rings provide vision at distance and near levels. The lenses are independent of the patient’s pupil size. It improves the reading vision even in low light conditions.
 
Tecnis multifocal lens implant offers quality vision at multiple distances. The enhanced vision for a specific near point is often personalized to the patient’s lifestyle. This allows them to focus on places they use their vision most.
 
The lenses correct presbyopia and astigmatism while reducing one’s dependence on contact lenses.
 
Beneficiaries of this procedure are patients with healthy eyes who want to stop using glasses at all distances. It cannot work well if the eye has severe glaucoma or macular disease (macular scar or hole, macular pucker, or macular degeneration). Also, Tecnis multifocal lens implant cannot correct astigmatism, especially if it’s significant.
 
A multifocal lens implant works best when implanted in both eyes. If performed in one eye, the patient may need glasses to accomplish some tasks. This procedure aims to provide independence from contact lenses at every distance.
 
The good thing about the Tecnis multifocal lens is the lack of risk during surgery. After surgery, a patient may experience some halos and glare with night driving. There’ll also be slight ghosting or blurring or a waxy vision for a short period.

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The Best Treatment For Keratoconus

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Taking the static out of the disease

Keratoconus, which is sometimes called KC is a non-inflammatory eye condition. It typically causes the round dome-shaped cornea to thin and become weak. This then causes the development of a cone-like bulge. People who have this condition often say they can see a “static” in their vision which can cause serious visual impairment.
 
Corneal Cross-Linking

The best-known treatment for Keratoconus is available at The Eye Center, a Columbia SC Eye Clinic, which is iLink corneal cross-linking. This procedure is minimally invasive and is an outpatient procedure that uses ultraviolet light and a specific kind of formulated eye drops to strengthen and cause the corneas to stiffen that have been affected by this disease or refractive surgery. This procedure is considered the standard in the care of Keratoconus worldwide.

  • Thickening and shortening of collagen fibrils
  • Stiffening of the corneas
  • Creating a new corneal collagen cross-links

 The Use of Riboflavin

iLink corneal cross-linking consists of the use of formulated pharmaceutical-strength riboflavin drops. These drops are called Photrexa and Photrexa Viscous, which help modify the cross-linking reactions.
 
The Use of Ultraviolet Light

The Columbia eye center utilizes UV light by applying the light from a machine called the KCL system. It is applied after the cornea is drenched in the Photrexa (riboflavin) and Photrexa Viscous eye drops. And once both the UV light and the eye drops are applied together during the procedure, the cornea begins to stiffen and strengthen slowly and/or stop the keratoconus.
 
If your doctor diagnoses you with keratoconus, you will be referred to an ophthalmologist who has the training and certification to determine which option is best for you and the severity of your condition. Before your first appointment, gather notes of what you’ve been experiencing, such as:
 

  • Your vision changes
  • How long your symptoms have persisted
  • Stress or any life-changing events
  • Any medications you take – including eye drops and vitamin supplements
  • Any questions you think you might like to ask your doctor

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Have Questions? Feel free to contact us and our team will get back to you as soon as possible.