More than 4.2 million Americans have glaucoma and many don’t even realize it. That’s why regular eye exams are so important. The earlier glaucoma is diagnosed, the better the outcome in preserving vision.
What Is Glaucoma?
Glaucoma refers to a group of eye conditions that damage the optic nerve (which connects the eye to the brain) and can lead to vision loss or blindness. Most often, this damage is associated with increased pressure inside the eye (intraocular pressure), though other factors may play a role. There are different types of glaucoma, including:
- Angle-Closure Glaucoma: A sudden or chronic rise in internal pressure when drainage canals are blocked.
- Congenital Glaucoma: A rare, affecting babies or young children, often due to developmental issues in the eye’s drainage system.
- Primary Open-Angle Glaucoma (POAG): The most common form. It develops gradually as drainage canals slowly clog; often without any early warning signs (the “sneak thief of sight”).
- Secondary Open-Angle Glaucoma: Glaucoma that arises from a known trigger, such as an eye injury, inflammation, certain medications (e.g. steroids), pigment dispersion, or other eye conditions.
Because glaucoma often has no symptoms until significant damage occurs, early detection is critical.
How Is Glaucoma Diagnosed?
We use modern, comprehensive testing, including optic nerve imaging, optical coherence tomography (OCT), intra-ocular pressure (IOP) measurement, corneal thickness measurement, and other diagnostics. Pupil dilation may be needed to thoroughly examine the internal structures of the eye.
Early detection enables interventions that can slow or prevent vision loss.
How Is Glaucoma Treated — and What’s New?
While there is no cure for glaucoma, treatments aim to lower eye pressure to slow or halt damage to the optic nerve. Treatment is tailored to each patient and may include: eye drops, laser therapy, sustained-release implants, or — in advanced cases — surgery.
In recent years, new options have expanded the ways to manage glaucoma, giving many patients the possibility of reducing or even avoiding daily eye-drop regimens.
Laser Option: Selective Laser Trabeculoplasty (SLT)
- SLT is a gentle in-office laser procedure that helps fluid drain more effectively from the eye, reducing IOP. It selectively targets pigmented cells in the eye’s drainage tissue, leaving surrounding tissue intact, which helps minimize scarring and side effects. Glaucoma Research Foundation+1
- Many ophthalmic experts now offer SLT as a first-line treatment for open-angle glaucoma or ocular hypertension — even before trying daily drops. Glaucoma Research Foundation+1
- SLT can lower eye pressure by approximately 20–30%, similar to the effect of powerful glaucoma eye drops. Glaucoma Research Foundation+1
- The benefits often last 1–5 years (or longer) and — because SLT does not permanently change the drainage anatomy — the procedure is repeatable if pressure rises again. Glaucoma Research Foundation+1
What this could mean for you: If you are newly diagnosed with open-angle glaucoma, or you have difficulty using eye drops reliably, SLT may be a convenient, effective, first-step treatment. Many patients are able to reduce or stop glaucoma drops (at least for some years) after SLT.
Sustained-Release Implants: DURYSTA and other drop-free options
- DURYSTA is a tiny, biodegradable implant containing the glaucoma medication bimatoprost. It is placed into the front chamber of the eye, where it slowly releases medication over several months. Glaucoma Research Foundation+1
- For many patients with open-angle glaucoma or ocular hypertension, a single DURYSTA implant can help maintain lower IOP, which may reduce or eliminate the need for daily eye drops. Glaucoma Research Foundation+1
- Because the drug is delivered continuously, these implants eliminate the peaks and troughs in eye pressure that can occur with drops (especially when doses are missed), offering more stable pressure control. Glaucoma Research Foundation+1
- DURYSTA is administered in an office setting (no operating room needed) using a small-gauge injector. PentaVision+1
Who may benefit from an implant like DURYSTA: Patients who have trouble remembering to use drops regularly, who dislike or are sensitive to preservatives in drops, or who would prefer a simpler “set-and-forget” option.
Some newer sustained-release implants (beyond DURYSTA) are also being developed for longer-term control, which may further broaden options in coming years. PentaVision+1
Why These Advances Matter
- Better quality of life: Fewer or no daily drops, fewer missed doses, less dependence on self-medication.
