Glaucoma Treatment In Bangladesh - Get Affordable Surgery

Diagnosis Before Glaucoma Treatment

Testing for glaucoma involves a comprehensive eye exam that may include the following tests:

• Visual Field Test Or Perimetry: it is a simple, painless test often part of a routine eye exam that measures your central and peripheral vision. Central vision is the area that is right in front of you that you can see, whereas peripheral vision is the area that you can see that is not right in front of you. It is particularly useful to identify loss of peripheral vision even when there are no symptoms of glaucoma.
• Puff-Of-Air Test: Also called tonometry, this test is used to determine the pressure within the eyes. For this, the doctor may use a small device or a warm puff of air to apply a slight pressure to the eyes. While the normal range for intraocular pressure is between 12-21 mm HG, it is possible for some individuals to have glaucoma within this range. It is important to remember that eye pressure is unique to each person.
• Optical Coherence Tomography: It is an imaging technique that creates a picture of the retina and the optic nerve located at the back of your eye. The picture is created as a dim red light reflects off the retina and the optic nerve. OCT helps measure the thickness of the retina, a useful measure to assess the damage to retinal cells due to glaucoma.
• Gonioscopy: This test determines whether the angle between the iris and the cornea is open and wide or narrow and closed. The angle helps the doctor to differentiate between acute and chronic glaucoma. At the start of the test, the doctor will use eye drops to numb your eyes. A contact lens is then placed over the eyes, which has a mirror that shows the doctor the angle between the iris and the cornea.
• Pachymetry: A probe called a pachymeter is placed over the eyes to measure the thickness of the cornea. This is a helpful reading for the doctor because corneal thickness influences the pressure inside the eyes.

How To Prepare For Glaucoma Surgery?

Glaucoma surgeries are typically outpatient procedures, which means you can return home the same day. Laser surgeries are usually performed in the ophthalmologist’s office, while Cyclophotocoagulation procedures are conducted in the operating theater.

Before your surgery, you will be provided with a list of pre-operative instructions, which can vary from patient to patient. Generally speaking:

• You may be asked to avoid NSAIDS, aspirin, or blood thinners to reduce the risk of bleeding.
• Due to the use of anesthesia, you will need to arrange for a friend or family member to pick you up after your procedure.
• Your surgeon could ask you to stop certain medications prior to the surgery.
• Depending on the anesthesia to be given during surgery, you will be asked to stop eating or drinking a few hours before the surgery.

What Happens During Glaucoma Surgery:

Before the procedure starts, drops are used to numb the eyes. There are two main types of glaucoma surgery: laser and incisional.

Types Of Treatment for Glaucoma

Laser Treatments For Glaucoma:

• Open-Angle Trabeculoplasty (ALT): A type of laser treatment where a laser is used to help drain the tissue at the angle where the iris meets the cornea. It takes a few weeks before the effects of this surgery are visible.
• Selective Laser Trabeculoplasty (SLT): This is similar to ALT but can be repeated, unlike ALT.
• Laser peripheral iridotomy: This uses a laser to create a small hole in the iris to allow fluid to flow through the iris. This opens the drainage angle of the eye and relieves eye pressure. It may be recommended for acute angle closure glaucoma.
• Cyclophotocoagulation (CPC): In this procedure, the ciliary body is targeted with a laser to reduce its production of eye fluid or aqueous humor. The surgeon may apply the laser outside the eye, in the case of transscleral CPC, or during cataract surgery, as in the case of endoscopic CPC.

Incisional Surgery Treatments:

• Filtering Surgery: Also known as trabeculectomy, this is a procedure where an opening is created in the sclera of the eye to create space for excess fluid to drain.
• Drainage Tubes: This involves the insertion of a tube into the eye to drain excess fluid. This helps lower eye pressure.
• Minimally Invasive Glaucoma Surgery: These refer to a group of glaucoma surgeries that utilize small incisions to lower eye pressure. Compared to traditional glaucoma treatments, these require less immediate postoperative care and carry lower risk.
• Glaucoma Drainage Devices Implants: Implants are used when other treatment methods fail. A small tube or filament is inserted into the front chamber of the eye to drain excess eye fluid. The filament allows the fluid to drain into the area around the back of the eye, where it is reabsorbed. Compared to trabeculoplasty, this procedure carries a slightly elevated risk.

What Can I Expect After Glaucoma Surgery:

Surgery can help stabilize vision in patients for a long time. However, your doctor will need to monitor your glaucoma during this time. You may experience temporary side effects following the surgery. These could include:

• Redness
• Irritation
• Eyelid swelling and tearing
• Transient blurred vision
• Foreign body sensation (often described as sand or grit in the eye)

If you were using eyedrops before glaucoma surgery, you would likely be prescribed different eyedrops after the procedure. Most patients do not experience pain after the surgery, but if you do, you should consult your eye doctor for the best advice on how to relieve it.

Recovery After Glaucoma Treatment

A full recovery from glaucoma can take up to 6 weeks, though your eyes may feel better almost immediately. Most of the recovery will typically take place within the first few days after the surgery. You should follow the after-care surgery instructions given by your doctor to ensure a smooth recovery and make sure to attend all follow-up appointments.

What To Avoid Following Glaucoma Surgery

For procedures where eye pressure is low, the following activities are not recommended:

• Any exercise that causes elevation in heart rate, breathlessness, or sweating is not recommended.
• Lifting heavy objects
• Bending over at the waist

To avoid infections, wearing eye makeup or reusable contact lenses and swimming is not recommended.

Risks And Complications of Glaucoma Treatment

Surgery has very high success rates of slowing down the progression of glaucoma. However, like any other surgery, there may be potential risks associated with glaucoma treatment. Given the rare nature of these risks, in the vast majority of glaucoma surgeries, the benefits outweigh the risks. Nonetheless, your doctor will discuss these with you during your consultations. Some of these risks include:

• Vision Loss: glaucoma surgery can temporarily disrupt your vision. In rare cases, there may be permanent loss of vision. Since this is not a common side effect, it’s more likely you will benefit from glaucoma surgery.
• Bleeding In The Eye: Despite the best techniques, bleeding may occur after the operation. If you are on blood thinners, it is best to discuss this with your doctor and follow his instructions to continue or discontinue your medications before the surgery.
• Infection: Antibiotics are given before, during, and after the surgery, but there is always a small chance that an infection could occur. This could happen right after the surgery or years later. Therefore, it is best to consult your doctor immediately if you have signs of an infection like redness, pain, or excessive tearing.
• Scarring: Our eyes have a natural tendency to scar, which can result in very high pressure inside the eyes. If the scarring is intense, it could necessitate repeated surgeries or glaucoma medications.
• Cataract Formation: Glaucoma surgery can increase the chance of cataract formation, but these cataracts are usually easier to treat surgically. In cases where your vision may be significantly impacted by cataracts, your eye doctor may recommend combining the surgeries together.
• Low Eye Pressure: The surgery could result in low eye pressure (hypotony). When this happens, fluid may collect behind the retina, which can cause a shadow in your side vision. Hypotony is usually a temporary complication, but if it persists, surgery must be conducted to treat it.