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Dropless Glaucoma Treatment: Durysta & Glaucoma laser

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Glaucoma Treatment

Before we get into dropless glaucoma treatment, let’s begin with the definition and what actually it is all about.

What is Glaucoma?

Glaucoma is the world’s predominant cause of blindness, which affects over 3 million individuals in the United States itself. Sadly, until vision is already impaired or lost,  glaucoma is usually notIced.

Why Dropless Glaucoma Treatment?

Since people suffering from glaucoma are facing so many issues with the glaucoma medication eye drops treatment. Many people share their trouble of remembering their drops on time while others face some issues of allergies such as dry or red irritated eyes and the most common reason for getting tired of huge bills for medications as well always having to go to pharmacy or call in for refills. To overcome all these issues, Dr Marcelin promotes  drop-less ( or minimal medication) approach or treatment for Glaucoma .

Durysta & Glaucoma laser

Many people with open-angle glaucoma do not encounter symptoms they will not be conscious that they have the condition. A major difficulty in the treatment of open-angle glaucoma (OAG) and ocular hypertension (OHT) has been to ensure that patients comply with the prescribed eye drops given for intraocular pressure management (IOP). In fact, 80% of glaucoma patients, either because of complications or inattentiveness, do not use their medication topical drops as advised. That’s why Drop less Glaucoma Treatments, like Durysta & Glaucoma laser and Minimally Invasive Glaucoma Surgery  are all beneficial options.

What is Durysta and how does it work?

For glaucoma patients with open-angle glaucoma or ocular hypertension, Durysta is a micro sustained-release implant. To further alleviate and sustain a stable eye pressure level, Durysta is ican be placed in the eye. This is an in -office procedure

The implant is rod-shaped and inserted into the eye, where the lower angle rests. Via prolonged release of bimatoprost( Lumigan) over several months, it decreases eye pressure. The orientation at the angle of the anterior chamber causes the tissues of the trabecular meshwork and the uveoscleral routes to be positioned nearest to them. This is optimal since this spot can supply the bimatoprost non-stop over several months.

Is Durysta safe?

Dropless Glaucoma Treatment

Durysta has recently gained FDA clearance and is a milestone in the treatment of open-angle glaucoma or ocular hypertension. For those people who have trouble taking regularly prescribed eye drops for glaucoma, Durysta would be a game-changer because it liberates patients from needing to administer drops entirely.

What is Glaucoma Laser?

The sort of laser surgery will rely on how serious it is and the type of glaucoma. Lasers emit a concentrated beam of light that will cause a very slight burn or opening in your eye tissue depending on the intensity of the light beam.

The eye is numb during laser surgery so there is minimal to no discomfort. The eye specialist then holds the eye with a special lens. The laser beam is focused on the target areas inside the eye.

The most common laser procedures to treat glaucoma are as follows.

  1. a) Laser Trabeculoplasty

Laser Trabeculoplasty ( ALT, SLT, MLT) is the treatment for the patients of open-angle glaucoma treatment (POAG). The laser beam expands the eye’s fluid pathways, helping them function together for the drainage system.

Half the fluid channels are generally treated first. The other fluid channels may be handled at another time in a different session, if appropriate. This method avoids over-correction and decreases the risk any pain after the surgery.  In up to 75% of patients studied, Trabeculoplasty has successfully reduced eye pressure.

  1. b) Selective Laser Trabeculoplasty

SLT is the treatment for the patients of open-angle glaucoma treatment (POAG). A laser which works at very low levels is used by SLT. It selectively treats individual cells, leaving untouched untreated portions of the trabecular meshwork; SLT can be repeated safely when needed. And those who have been treated unsuccessfully with ALT or pressure-lowering drops, SLT can be an option.

  1. c) Laser Peripheral Iridotomy

LPI is the treatment for the patients of narrow angles and narrow-angle glaucoma. When in the eye, the angle between the iris and the cornea is too wide, narrow-angle glaucoma can  exists. This fluid drainage can be blocked by the iris, raising inner eye pressure intermittently or can shut down all together causing an Acute Angle Closure Attack and causing sudden accuse painful loss of vision. A tiny opening in the iris is created by LPI, which helps the fluid reach the channels ( angles) easier and flow through the drainage channels

  1. d) Minimally Invasive Glaucoma Surgery

 Over the past 5-10 years there has been a revolution in glaucoma surgery, specifically Micro-Invasive Glaucoma Surgery, commonly called MIGS.