- More consistent pressure control: With laser or implant, eye pressure tends to be more stable, reducing “pressure spikes”.
- Flexible, personalized care: Combining traditional drops, laser, and implants lets us tailor glaucoma treatment based on your lifestyle, risk factors, and comfort.
- Early intervention: Newer therapies make managing glaucoma easier and more accessible, especially for newly diagnosed patients.
What This Means for You
If you’ve been diagnosed with glaucoma (or are at risk), we now offer more than just eye drops. You may be a candidate for SLT (laser therapy) or DURYSTA (implant), potentially allowing you to reduce or even eliminate daily drops.
We encourage you to discuss these newer options with us. During a consultation, we’ll:
- Review your eye history and risk factors
- Evaluate whether SLT, an implant, or traditional drops (or a combination) are most appropriate
- Develop a customized glaucoma-management plan tailored to your lifestyle and needs
Glaucoma Treatment FAQ
What is the goal of glaucoma treatment?
The goal is to lower the pressure inside the eye (intraocular pressure or IOP). Lower pressure helps protect the optic nerve and slows or prevents further vision loss. While glaucoma cannot be cured, it can be very effectively managed with the right treatment plan.
Are eye drops still used for glaucoma?
Yes. Eye drops remain a common and effective treatment for many patients. They work by reducing fluid production inside the eye or helping fluid drain more efficiently.
However, newer technologies now offer alternatives for patients who prefer options beyond daily drops.
What is SLT (Selective Laser Trabeculoplasty)?
SLT is a gentle, in-office laser treatment that improves the eye’s natural drainage system to lower eye pressure.
- It usually takes just a few minutes
- There is no incision and minimal discomfort
- The effect can last 1–5 years or longer
- The procedure can often be repeated if pressure rises again
For many patients with open-angle glaucoma, SLT can reduce or even eliminate the need for daily eye drops.
Is SLT safe?
Yes. SLT uses low-energy pulses that selectively target pigmented cells in the drainage tissue, leaving surrounding tissue unharmed. Most people return to normal activities right after treatment.
What is DURYSTA?
DURYSTA is a tiny, biodegradable implant that slowly releases glaucoma medication (bimatoprost) inside the eye over several months.
The implant is placed during a short office visit and gradually dissolves, meaning no daily drops to remember while it is active.
Who may benefit from DURYSTA?
DURYSTA may be a good option for patients who:
- Have difficulty remembering or putting in drops
- Want fewer preservatives or less irritation
- Prefer a “set-and-forget” treatment approach
- Have mild to moderate open-angle glaucoma or ocular hypertension
Can DURYSTA replace my glaucoma drops?
For many patients, yes — at least for the duration of the implant’s effect.
However, some patients may still need additional treatment. Your doctor will review whether DURYSTA is appropriate for you.
Is DURYSTA permanent?
No. DURYSTA works for several months and then slowly dissolves. Currently, it is approved for a single administration per eye. Your doctor will tell you if you are a good candidate based on your eye health and corneal status.
How do SLT and DURYSTA compare?
| Feature | SLT (Laser) | DURYSTA (Implant) |
|---|---|---|
| Type of treatment | Gentle laser | Sustained-release medication implant |
| Where it works | Eye’s drainage system | Inside the front chamber of the eye |
| Drop-free? | Often reduces or eliminates drops | Designed to eliminate drops temporarily |
| Duration | 1–5+ years | Several months |
| Repeatable? | Yes | No (currently one-time per eye) |
Both treatments can be excellent options and many patients choose laser first because of its long-lasting effect and repeatability.
How do I know which treatment is right for me?
Your doctor will look at:
- The type and stage of your glaucoma
- Your eye pressure goals
- Your ability and preference for using drops
- Any corneal conditions that may limit implant use
- Your overall health and lifestyle
We’ll work with you to create a plan that keeps your vision safe and fits your daily life.
Will I still need surgery later?
Most patients do very well with drops, laser, or implants. Only a small percentage ever need more invasive surgery.
Early, consistent treatment is the best way to prevent more advanced interventions.
How soon can I return to normal activities after SLT or DURYSTA?
Most people resume their usual activities the same day or the next day. Your doctor will give you specific instructions based on your eyes.
If you would like to be checked for glaucoma or would like to discuss treatment options, contact us today.