Open Angle Glaucoma Treatment : Eye Drops for Glaucoma and Glaucoma Surgery

By Adem Lewis / in , , , , , , , , , , , , , , , , , , , , , , , , /

So open-angle glaucoma Treatment well in this video I get to review the different eye drops for glaucoma and glaucoma surgery. So let’s take a look Hey guys welcome this is dr Joe Allen here from doctor eye health bringing the best in education about the eyes vision and vision product So if you new here consider subscribing Also at any point throughout the video check out the show notes and links below for further information about everything that we go over Also, keep in mind this video is part of a complete video series about glaucoma So if you’re new here, that’s great But don’t miss out on all the other good videos about glaucoma and I’ll hook you up with a link to that in the description Below as well as in the YouTube card up above otherwise, let’s go over open-angle glaucoma Treatments now when it comes to glaucoma treatment, there are many different treatments out there however the same concept across the board for all those treatments is the same we treat glaucoma by lowering the pressure of the eye and We can do that with Medicated eyedrops. We can do that with laser surgeries we can even do that with more intense surgeries in the operating room where we physically make an Increased drainage canal or we can do implants to again increase the drainage of the eye or we can use a combination of all those different strategies So overall the treatment outlook for glaucoma is usually very good now if you are diagnosed with open-angle glaucoma here in the United States and you’re gonna be started on treatment you usually Started on a medication called a prostaglandin Analog these eyedrops come with a little kind of Bluegreen almost a teal colored cap Now I don’t have any affiliation with brands or anything. One of the more common ones is called Xalatan The generic form is called latanoprost now. These drops are excellent The reason they’re prescribed usually first-line is because one they’re pretty cheap the generic form has been out since I think like the mid 90s and Over all that are pretty cheap for people to take also they’re incredibly effective So just using this drop one time at night every day in both eyes will lower the pressure of the eyes Anywhere from 25 to 33 percent That’s an excellent decrease in eye pressure. And so for again that the kind of the cost benefit of taking this medication and a Significant drop in eye pressure it makes this really the first line for first line treatment for glaucoma now because this glaucoma medication is Used so commonly there are some side-effects. I wanted to kind of mention So if you’re taking this medication already, you could notice that these drops make the eyes a little bit red or a hyperemic That’s what we call it in the in the clinic. But usually you’re using this drop right before bedtime So you’re going to bed anyway, so it’s not really that huge of a deal Some people will notice their eyelashes grow a lot longer thicker and fuller Actually a lot of our lady patients who are put on this medication they don’t really mind too much because it’s basically like getting a prescription for Latisse the Medication that can actually grow your eyelashes longer. In fact, they’re the same classification of medication. They’re both prostaglandin analogues now Beyond just that this medication is known for helping change the eye color Now no one really prescribes this for this reason, but as a side effect people with lighter colored eyes Like myself I have blue eyes if I was to start taking this medication and I took it for a long time a couple eight years then the pigment of my eye you could actually maybe notice it start to get darker and Eventually, some people even can do that kind of light brown eyes from taking this medication One of the more lesser common known side effects of a prostaglandin analog is it changes the fat deposition. around the eyes So usually we don’t prescribe a prostaglandin analog in just one eye by themselves but Occasionally if somebody is using it in just one eye and not the other that one I could start to look like it’s sunken back Deeper inside the skull and that’s this because the fat around the eye is just not kind of depositing Normally as it would be in the eye that’s not taking that medication Now beyond just using a prostaglandin analog if your doctor feels that that medication either isn’t right for you Or maybe it’s not being effective enough Maybe you need your eye pressure lowered even more they’ll consider adding another medication now It’s always up to your doctor which medication they choose for you next and which one’s the best for you based on your health and make a shion’s you’re taking but Often times here in the United States probably the second most commonly prescribed I drop for glaucoma. It fits into a classification called beta blockers One of the most famous names is called timolol. There’s a couple of different concentrations of timolol. There’s either timolol eyedrops There’s