Selective laser trabeculoplasty: are you a candidate?

Glaucoma is an eye disease that, if left untreated, can lead to blindness. In eyes with glaucoma, the eye pressure is usually higher than normal. The eye is filled with clear fluid that flows in through a spigot and flows out through a drain. In glaucoma, the drain of the eye gets plugged, and fluid coming into the eye cannot get out, raising the eye pressure. This high eye pressure causes nerve damage, which leads to loss of sight.

Glaucoma is treated by lowering the eye pressure to prevent further damage. Eye pressure can be lowered in several ways. One common way to lower eye pressure is to use eye drop medication. There are many different glaucoma eye drop medications, and they lower eye pressure by either turning down the spigot or opening up the drain of the eye. Most people with glaucoma use at least one eye drop medication to lower their eye pressure.

Another way to lower eye pressure is with laser therapy. A common laser treatment for glaucoma is called selective laser trabeculoplasty, or SLT. In SLT, laser treatment is applied to the drain of your eye in order to open it up and let fluid out, lowering the eye pressure and saving your sight. SLT treatment takes only a few minutes, is performed in the office (not the operating room), is safe, and effectively lowers eye pressure in most people. The treatment is approved by the Food and Drug Administration (FDA) for treating glaucoma, and is covered by essentially all insurance plans.

Are you a candidate for SLT? People who might benefit from SLT are described below. If any of these descriptions apply to you, ask your doctor if SLT is right for you.

• Eye pressure not controlled despite using one or more eye drop medications—if you have tried several medications and your eye pressure is still not under control, SLT may be the next step.

• Inability to tolerate eye drop medications—some people have medical problems that make using eye drop medications unsafe, and others may be allergic to the preservatives in bottles of eye drop medications.

• Inability to put eye drop medications in your eyes—if you have arthritis, or a tremor, or very poor vision, you might not be able to put the drops in your eye.

• Frequently forgetting to use your eye drop medications—if you often forget to put your drops in, your eye pressure may be going up and down a lot; these fluctuations in eye pressure can make glaucoma worse.

• Inability to afford your eye drop medications—many people have insurance that will cover SLT but will not cover medications. If you cannot afford your medications, SLT might be a more cost-effective way to control your glaucoma.

• Desire to reduce the number of eye drop medications you are using—if your eye pressure is controlled but you require several eye drop medications to keep it controlled, SLT might allow you to reduce the number of medications you are using for eye pressure.

• Desire to avoid starting eye drop medication therapy—if you have just been diagnosed with glaucoma, you may prefer to avoid eye drop medications entirely. SLT may help you accomplish this.