Glaucoma Treatments
Glaucoma is the name for a group of diseases of the eye where the optic nerve, which connects the eye to the brain, becomes damaged.
There are three main types of glaucoma. These are primary, secondary and developmental (glaucoma in babies and children).
It is quite a serious condition that has no obvious symptoms in its early stages, and can be characterised by pressure building up inside the eye which then leads to the damage to the optic nerve. The optic nerve is used to transfer visual information to the brain, and any damage to the nerve fibres will not recover.
If glaucoma is not treated it can lead to sight loss, or even blindness neither of which are reversible. It is essential to keep up to date with regular eye tests, as this is the way to detect that you are suffering from glaucoma. Early intervention is vital along with careful monitoring to ensure that any damage does not result in permanent loss of vision.
How could my Eyes be Affected by Glaucoma?
It is important to understand a little about the structure of the eye to appreciate the effects of glaucoma.
Aqueous humour, which is a clear fluid, flows through your eye. It maintains the shape of the eye so that it can function properly and does this by keeping the correct amount of pressure inside your eye. This pressure is called intraocular pressure.
High pressure in the eye is called ocular hypertension. The damage to the optic nerve is usually caused when the intraocular pressure becomes excessively high, killing the nerve fibres.
Not all patients who suffer from ocular hypertension will develop optical nerve damage, but they do need to be monitored carefully for signs of glaucoma so that preventative treatment can be given if required.
Damage to the optic nerve can also occur when the intraocular pressure is normal. This condition is called normal tension (or low tension) glaucoma.
Understanding the structure of the eye
The part labelled the ciliary body is where the aqueous humour (the fluid within the eye) is made.
Between the iris and the cornea is the so-called ‘drainage angle’ of the eye. The aqueous flows down behind the lens and under the iris, then through the pupil and drains out through the drainage angle. The intraocular pressure is a balance between the production of fluid in the eye and the drainage out of the eye.
When the drainage out of the eye is restricted the balance becomes uneven and the pressure in the eye will rise.

What types of glaucoma are there?
To understand the different types of glaucoma, it is useful to know how drainage occurs in the eye.
As you can see in the section labelled ‘How could my eyes be affected by glaucoma?’ your eye pressure is controlled by watery fluid called aqueous humour. It is made in the ciliary body, flows through the pupil and drains away through tiny channels called the trabecular meshwork in the angle between the cornea and the iris (the drainage angle). If the balance between the inward flow and the outward flow is disrupted this can cause the eye pressure to rise.
Who is at Risk of Glaucoma?
How is Glaucoma Diagnosed?
In most cases the early signs of glaucoma are detected during a routine eye test with an optometrist.
It is very important that you have your eyes tested every two years because conditions like glaucoma, diabetes, high cholesterol and macular degeneration can all be spotted at these consultations.
This is even more important to remember if you are Asian, African-Carribean, have low blood pressure, are diabetic or short sighted because this could mean that you have a higher risk of developing glaucoma.
If the optometrist identifies that you may have glaucoma you will be referred to a specialist glaucoma service. If you are referred for further consultation this does not mean that you definitely have glaucoma and it does not mean that you will lose your sight, only that you may be at increased risk.
We may use several different tests to determine whether you have glaucoma.

What Treatments are Available for Glaucoma?
Eye drops
Many different eye drops are available for the treatment of glaucoma, and they all work in different ways to reduce the intraocular pressure of your eye by reducing the amount of fluid in your eye. This in turn leads to reduced damage to the optic nerve.
YAG Selective Laser Trabeculoplasty (SLT)
In the healthy eye, the fluid called aqueous humour flows freely into the front of your eye through the pupil then drains away through channels called the trabecular meshwork. In some cases these drainage channels do not work properly, and your eye pressure increases.
We use YAG selective laser trabeculoplasty (SLT) to apply a laser beam to the drainage channels, which helps to unblock them. The fluid in your eye can then flow through the channels more easily, which reduces the pressure in your eye.
- Trabeculectomy Surgery
A trabeculectomy is an eye operation that will improve the drainage of fluid out of the eye. This is achieved by creating a small blister (called a bleb) under the surface of the eye, which acts as a trap door to allow extra fluid to pass out of the eye, improving the drainage of the eye and in turn reducing the intraocular pressure and protecting the optic nerve.
YAG Laser Peripheral Iridotomy
If you have angle closure this means that the coloured part of the eye, the iris, can move forward and obstruct the drainage channels. When this happens the fluid can not escape from the eye and your intraocular pressure increases.
We use YAG laser peripheral iridotomy to create a small hole in your iris to form a permanent small passage which allows the excess fluid to escape. The laser is used to push the iris tissue backward to unblock the drainage channels.
Aqueous shunt implantation
An aqueous shunt is a device which is implanted into the eye. The shunt comprises two parts, the first is a small tube made from silicon, and the second is a plate that sits in the surface of the eye. The extra fluid in the eye can then drain away through the tube to a small blister (called a bleb) under the surface of the eye and drain away. This improves the drainage of the eye and in turn reduces the intraocular pressure and protects the optic nerve.
An aqueous shunt is also referred to as tube implant, glaucoma drainage implant or glaucoma tube shunt.
MIGS
Minimally invasive glaucoma surgery, or MIGS encompasses a range of techniques, implants and devices which all work to lower the intraocular pressure in the eye by increasing the drainage of the eye and thus protect the optic nerve.
The reason these procedures are called “Minimally invasive” is that very tiny incisions and/or microscopic equipment is used. This has been designed to minimise risk as compared to other treatments such as trabeculectomy or aqueous shunt.
iStent Drainage Implant Surgery
In the healthy eye, the fluid called aqueous humour flows freely into the front of your eye through the pupil then drains away through channels called the trabecular meshwork.
In some cases these drainage channels are partially blocked and your eye pressure increases.
We use iStent drainage implant surgery to provide additional drainage and reduce pressure inside the eye.
The iStent is a microscopic, one millimeter long, non-magnetic titanium tube, which is inserted into the drainage channel in the eye. This procedure is most commonly undertaken in conjunction with cataract surgery, but it can also be used as a stand-alone procedure.
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Contact Info
Eye Wales
Parkway Clinic, Lamberts Way
Swansea Waterfront
Swansea SA1 8EL