tomorrow gel drops. They’re a little bit thicker Usually these drops come in a cat come in the bottle with a yellow cap And these drops are usually prescribed at least once a day I’ve seen a prescribed twice a day, but usually at least once a day and in the mornings These medications do lower the eye pressure by about 25% and they do that by decreasing the formation of the fluid inside the eye Prostaglandins actually help decrease the fluid by help actually getting the fluid to drain out of the eye better So again prostoglandins help drain the fluid out of the eye and then Tim will or beta-blockers will help Decrease the formation of fluid inside the eye and so if you actually push the doctor was to prescribe these both together It’s a very powerful effect. Now, of course with latanoprost, you know, we have to watch about some of those Complications those contraindications or side effects with timolol the few side effects that can occur Usually your doctor has to kind of screen to make sure you’re not known of a history of asthma Or a breathing issues like with COPD and there’s other type of medications that could interact So again, those are things your doctor will consider now beyond using either latanoprost again the teal green cap Or you got timolol the beta blocker that comes with a yellow cap. Then there’s other medications one that comes in an orange cap is called a carbonic anhydrase inhibitor or CA is and that’s either gonna be called a brinzolamide or dorzolamide now these medications They actually do lower the eye pressure by decreasing the formation of the fluid just like timolol But on their own they only decrease the eye pressure just a little bit. So usually these ones are used in combination with something like timolol And that actually helps amplify the amount of decreased eye pressure by up to about 15 percent Now again these medications if they’re prescribed alone usually are three times a day But oftentimes they prescribe just twice a day because using it in combination with the other eyedrops beyond the carbonic anhydrase inhibitors Then there’s a medication that comes in a purple cap, and that one’s called an alpha Agonist and that one is called brimonidine now bromonidine this alpha agonist not only decreases the formation of fluid inside the eye but it also increases the Outflow of the fluid inside the eye. So this medication again works pretty well Oftentimes it is used as an adjunct to either Latanoprost or perhaps timolol But again, these are all actually the major Classifications of the different medications the different eye drops for glaucoma now beyond just these drops that we’ve mentioned again There are combo drops out there. These are medications that are kind of like having the shampoo and conditioner Combos that you have in the shower, these medications are basically the mix of the other ones we mentioned They work fantastic but they’re basically just put together like that to make it more convenient rather than having like five or six bottles that you got a dump in your Eye throughout the day. It just makes it more convenient increases the adherence to the medication Things like that. There is another medication that just came out maybe about a year ago. I think it finally got FDA approved in 2017 and that one’s called Ropressa. That’s the brand name I have no association with that brand but that medication actually helps again drain the fluid out of the eye through the Trabecular meshwork, that’s one and again that ways that the fluid actually drains out of the eye Being that this medication is newer. It is a bit more expensive however It is kind of making its run for its money because it actually has such a good effect at lowering the eye pressure I think it’s also pretty close to that of a prostaglandin analogue Now again, it’s just a newer medication. We want to kind of throw it out there I don’t think too many people are using it yet But it could be on the rise as a future big name for glaucoma treatment now I also want to mention that if you are taking any of these eye drops it is very likely that a lot of people will start off taking these medications and it because glaucoma has no symptoms people will start taking it and then they’ll just stop taking their eye drops or it’s easy for them to Forget but it’s really important that if you’re taking these drops for any reason for glaucoma You try not to forget don’t stop doing it. Unless your doctor told you to stop taking them Really, you know damage from glaucoma is permanent There’s no way for us to back the train up and get vision back from this damage so really taking these eye drops is the only way for your eye doctor to control the pressure and prevent or delay for their vision loss and if you’re somebody who’s taking any of these eye drops and you’re having Difficulty getting the drops in I did make another video on how to put eye drops in on your own and I’ll hook that up Here in the YouTube card up above as well as in the description below now beyond taking those medications There are a couple other treatments and