Glaucoma is a degenerative disease that if left untreated can cause permanent damage to the optic nerve, resulting in gradual vision loss and eventual blindness. Damage to the optic nerve due to glaucoma is usually caused by an elevated intraocular pressure (IOP). Clear fluid, called aqueous humor, circulates through the eye to provide nourishment to the tissue and applies pressure to help maintain the shape of the eye.
Open-angle glaucoma occurs when there is an increase in fluid production or a decrease in fluid drainage, destroying optic nerve fibers and gradually causing peripheral (side) vision loss. Aqueous humor flows out of the eye through the trabecular meshwork near the edge of the iris. If the trabecular meshwork is blocked, restricting drainage, the pressure inside the eye increases.
Vision loss from glaucoma is permanent, but can be prevented with early detection and treatment. Glaucoma management is usually a lifelong process that requires frequent monitoring and constant treatment. Since there is no way to determine if glaucoma is under control based on how a person feels, doctor visits should be on a regular basis.
Treatment of Glaucoma
Treatment concentrates on lowering the pressure inside the eye to prevent optic nerve damage. Eye drops are most commonly used to control glaucoma, however, they can be very expensive, have unwanted side effects, and may need to be taken for the rest of your life. If non-surgical methods fail to decrease pressure, surgery may be required. The SLT does not rely on medicines, but uses an advanced laser system to target specific cells of the eye, leaving surrounding tissue intact. As a result, your body’s own healing response helps lower the pressure inside the eye. SLT therapy is reimbursed by Medicare and other insurance providers, which minimizes your out-of-pocket expenses.
How SLT Works
Selective Laser Trabeculoplasty (SLT) is an advancement over other lasers that have been used safely and effectively in the treatment of glaucoma for over two decades. SLT uses a special wavelength and energy to affect only pigmented (melanin containing) cells in the trabecular meshwork at the boundary of the iris, improving the flow of fluid in the eye and reducing pressure.
SLT is usually performed in the doctor’s office and only takes a few minutes. Prior to the procedure, eye drops will be given to prepare the eye for treatment. The laser applications are applied through a special microscope similar to the ones used for eye exams. A lens is placed over the eye to direct the light to the trabecular meshwork.
Your eye pressure may drop as quickly as a day or more after having SLT performed. Your doctor may treat the eye with an anti-inflammatory eye drop that will be continued after the procedure. You will need to return for follow-up visits.
Generally, the laser treatment does not cause pain, though some patients experience a sensation during treatment. You may see a green flash of light but feel nothing from the laser. The lens used on your eye may cause some redness or irritation. Unlike some glaucoma medicines, there are no incidences of allergy or systemic side effects with SLT. Complications are minimal but may include inflammation, temporary increase in eye pressure, blurred vision, headache, iritis, corneal edema, corneal lesion, conjunctivitis, or eye pain. Because each individual reacts differently to SLT, you may need to continue using eyedrops following the SLT procedure.