Glaucoma Treatment Options: Can Glaucoma Be Cured?

Hearing that you have glaucoma, or that you are at risk for it, can be unsettling. One of the first questions most people ask is whether it can be fixed, and the second is what their treatment will involve.

This guide gives an honest overview: what glaucoma treatment can and cannot do, the main types of treatment, and what you can do day to day to protect your vision. It is general information, not a substitute for advice from your own eye doctor, who will tailor a plan to your eyes.

The Short Answer

Glaucoma cannot be cured, and vision already lost to it cannot be restored. But it can be treated, and treatment can often slow or stop further damage. Every current treatment works by lowering the pressure inside the eye, using prescription eye drops, laser procedures or surgery, alone or in combination. The best treatment is the one that keeps your eye pressure at a safe level for you and that you can stick with, backed by regular follow-up visits for life.

What Is Glaucoma?

Glaucoma is a group of eye diseases that damage the optic nerve, the cable that carries visual signals from the eye to the brain. The damage is most often linked to pressure inside the eye being too high for that eye to tolerate.

Your eye constantly makes a clear fluid that nourishes its front portion, and that fluid normally drains out through a drainage area called the angle, where the iris and cornea meet. When fluid does not drain well, pressure can rise. Over time, the optic nerve is damaged, usually starting with side (peripheral) vision.

In its most common form, glaucoma is painless and develops slowly, so many people do not notice anything until significant vision has been lost. That is why it is sometimes called the “silent thief of sight.” Learn the warning signs in what are the symptoms of glaucoma.

Types of Glaucoma

The type of glaucoma you have shapes your treatment.

• Open-angle glaucoma: the most common type. The drainage angle is open, but fluid drains less efficiently over time, so pressure rises gradually. It usually has no early symptoms.
• Angle-closure glaucoma: the iris blocks the drainage angle. It can develop gradually, or it can happen suddenly as an acute angle-closure attack, which is a medical emergency.
• Normal-tension glaucoma: optic nerve damage happens even though eye pressure measures in the normal range. Lowering pressure further is still the main treatment.
• Secondary glaucoma: caused by another condition, such as an eye injury, inflammation, certain medications (including long-term steroid use) or diabetes-related eye disease.
• Congenital and childhood glaucoma: rare forms present at birth or in early childhood, often needing surgery.

Know the signs of acute angle-closure glaucoma

Get emergency care right away if you suddenly develop severe eye pain, a severe headache, blurred vision, halos or rainbows around lights, a red eye, or nausea and vomiting. Eye pressure can rise very quickly in an attack and cause permanent vision loss within a short time.

Can Glaucoma Be Treated?

Yes. Even though it cannot be cured, glaucoma is very treatable. The goal of treatment is to lower eye pressure to a level your eye doctor sets for you, often called a target pressure, to protect the optic nerve from further damage.

Your eye doctor chooses treatment based on:

• The type of glaucoma and how advanced it is
• Your current eye pressure and how much it needs to come down
• How your optic nerve and visual field are changing over time
• Your overall health, other medications and any side effects
• What fits your daily life, including how easy it is for you to use drops

Glaucoma Treatment Options

Prescription eye drops

Eye drops are often the first treatment for open-angle glaucoma. Different types of drops lower pressure in different ways: some help fluid drain out of the eye, and others reduce how much fluid the eye makes. Some people need more than one type.

Drops only work if they are used every day, as prescribed. Side effects such as redness, stinging or dryness are possible, and different drops have different side effects. If a drop bothers you, tell your eye doctor rather than stopping it; there are often alternatives.

Tips for using drops well:

• Use them at the same times each day, linked to a routine such as brushing your teeth.
• Wait several minutes between different drops so one does not wash out the other.
• Gently close your eyes and press on the inner corner of the eye for a minute or two after a drop, which can help it stay in the eye.
• Bring your drops or a list of them to every appointment.

Oral medications

Pills that lower eye pressure are sometimes used, usually for a short time or when drops alone are not enough. Your doctor will weigh their side effects against your overall health.

Laser procedures

Laser treatments can help lower eye pressure, either by improving how fluid drains from the eye or, for angle-closure glaucoma, by creating a small opening in the iris so fluid can flow more freely. They are usually done as outpatient procedures with a short recovery. Some people use laser treatment as their first treatment, and others have it when drops are not controlling pressure well or are hard to tolerate. The effect can wear off over time, and some people need repeat treatment or continue to use drops.

Surgical procedures

When drops and laser are not enough to protect the optic nerve, surgery may be recommended. Glaucoma surgeries generally lower pressure by creating a new drainage pathway for fluid or by placing a tiny device that helps fluid leave the eye. Some less invasive procedures can be done at the same time as cataract surgery.

Surgery can be very helpful, but it does not cure glaucoma or restore lost vision, and like any surgery it carries risks. Many people still need drops afterward, and all need ongoing monitoring.

Why Consistent Treatment and Follow-Up Matter

Because glaucoma is usually painless, it is easy to feel that nothing is wrong. But damage can quietly continue if pressure is not controlled.

• Keep using your treatment even when your eyes feel fine.
• Keep every follow-up appointment. Your eye doctor measures your eye pressure, examines and often images your optic nerve, and checks your visual field to see whether treatment is working.
• Report changes, such as side effects from drops or any new vision problems.
• Tell all your doctors you have glaucoma, since some medications, including steroids, can raise eye pressure.

Glaucoma care is lifelong. Read more about why it is important to manage chronic eye conditions.

Lifestyle Factors: What Can Help

Lifestyle changes cannot replace medical treatment, but some habits support your overall and eye health. Talk with your eye doctor before making major changes.

• Stay active. Regular moderate exercise is good for overall health. If you have glaucoma, ask your doctor about head-down positions, such as some yoga poses, and heavy straining.
• Eat a balanced diet with plenty of leafy greens and colorful vegetables.
• Don’t smoke.
• Manage blood pressure and diabetes with your primary care doctor.
• Protect your eyes from injury with safety glasses during sports and work, since eye injuries can lead to glaucoma.
• Know your family history. Glaucoma often runs in families, so encourage relatives to have regular eye exams.

Glaucoma Care in East Tennessee

The best defense against glaucoma is finding it early and staying on treatment. Tennessee Eye Care provides glaucoma screening, diagnosis, treatment and ongoing monitoring through our glaucoma services, with clinics in Harriman, Knoxville, Lenoir City, Morristown and Powell. If you are over 40, have a family history of glaucoma or have been told your eye pressure is high, find a location near you and schedule an eye exam.