that involves different types of glaucoma Surgery, the two major forms a surgery that we’re gonna cover today is laser trabeculoplasty And then we’re gonna roughly review some of the different Implants and the different kind of more invasive procedures that can be used for glaucoma now The first one is laser trabeculoplasty This actually it I actually really like laser trabeculoplasty Because this is a way for us to pay much get rid of some of the eye drops if somebody doesn’t want to take them now laser trabeculoplasty involves putting a special type of Mirror contact lens on the eye while the patient sits behind a small Laser device we have in the clinic and then the doctor will activate this laser and they’ll actually burn in burn little drainage canals Into the already existing drainage canal of the eye So they basically widen the drainage canal to increase the outflow Now this procedure isn’t ideal for everybody with open-angle glaucoma You basically do need Some type of pigment in the drainage canal of your eye for this to work if you don’t have any pigment Then you are not an ideal candidate for this procedure However, by having this done again We can lower the eye pressure and some people can lower the pressure so much That they maybe can stop taking all their other eye drops They don’t have to pay for those drops. They don’t have to take them throughout the day however, saying however Then now that I said that there are sometimes people will get that procedure and then they still have to be on eyedrops So it’s not a panacea. It’s not a cure-all This method this sort of treatment. However is not always first-line it can actually be done just about at any point throughout the treatment period The only real big downsides again is that it’s not available for everybody and it actually tends to wear off. So after about five years Of having the benefits of having this procedure it can wear off and has to be repeated again So this isn’t a fantastic option and I do think it’s great for some people But you have to also there’s a few other things you have to weigh out with your eye doctor With the patient to make sure that hey they’re a good candidate. Also. This procedure isn’t always covered by insurance And so sometimes this can cost quite a bit of money to have done I’ve actually seen it anywhere from four to up to like seven thousand dollars to have this procedure completed here in the United States so again If it’s something you’re interested in if maybe you’re having trouble taking medications talk to your doctors about this option of having a laser trabeculoplasty now beyond just taking Medications to lower the eye pressure or having the laser procedure to lower the pressure If for some reason the pressure isn’t low enough or the advanced or glaucoma continues to advance then your doctor will recommend more intensive More invasive surgeries. Now. These surgeries are always our last line of defense They’re not recommended right away because they are associated with more complications Classically we have the trabeculectomy or maybe an external tube shunt such as the ahmed valve these do lower the eye pressure Considerably. However, they are associated with more complications So now we’re recommending what are called MiG’s these are minimally invasive glaucoma surgeries And these usually involve really tiny implants inside of the eye again to decrease that eye pressure And what’s great is that these can oftentimes be is so be combined with other surgeries such as cataract surgery So it’s kind of like getting a two-for-one. So these are excellent They’re less complication rates and they usually lower the considerable amounts. No if you’re gonna have any of these surgeries Do keep in mind that you are gonna be on several eye drops before the surgery. Probably even more eye drops after the surgery And sometimes even after surgeries People are still on I pressure lowering medications You have to see your doctor several times a year just to keep that pressure low and verify that it’s in a safe Level and if for some reason these surgeries really just don’t take well, it doesn’t it doesn’t go well for you Sometimes they have to be repeated again And yeah, that kind of stinks but we have to do whatever we can to preserve vision All right So I health question of the day which glaucoma treatments have you heard of which are some of your favorites? Do you have any other questions, please? Go ahead and comment in the section below. Alright, everyone. Thanks so much for watching Go ahead and like the video subscribe if you’re new and share this video with any friends or family that you think it might help Otherwise if you’d like to catch other cool videos from dr Eye health just click or tap the screen up here to the side or click or tap the screen down here Otherwise again, this is doctor Joe Allen hear from dr. Eye health bringing the best in education about the eyes vision and vision products Keep an eye on it. We’ll talk to you soon Hey guys, so I got a couple of quick hey guys, so I had a pup. Okay. Hey guys, so I had

