Name of the Procedure:

Intraocular Pressure (IOP) Reduction by ≥15%

Summary

Intraocular pressure (IOP) reduction by at least 15% involves interventions to lower the pressure inside the eye, which can help prevent damage to the optic nerve and preserve vision.

Purpose

This procedure addresses elevated intraocular pressure, which is a major risk factor for glaucoma. The primary goal is to reduce the risk of optic nerve damage and vision loss through effective pressure management.

Indications

• Diagnosed glaucoma
• Ocular hypertension (elevated eye pressure without significant optic nerve damage)
• Risk of developing glaucoma due to elevated IOP
• Failure of initial medical therapies for lowering IOP

Preparation

• Patients may need to fast if sedation is required.
• Regular medications should be reviewed with the healthcare provider, with potential adjustments for anticoagulants or blood pressure medications.
• Pre-procedural eye exams and IOP measurements to establish a baseline.

Procedure Description

1. The patient receives local anesthesia to numb the eye.
2. Depending on the method used (medication, laser treatment, or surgery):
   • Medications: Eye drops or oral medications are administered to reduce fluid production or enhance fluid drainage.
   • Laser treatment: A laser is used to improve the drainage angle or trabecular meshwork, facilitating better outflow of aqueous humor.
   • Surgical options: Techniques like trabeculectomy or glaucoma drainage devices are implemented to create a new drainage pathway or enhance existing ones.
3. Post-procedure, IOP measurements are taken to ensure the effectiveness of the intervention.

Duration

The procedure typically takes 30 minutes to several hours, depending on the method used.

Setting

• Outpatient clinic (medication or laser treatment)
• Hospital or surgical center (surgical interventions)

Personnel

• Ophthalmologist or glaucoma specialist
• Nurses or medical assistants
• Anesthesiologist (if general anesthesia is required)

Risks and Complications

• Common: Eye irritation, redness, temporary blurred vision
• Rare: Infection, bleeding, significant vision changes, chronic inflammation
• Management includes follow-up visits, medication adjustments, or additional surgical interventions if complications arise.

Benefits

• Significant reduction in IOP
• Decreased risk of optic nerve damage and vision loss
• Improvement typically noticeable within the first few days post-procedure

Recovery

• Instructions include using prescribed eye drops, avoiding strenuous activities, and wearing protective eyewear.
• Most patients can return to normal activities within a few days to weeks.
• Follow-up appointments to monitor IOP and assess recovery progress

Alternatives

• Medical management with eye drops or oral medications
• Laser therapy (SLT: Selective Laser Trabeculoplasty)
• Conventional surgery (Trabeculectomy, Glaucoma drainage devices)
• Pros and cons depend on factors like effectiveness, patient’s health, and potential side effects.

Patient Experience

• Patients might experience mild discomfort or pressure during the procedure.
• Post-procedure: Mild pain managed with over-the-counter pain relievers and prescribed eye drops.
• Most patients report improvement in symptoms within days, with minimal discomfort.