MIGS can be thought of in a few broad categories, either enhancing fluid outflow using the eye’s inherent drainage system (GATT, Kahook Dual Blade Goniotomy, Trabectome, iStent), shunting fluid to the outside of the eye (XEN Gel Stent) or decreasing production of fluid within the eye (ECP). Some types of MIGS procedures are FDA approved to be performed only in conjunction with cataract surgery (iStent) whereas other MIGS procedures are approved to be performed independent of cataract surgery (GATT, goniotomy, Trabectome, XEN Gel Stent, and ECP).

While MIGS procedures will not replace or eliminate traditional glaucoma surgery, they have greatly decreased the number of patients who require these more invasive surgeries, which can be wrought with complications,  to control their IOP. Due to their better safety profile than other major glaucoma surgery , MIGS procedures have allowed us to have a lower threshold for a surgical intervention with the goal of providing better IOP control while decreasing a patient’s glaucoma medication burden.

  1. e) Laser Cyclophotocoagulation

Glaucoma Surgery

This is an alternate to microsurgery filtering that is generally used later in the care algorithm. It is possible to get several different kinds of lasers to hamper the capacity of the ciliary body to make fluid and therefore lower the pressure of the eye. In order to completely control glaucoma, the procedure will need to be repeated.

  1. f) Trabeculectomy

Your ophthalmologist may evaluate that Major glaucoma surgery should be done if treatment with eye drops, tablets, or laser surgery does not reduce intraocular pressure to a healthy level. A Trabeculectomy involves making a new drain in the eye is one way of reducing eye pressure in an eye with glaucoma.

  1. g) Tube Shunt Surgery

Patients with signficant uncontrollable glaucoma, unsuccessful trabeculectomy, or susceptibility to forming scar tissue may be referred for treatment. To allow drainage, a small, flexible tube (a shunt) with a silicone pouch is placed into the tissues of the eye.

Is the dropless treatment right for me?

For people who would prefer to manage their eye pressure without the use of eye drops, dropless glaucoma therapy can be a suitable option for various reasons: patient comfort, trouble recognising or instilling eye drops, eye drop prices, eye drop allergies such as red or dry irritable eyes, or suboptimal eye pressure when using eye drops. You will find out more about these solutions from your glaucoma specialist .

What do we do?

At Hudson Ophthalmology, Dr Kerline Marcelin MD is a board certified ophthalmologist with additional fellowship training in glaucoma diseases and treatments. She also is a Clinical Assistant Professor of Ophthalmology in glaucoma at the New York Eye & Ear Infirmary since 2000. professionals specialised in the treatment of glaucoma are dedicated to combating this debilitating condition by using medications, lasers or surgeries and as appropriate.

If traditional glaucoma drugs are not successful or accepted, there may be rge the potential to provide several dropless alternatives, such as Durysta Implant (an innovative experimental glaucoma treatment) and other laser therapies including Selective Laser Trabeculoplasty (SLT), Argon Laser Trabeculoplasty (ALT), Laser Peripheral Iridotomy (LPI), YAG Laser Cyclophotocoagulation, Trabeculectomy or Tube Shunt Surgery, helping you fight glaucoma and prevent irreversible blindness.

After a comprehensive review of your individual condition, Dr. Kerline Marcelin  will decide which form of therapy is appropriate for you.

Vision Problem and Autoimmune Disorders

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Autoimmune Disorders

Autoimmune disorders can affect every possible inch of your body, from your joints and nerves to your eyes. However, with the existence of more than 80 different autoimmune diseases, it is difficult to determine all possible impacts of these diseases on your vision.

Therefore it is essential to be informed about all risks that your autoimmune disorder poses to your vision. Seek assistance if you start experiencing any change in your vision like blurriness, cloudiness, dryness, light sensitivity, or pain.

Limit the impact of the autoimmune disorders on your eyes by proper medication and timely eye care.