55 thoughts on “Open Angle Glaucoma Treatment : Eye Drops for Glaucoma and Glaucoma Surgery

  1. ❗❕❓ EYE HEALTH QOTD: Which are some of your favorite Glaucoma treatments? Do you have any questions about them? Let Me Know!

  2. Thank you so very much for this video! I have learned so much and now having Glaucoma doesn't seem so scary look forward to "seeing" and learning more from you

  3. How do yoy resolve a broken bloid vessel in the wye? I had an Avastin shot. That didn't resolve it. I use fish oil supplements. Not workung. Ir broke when I took a muscle relaxer. Next day I noticed black stuff floating in one eye. Daily tear drops not working. Can-see not working. Ugh.

  4. Great Presentation … I am an MD and I have undergone, medication, laser and now even the invasive surgery treatments. The invasive surgery has helped to bring my pressures down. Initially the IOP was at 35 mm Hg… I lost some naso-medial vision because I was not even aware of the problem until I began to notice some halos around lights. I still take the medications for the Right eye until it, too, has the invasive surgery. The Laser "Surgeries" did not work for me and, indeed, made my eye pressures to rise. Thanks again for your brilliant explanation of the medications and their uses and side effects.. Another satisfied customer …

  5. My grandma uses eye drops and also had LASIK a few years ago to help her glaucoma my grandma is doing very well her optometrist is happy with how she's going

  6. And here in India you just read your textbook stating "the only drawback of PROSTAGLANDIN ANALOGUE is pricing"😑

  7. please make video on eye exams – for some reason 90% of the glasses i have gotten have Not been good- view not focused- does not seem to matter how much money i spend – view threw glasses blurred – please help – Thanks

  8. Thank you, thank you, thank you for all yours content, especially glaucoma connected. I have higher eye preasure, but mine doctor still not confirm is it glaucoma . I use Taptikom (tafluprost/timilol) at night and twice a day Luxfen (brimonidine tartrate). Are they safe to be used in pregnancy? I am planning to get pregnant soon, and i am really scared about those kind of medication . Which kind of eye drobs are OK for pregnancy?

  9. Hi, I’ve been to three doctors (an ophthalmologist, optometrist, and a retina specialist) and they all say I’m all fine, but i have such bad after image I guess like Palinopsia, and I see things like floaters but they glow in the dark a purplish and white color. What do you think that could be? Also I recently found out I have vitreous syneresis by reading the examination recap my doctor wrote, could that be the cause?

  10. So I’m a nursing student, and today we were practicing neuro exams. When my parter shined the light in my eyes she noticed that my pupils were contracting and dilating in a pulsating sort of way, even though she wasn’t moving the light around. We showed our instructor and she just said it was weird and that she hadn’t seen it before. I did some googling (I know, bad idea) and now I’m convinced I have Addison’s disease or some type of adrenal insufficiency. I mean, nursing school is stressful so maybe my adrenal gland is tapping out? I’m just wondering if you’ve seen this before and if I should actually be worried. I had some eye surgeries when I was a baby to correct a lazy eye I was born with, could that have anything to do with it?

  11. Hello had a clear line develop on my right eye dosent seem to bother my vision…unless I focus looking through the line…dnt know what it could be

  12. hey doctor so im a 16 year old kid and i was diagnosed with glaucoma and i dont want to keep putting in my eye drops for the rest of my life so i was curious what are my options? i also wanted to ask if this is genetic?

  13. I'm taking three drops in both eyes. Two in the morning and three at night. Adopt, Combigan and Travatan and I don't miss a drop. My right eye is really bad and I'm going to see a specialist next week. I've been on melds for 5 years and now I'm 62. It's kinda scary to lose your sight. So, I don't miss my drop.

  14. My Ac has not been formed after conventional glucoma surgery. My sight is going generally. Help me sir . Gibe me some advices. The surgent is a fool. I use Topin or Atropine sulphate daily. If the drop missed sight goes blurred.

  15. Hi… This is Vijay from India 33 years old recently about a year ago I came to know that I am suffering from Pigmentory Glaucoma. Can I share my reports via email and can you please advise on the same…?

