Glaucoma blindness and its treatment

Introduction to Glaucoma Treatment

Glaucoma is a public health condition that is of worldwide concern. This is because close to seven million people are affected by the disease. Another concern is that unlike many other types of eye diseases the blindness caused by glaucoma is permanent.

Various studies suggest that glaucoma is epidemic in developing nations. The doctors and facilities are not there to treat the disease. There is also very little public knowledge about the disease and how it can be prevented. Even in developed nations only half of the people who have glaucoma are aware that they have it. This is unfortunate as patient education can go a long ways towards preventing the complications that can result from having glaucoma. Of course the situation is even worse in terms of awareness of the disease in developing parts of the world.

Although more awareness of glaucoma needs to be created there has substantial progress in the treatment of the disease. The process of reducing intraocular pressure is an effective approach to treating glaucoma in its early stages. Choosing the right kind of therapy is also a crucial, if complex part of the treatment of glaucoma.

Glaucoma therapy strategies

In order for a therapeutic plan to be successful the practitioner must decide on a therapeutic plan to ensure minimum risks and the best possible outcome fro the patient.

Here are a few pointers to ensure a successful glaucoma treatment strategy:

• Before embarking on a surgical or drug related therapy for glaucoma, a doctor must also be knowledge about the corrective treatment to be implemented, its disadvantage and side effects
• Both the patient and the doctor need to participate in a discussion about the advantages and disadvantages of the therapy
• A detailed examination into the patient’s general health, medical history and psychological well being
• A noting of the medications that the individual is already on
• An evaluation of the risk factors for an operation in tandem with the person’s age. This evaluation should assess the patient’s intraocular pressure, age, and ethnicity

The physician should also have some detailed knowhow about how to recommend medication that will fix a high intraocular pressure. The quality and quantity of medication must also be carefully handled and the eye care professional working on the case should also be aware of any drug interactions or health risks that might occur with the medication that the person is already on.

The lowering of intraocular pressure (IOP)

Lowering intraocular pressure with medication has been a standard part of preventing glaucoma for many years.

Recently lowering the IOP has also been shown to be effective when it comes to helping with open-angle glaucoma (POAG). An number of medical research studies have confirmed this including the Normal tension Glaucoma Study, the Collaborative Initial Glaucoma Treatment Study, The Early Manifest Glaucoma Trial and the Normal Tension Glaucoma Study.

Intraocular pressure-lowering medication

There are over 25 varieties of glaucoma drugs that are divided into six types. Here is an overview of the drugs based on the way they behave on the body.

• Prostaglandin analogues like isopropyl unoprostone, travoprost latanoprost and bimatoprost
• Beta-blockers like careolol, timolol, betaxolol, levobunolol and metipranolol
• Carbonic anhydrase inhibitors such as brinzolamide, acetazolamide, methazolamide and dorzolamide
• Adrenergic agonists like brimondine, epinephrine, dipivefrin and apraclonidine Apraclonidine and brimonidine are the most commonly prescribed medications
• Hyperosmotic agents may be prescribed if other medications are too slow or ineffective at lowering IOP. Examples of hypersomatic medicines that may be prescribed are theoral drug glycerol and isosorbide and the intravenous drug mannitol.
• Parasympathomimetic/Cholinergic agents include the acetyl choline receptor agonist, pilocarpine, and the indirectly acting echothiophate iodide may be prescribed but rarely. They have serious side effects.
• A cocktail that is a combination of drugs is one of the most powerful and effective ways to treat glaucoma. Almost 40% of glaucoma cases need to use more than one IOP-checking drug to get results. A commonly prescribed combination of drugs are cosopt, xalacom, timpilo and extravan.

Treatment of glaucoma with neuroprotective agents

Reducing IOP can damage the nerves of the eyes. The optic nerve can become cupped. This is the result of the death of cells in the retina. This can occur simultaneously with the reduction of intraocular pressure. To combat this neuroprotective agents are often prescribed as part of treatment. Some of the neuroprotective agents available are beta blockersmementine, calcium channel blocker and alpha-2 adrenergic agonists.

Both the physician and the patient need to have knowledge of the latest therapies for treatment of the disease in order to have optimal results. If treated early the prognosis for glaucoma is quite positive.