Ophthalmology | Bethpage | Lake Success 516.731.4800 516.358.2300
Ophthalmology | Bethpage | Lake Success Ophthalmology | Bethpage | Lake Success Ophthalmology | Bethpage | Lake Success Ophthalmology | Bethpage | Lake Success Ophthalmology | Bethpage | Lake Success Ophthalmology | Bethpage | Lake Success Ophthalmology | Bethpage | Lake Success
Ophthalmology | Bethpage | Lake Success
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Glaucoma Surgery

How is glaucoma treated?

At this time, glaucoma is not curable but it is treatable. This means that people diagnosed with glaucoma or as suspicious for glaucoma need to be routinely monitored by an experienced physician. At times, people who have significant risk factors for glaucoma without evidence of definitive glaucoma are offered treatment to reduce the risk of developing glaucoma in the future. This can be thought of as treating high blood pressure or high cholesterol to treat heart disease. Our physicians have cumulative decades of experience in treating glaucoma with the latest cutting-edge therapies.

There is ample evidence that lowering intraocular pressure decreases the risk of progression of glaucoma, although we know that there are probably many factors that contribute to the development of glaucoma. Research is ongoing to explore other targets for glaucoma therapy besides intraocular pressure. It is important to remember that glaucoma treatment can slow or stop advancement of glaucoma but it cannot reverse glaucoma damage that has already occurred.

Eye Drops
Glaucoma Surgery | Laser Trabeculoplasty | Trabeculectomy | Bethpage | Lake SuccesGlaucoma is usually treated with topical drops that lower intraocular pressure by either increasing fluid drainage from the eye or decreasing fluid production. Lowering intraocular pressure can be thought of as a bathtub in which you can either turn down the faucet or clear up the drain. Advancements in topical therapy allow many patients to have adequately lowered intraocular pressures with as little as one drop a day with minimal side effects.

Laser Treatment
Glaucoma Surgery | Laser Trabeculoplasty | Trabeculectomy | Bethpage | Lake SuccesLaser therapy termed laser trabeculoplasty is a common alternative or additive to topical therapy for glaucoma. The principle behind laser trabeculoplasty is to enhance drainage through the eye's drainage system (the trabecular meshwork) by applying laser therapy to the area. Laser trabeculoplasty is a common procedure that is relatively painless and performed in the office in approximately 5 minutes. There are two types of laser trabeculoplasty that are routinely used called Argon laser trabeculoplasty (ALT) and selective laser trabeculoplasty (SLT, or "cold laser"). There are few studies that compare the effectiveness of ALT verses SLT, although SLT has the theoretical advantage that it is repeatable because it does not actually alter the microscopic structure of the drainage system. If your doctor detects a component of narrow angles on examination, correction of this condition with laser iridotomy may be indicated in addition to lowering intraocular pressure.

Surgical Therapy Options
When topical therapy and laser therapy are not effective in lowering intraocular pressure, surgery may be recommended. Our glaucoma-trained physicians specialize in the latest, state-of-the-art glaucoma surgical procedures. The principle behind most glaucoma surgery is to lower intraocular pressure by bypassing the eye's own native drainage system to allow fluid to leave the eye in a controlled fashion.

Glaucoma Surgery | Laser Trabeculoplasty | Trabeculectomy | Bethpage | Lake SuccesTrabeculectomy is the most common procedure performed for glaucoma. It involves creating a tiny flap on the white of the eye that is hidden by the upper eyelid. Fluid flows from underneath this flap in a controlled fashion so that intraocular pressure is maintained at a lower level. Trabeculectomy is very effective in lowering intraocular pressure, often without the need for medications. The most common problem encountered following trabeculectomy is the development of scar tissue which can cause the flap to heal and cease working. Anti-scarring agents such as mitomycin C and 5-fluorouracil are now routinely used to improve the outcome of trabeculectomy. A device called the ExPRESS® mini glaucoma shunt can be used during trabeculectomy with improved outcome in select cases.

In certain types of glaucoma, trabeculectomy has decreased effectiveness due to the propensity for scar tissue formation. In these cases, and in cases in which trabeculectomy has failed, implantation of a glaucoma device or "tube" can bypass the concern of scar tissue. Our doctors have extensive experience with the latest glaucoma devices that include Ahmed Valves®, Baerveldt Glaucoma Implants® and Molteno Implant®.

One of the most exciting advancements in glaucoma therapy is the introduction of newer techniques such as Canaloplasty® and Trabectome®. Canaloplasty® is a novel "non-penetrating" surgery in which a suture is carefully threaded into the eye's drainage system using a lighted catheter without actually entering the eye. The suture is then tightened and tied to improve the effectiveness of the eye's own drainage system. Click here to here about Dr. Craig Marcus performing the first Canaloplasty® procedure on Long Island.

Trabectome® is a minimally invasive procedure in which tissue in the eye's native drainage system is augmented using an electrosurgical pulse. Both procedures have the advantage of avoiding some of the complications that may be involved in traditional glaucoma surgery.

Our glaucoma-trained physicians have been abreast of the latest developments in glaucoma surgery and are committed to offering our patients the most advanced surgical options.

How should I insert my eye drops?

Glaucoma Surgery | Laser Trabeculoplasty | Trabeculectomy | Bethpage | Lake SuccesInfections, inflammation, glaucoma, and many other eye disorders are treated with eye drops. Surprisingly, even the small amount of medication in an eye drop can create significant side effects in other parts of the body. It is important to remember that all medicines have side effects. There are ways to decrease the absorption of the eye drop into the system, and to increase the time the eye drop is on the eye, making the medicine more safe and effective.

Inserting eye drops may seem difficult at first but becomes easier with practice. To put in an eye drop, tilt the head back. Then create a pocket in front of the eye by pulling the lower lid down with an index finger or gently pinching the lower lid outward with the thumb and index finger. Let the drop fall into the pocket without touching your eye or eyelid (to prevent contamination of the bottle).

Immediately after instilling the drop, gently press the inner corner of your eye where it meets the nose with each of your index fingers for one minute. This prevents most of the drop from traveling down the tear duct to the rest of the body, and keeps the drop inside your eye so that it works better.

Keep your eyes closed for three to five minutes after instilling the drop. Because the volume of a single drop exceeds the capacity of the surface of the eye, it serves no purpose to use two drops at the same time.

Before opening your eyes, dab unabsorbed drops and tears from the closed lids with a tissue.

If you are taking two different types of eye drops, wait at least five minutes before instilling the second drop.

How can I learn more about glaucoma?

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Eye Care Associates & Glaucoma Consultants of Long Island
4212 Hempstead Turnpike | Bethpage, NY 11714 | Phone: 516.731.4800 | Fax: 516.731.4805
2001 Marcus Avenue | Lake Success, NY 11042 | Phone:516.358:2300 | Fax: 516.358.2329