  16. I’m 38 and was put on 3 different eye drops starting 5 months ago .. my eye Doctor now says it’s pigmental glaucoma .. (My pressure seems to fluctuate throughout the years from 15-30.. do you think I should get a second opinion? This is making me so dam depressed

  17. Hi Doc, i hav juz done e laser to treat e narrow drainage problem to my eyes. Durin the diagnosis i do not have glaucoma, juz drainage problem. I was told e laser will help to prevent glaucoma. However 2 months after e laser which i went for the post medical review, e doc detected abnormalities shown in the test machine (clicking of halo lights) & i was told i hav a possibility of glaucoma. Seriously i do mot understand.
    1. I did NOT hav glaucoma before the laser, just a drainage problem.
    2. After the laser, i was detected to have possibility of glaucoma!
    3. After the laser, my eyesight seem to be worse off, i can see white 'moons' or white lines in my vision. Doc told me it does not go away, i just hav to get used to it!

    Doc i really do not understand. Please enlighten me. Tks.

  18. When you talk about pigment , do you mean pale eyes? . I’ve had laser, have very pale blue eyes. After two weeks the Specialist said it hadn’t worked – which I felt was a big early, and put me back on drops. I have low pressure glaucoma. 17 one eye 18 the other. The doctor wants it down to 14.

  19. my mom is suffering this glucomo disease and she already lost one eye vision and doc says another also going to be lose l love my mom and i want to save my mom vision pls suggest me if there is any doc or hospital i love my mom lots…

  20. Hi Doc, i hav juz done e laser to treat e narrow drainage problem to my eyes. Durin the diagnosis i do not have glaucoma, juz drainage problem. I was told e laser will help to prevent glaucoma. However 2 months after e laser which i went for the post medical review, e doc detected abnormalities shown in the test machine (clicking of halo lights) & i was told i hav a possibility of glaucoma. Seriously i do mot understand.
    1. I did NOT hav glaucoma before the laser, just a drainage problem.
    2. After the laser, i was detected to have possibility of glaucoma!
    3. After the laser, my eyesight seem to be worse off, i can see white 'moons' or white lines in my vision. Doc told me it does not go away, i just hav to get used to it!

    Doc i really do not understand. Please enlighten me. Tks.

  21. Hi Doc, i hav juz done e laser to treat e narrow drainage problem to my eyes. Durin the diagnosis i do not have glaucoma, juz drainage problem. I was told e laser will help to prevent glaucoma. However 2 months after e laser which i went for the post medical review, e doc detected abnormalities shown in the test machine (clicking of halo lights) & i was told i hav a possibility of glaucoma. Seriously i do mot understand.
    1. I did NOT hav glaucoma before the laser, just a drainage problem.
    2. After the laser, i was detected to have possibility of glaucoma!
    3. After the laser, my eyesight seem to be worse off, i can see white 'moons' or white lines in my vision. Doc told me it does not go away, i just hav to get used to it!

    Doc i really do not understand. Please enlighten me. Tks.

  22. my name is engineer Godwin harry am thanking God for using a honorable herbal doctor name Dr olataki to cure my wife off the deadly cancel disease hodgkin lymphoma with his great herbal medicine,which he posted to me here in USA after doing all the neccessary things he ask us to do.he is very honest and trust worthy,and he is also know to cure related diseses like,hepatitis B and C,herpes,glaucoma,parkingson can contact him via Tel.+2348147931561 or email him via [email protected]

  23. Can u be put out for the first kind of lasik surgery… I'm very scared of being awake.. I don't think I can stay still or calm to do it..?

  24. Dr. If my eyes deosnt tear. Does it mean that I have glaucoma ? How do we feel the fluid ? The fluid isnt tears? When I use timilol I start to caugh. Which medication do u advice me ? Is there any treatment for cupping of the optic nerve ? Is there any tablets that lowers the optic nerve pressure ?u mentioned normal glaucoma that pressure is nornal and keep losing eye sight!how can that be treated if drops just lowers the pressure, if pressure is normal it means fluid runs normally..

