Using eye drops is the mainstay of treatment for most patients. The drops lower eye pressure by either decreasing the amount of fluid made in the eye, increasing the outflow of fluid from the eye, or a combination of both. Pills are sometimes used to lower eye pressure.

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Laser surgery has become increasingly popular as an intermediate step between drugs and traditional glaucoma surgery. The most common type of laser surgery performed for open-angle glaucoma is called Argon Laser Trabeculoplasty (ALT). The objective of the surgery is to help fluid drain out of the eye, reducing intra-ocular pressure that can cause damage to the optic nerve and loss of vision.

Although Dr. Kalski may suggest ALT surgery at any time, it is often performed after trying to control intra-ocular pressure with medicines. In some cases, you will need to keep taking glaucoma medications even after ALT surgery.

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If Dr. Kalski suspects that you have “narrow” or “closed” angles, this means that the drainage channel of your eye is nearly blocked or blocked, placing you at high risk for elevated intraocular pressure and vision loss. This is called Angle-Closure Glaucoma.

An acute attack of angle-closure glaucoma is marked by very high eye pressure and complete blockage of the drainage channel in the eye. Symptoms include pain, red eye, and decreased vision.

To treat narrow-angle or Angle-Closure Glaucoma, Dr. Kalski will perform a peripheral iridotomy (PI), creating a surgical opening within the upper part of the iris (the colored part of the eye) using a laser. This opening is typically so small that it cannot be seen with the naked eye. The opening in the iris allows fluid to flow from behind the iris through the opening, allowing the iris to fall back into a more normal position, opening the drain.

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Either a trabeculectomy or a shunt procedure can be performed on patients who do not respond appropriately to medicines or laser.  Both procedures work by increasing the outflow of fluid from a patient’s eye.