An experienced ophthalmologist says that several areas of the eyes are involved in the autoimmune disease. There are common building blocks like sugars and proteins involved, so when one area of the body is affected, your eye will become affected too.

Autoimmune Disorder: Time to see your Eye Doctor For regular checkups

One of the most important things you can do to protect your vision is to regularly see your ophthalmologist. An ophthalmologist is a professional eye doctor who advises all adults to get regular eye screening at or after 40. If you haven’t seen any eye doctor before then, you need to make an appointment, especially if you are aware of your autoimmune disorder.

  • It is generally advised to get vision health screening once in a year; you should not wait until 40.
  • Make sure you ask your eye doctor how often you need to get eye screened.
  • Get vision screening more frequently, especially if you are experiencing any vision-related difficulty.
  • If you are undergoing any autoimmune disorder medication for the treatment, which is known for affecting eyesight, you need to be extra careful.
  • Take all necessary precautions and advice from an ophthalmologist.

Take Care of Your Vision Health

How can you take care of your vision health?

Some medications for the autoimmune disorder may harm vision health over the long term.

Antimalarials: – Plaquenil can decrease vision.

Corticosteroids:-Long term use of this medication causes cataracts and enhances the risk of glaucoma.

If you have autoimmune diseases, you are certainly alert to the changes happening in your body- but don’t overlook your eyes. With regular screening and attention, you can preserve your sight for a long.

Patients with diabetes are at a high risk of developing eye diseases that can lead to blindness and vision loss, such as cataracts, glaucoma, etc. If you follow the statistics, you already know that diabetes is the leading cause of blindness in the US. Many a time’s diabetic eye conditions often develop unnoticeable vision pain or loss. By the time the patient experiences any symptom, significant damage may already be done to the eyes. Therefore diabetic patients need to have their eyes examined to prevent permanent damage.

What if a patient develops cataract?

In general, cataract is considered a common eye condition that causes clouding the eye’s natural lens. Every year millions of people experience the same problem, especially those 65 years old or above. This cloudiness developed as a result of the buildup of protein in the lens. The cataract is quite progressive and causes painless loss of vision. Therefore it is important to get proper medical attention.  Some people consider cataract is one of the changes in your eyes as you age, but this is not true. The exact cause of the cataract is unknown. Therefore it should not be considered as part of the natural aging process. It is a problem that needs serious medical attention.

What is the solution to this problem?

A series of tests conducted to diagnose cataracts. A dilated eye examination is performed to test the vision and the condition of the lens and other parts of the eye. Apart from this, doctors can also perform tonometry to measure the pressure in the eye. If the visual impairment begins to interfere with your capacity to read, write, or work, you need to consider cataract surgery to restore your vision. Laser cataract surgery is the most common surgical procedure to treat this problem. Further, it has an over 90 percent success rate and minimal risk of complications.

Ophthalmologist

Let’s dig some vital details of this procedure.

Different medical device companies have manufactured systems for performing Laser cataract surgery.  Several systems among them are FDA approved. The main goal of cataract surgery is to restore a person’s vision for watching television, driving, and other distance vision tasks.

Here we are listing three popular laser-assisted cataract surgery performed in the US.

  1. LenSx: –

    it is one of the most popular FDA approved femtosecond laser systems for cataract surgery performed in the USA. This system is approved for capsulotomies, corneal incisions, and cataract fragmentation and has been successfully used in 400,000 cataract refractive procedures worldwide.

  2. Presbyopia IOLs: –

    This advance presbyopia-correcting IOLs are quite similar to multifocal and bifocal contact lenses. Just because these multifocal IOLs are implanted inside the eyes, they don’t require routine replacement and care as general contact lenses do. Patients who have opted for this surgery find that they can go glasses-free anywhere or occasionally need only reading glasses for reading small prints.

  3. Astigmatism Correcting Lens- Toric Intraocular Lens: – 

    in this process premium intraocular lenses are used to correct farsightedness or nearsightedness as well as astigmatism

Clear vision is important to take care of it. Invest some time as well as money on the routine eye checkups. Further, if you experience any vision-related problem, don’t forget to get advice from an ophthalmologist.