  25. Glaucoma sucks. Lost my eye 6 years ago due to i. My doctor said it was the worst case he had ever seen. I had 2 tubes in my eye and had 8 surgeries o. It

  26. Hydrus stents, here. First one two weeks ago. Getting the other eye done next week. Positive results, so far

  27. I am so glad I found your videos. I'm 38, my left eye has strabismus and amblyopia and had muscle surgery 15 years ago. It was around that time when my eye doctor noticed elevated pressures, and I've had elevated pressures since then. My last annual exam, the eye doctor said she noticed cupping in my right eye and referred me to a glaucoma specialist. I'm already blind in my left eye this is all pretty scary.

  28. Diagnosed advanced OA glaucoma & cataracts six years ago. More advanced in left eye than in right. IOP of 33-35 mmHg. Used drops (Timolol & Latanoprost) for five years significantly lowering IOP to less than 20 mmHg. At age 79 tried cataract removal and Xen implant surgery in left eye. Pressure dropped to 7-8 mmHg but blurred vision includes halos and ghosting. Am 10 days post op and becoming afraid to have same surgery to right eye unless vision in left eye improves significantly as I live alone and the thought of not being able to drive troubles me more than a little. Comments please.

  29. I was diagnosed with OAG 15 years ago. The doctor who diagnosed me said my pressure was 30 and gave me some eye drops to take. He told me to come back in two weeks. For 2 weeks I was terrified as I dropped the meds in. I returned to him and was asking questions about his diagnosis. He suddenly said, "I didn't tell you have glaucoma ".
    As soon as I left his office I called a second doctor. He told me I did have glaucoma and to continue the medication. A few years later of seeing him he questioned my need of the medication. I went to a new doctor. He checked me over and said you need the medication. Fast forward he stopped my medication. For a year I didn't take any. He retires and a new doctor came in. He looks at my eyes says you need the medication and you have some mild damage to the nerve cup.
    All of the stopping and starting again has messed up my routine and it broke my habit. Now I have issues with remembering my meds because I'm a out of sight out of mind type of person. Now I'm fixing to have SLT on Monday. I'm nervous , but I'm ready for it.

  30. My cousin was born with Glaucoma and is 99.9% blind at age 51 now, she is being told that a cornea transplant will help her, but I understand that glaucoma is not curable – how does this cornea transplant help her?

  31. Sick of this dam bullshit I have glaucoma past ten years i do have open angle I do take Latanoprost and Cosep . I have best doctors in Seattle also retinal specialties.Hey m f stupid stop your Shit people need to see doctor you parrot shut up no need to make another video.America have excellent doctors and you ass hole you not telling field test about insurance this kind of eye disease insurance provided 100 percent.please shut up

  32. I have had LOTS of glaucoma treatments. One that didn’t work so well for me was the express shunt. My bubble collapsed unfortunately. I now have a tube in my right eye that I don’t think is performing so well anymore after some years. This is definitely a serious disease.

  33. Also look up David Sinclair. He’s a Scientist who’s in the final r&d stages of actually reversing the negative effects in terms of the Retina and optic nerve. Kinda interesting.

  34. Congrats on your good work. What is your opinion comparing Cosopt Eye Drops vs. Simbrinza?
    When I was using Cosopt Twice daily my eyes used to get red, Switching to Simbrinza 3 months ago, also twice daily, I do not get this redness.

  35. How long should I keep my eyes closed after using eyedrops? You said to take Latanoprost in the evening. What happends if I take it in the morning?

  36. I've had what's called a peripheral iridotomy done on BOTH my eyes, as I have glaucoma (open and closed-angle) and I take timolol twice a day; once in the morning and once before I go to bed at night!

  37. I was diagnose with Secondary Open Glaucoma because I had Uveitis. Thank you Doctor for this video. I'm using the medications you have mentioned.

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