Contemporary medicine has alleviated humankind from the scourge of disease, both by preventing or finding cures for various ills like glaucoma. The technological breakthroughs in primary open angle glaucoma (POAG) have been quite dramatic. POAG is a condition wherein there is a gradual build-up of pressure in the eye over the years due to failure of its normal fluid channels to drain. Because of its insidious nature, the earlier the intervention, the patient’s chance of losing her sight is eradicated, if not minimized.
Glaucoma treatment has greatly evolved for the past 30 years. From eye drops to eye surgery, a myriad of treatment options are now available for glaucoma patients. Though it has been previously a practice of glaucoma specialist since the 60’s to begin treatment with a wide array of eye medications like miotics, beta-blockers and prostaglandin analogs ( pilocarpine, timolol and latanoprost) as examples respectively, they are now slowly being replaced by sophisticated procedures like canaloplasty, viscocanalostomy and sclerotomy.
The advantage of these modern glaucoma cures is that they are far safer than and just as good in terms of lowering intraocular pressure as traditional eye surgery called trabeculectomy. Clinical trials have proven this, with early surgery saving the patient the inconvenience of applying eye drops each day and from suffering from their many side effects. Since majority of glaucoma patients are in their advanced years, it is expected for them to have medical co-morbidities like diabetes, hypertension and heart disease. Thus, eye medications in these cases can do more harm than good
Therapeutic trends show a growing number of glaucoma specialist foregoing medicines altogether and proceeding to glaucoma treatment surgery. The catch with traditional eye filtering surgery like trabeculectomy however, is its high rate of post-operative complications like infection, eye trauma and scarring. Trabeculectomy is often reserved only for those who have frank angle closure glaucoma- a severe form of glaucoma wherein patients are at the brink of blindness, and those whose remain to have uncontrolled eye pressures despite years of medication and laser.
But with the advent of non-penetrating surgery using artificial drainage devices (ADD), collagen implants ( deep sclerotomy) and micro catheter technologies(viscocanalostomy & canaloplasty), the treatment middle ground may not be far behind. One of the amazing and most promising among these is canaloplasty, which uses a flexible tube as thin as a human strand of hair to create an alternate bypass and enlarge the normal fluid channels without interfering with the rest of the structures of the eye.
Non-penetrating surgeries are hailed by glaucoma specialists as the next frontier in early treatment and an effective preventive measure for primary open angle glaucoma. It is estimated to be more cost-effective in the long term compared to a lifetime of eye medications. However, due to the high technical skill required of these procedures, you will be lucky to find a good glaucoma surgeon who performs them.
If you have already consulted an eye doctor or a glaucoma specialist for your glaucoma, you can ask about your non-medical and non-surgical alternatives in your next consult. A glaucoma specialist is in the best position to enumerate and discuss with you all your treatment options while considering your medical background and lifestyle. Shall you be qualified to undergo a non-penetrating procedure like canaloplasty, your eye doctor can refer you to a good glaucoma surgeon or you can find them through a glaucoma resource website like http://new-glaucoma-treatments.com/ or search for one in your area through online directories like citysearch, vitals and insiderpages.
References
- Porcella A, Maxia C, Gessa GL, Pani L. The human eye expresses high levels of CB1 cannabinoid receptor mRNA and protein. Eur J Neurosci 2000;12:1123-7.
- Flach AJ. Delta-9-tetrahydrocannabinol (THC) in the treatment of end-stage open-angle glaucoma. Trans Am Ophthalmol Soc 2002;100:215-22.
- Green K. Marijuana smoking vs cannabinoids for glaucoma therapy. Arch Ophthalmol 1998;116:1433-7.
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