Glaucoma: Argon Laser Treatment

What is argon laser trabeculoplasty?

Argon laser trabeculoplasty (ALT) is a procedure that uses a laser to treat some forms of glaucoma. Glaucoma is an eye disease in which the nerve that carries visual messages to the brain (optic nerve) is damaged. This is usually caused by high pressure inside the eye. Damage to the optic nerve can cause a permanent loss of vision. Glaucoma needs to be diagnosed and treated early to prevent blindness.

Normally, the fluid in the front of the eye is constantly flowing from where it is formed (the ciliary body) to the front of the eye. This fluid nourishes your eye and helps to keep its shape. The area between the iris (colored part of the eye) and the cornea (the clear outer layer on the front of the eye) is called the angle. Fluid drains out through the angle, into drainage channels, and is then reabsorbed by the body. When fluid flows out too slowly, eye pressure builds up.

When is it used?

Your eye care provider may recommend ALT after you have tried reducing the pressure in your eye with eyedrops or pills. Medicines may not lower your eye pressure enough or they may cause side effects. The procedure can lower the pressure in your eye and may help prevent more damage to the optic nerve and further loss of vision. After some time you may need to have the procedure again or you may need a different treatment.

Instead of this procedure, other treatments or procedures may include:

  • having a different procedure
  • taking medicine to help manage your symptoms

You may choose not to have treatment. Ask your healthcare provider about your choices for treatment and the risks.

How do I prepare for the procedure?

  • Plan for your care and a ride home after the procedure.
  • You may or may not need to take your regular medicines the day of the procedure, depending on what they are and when you need to take them. Tell your healthcare provider about all medicines and supplements that you take.
  • Do not wear eye makeup on the day of the surgery.
  • Follow any other instructions your healthcare provider gives you.
  • Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

What happens during the procedure?

This procedure is usually done in the provider's office. The provider uses eyedrops to numb your eye. During ALT a laser is used to treat the drainage pathways in your eye. During the laser procedure, you may see a few brief flashes of light and feel some discomfort.

The procedure usually takes less than 10 minutes. You will be able to go home the same day.

What happens after the procedure?

Your vision will probably be blurred for the rest of the day, but then it should clear. You will not need to wear an eye patch. If the blurriness does not go away within a day or if you feel any pain or discomfort, call your provider.

Several days or weeks after the procedure, the flow of fluid from your eye should improve. Improved flow usually reduces the pressure inside the eye. Your provider will want to check you regularly to see if the pressure inside your eye is getting lower. It may take 3 to 6 weeks, and sometimes longer, for the treatment to take full effect.

After the procedure you may or may not need to take medicine for glaucoma. Do not change your medicines unless instructed to do so by your eye care provider.

Ask your healthcare provider:

  • how long it will take to recover
  • what activities you should avoid
  • how to take care of yourself at home and when you can return to your normal activities
  • what symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

What are the risks?

Your healthcare provider will explain the procedure and any risks. Although there are some risks with the laser treatment, there are fewer risks than with other types of eye surgery. Problems that could threaten your vision are rare. The most common problem with ALT is that it does not lower your eye pressure. Ask your healthcare provider how these risks apply to you.

Reviewed for medical accuracy by faculty at the Wilmer Eye Institute at Johns Hopkins. Web site: http://www.hopkinsmedicine.org/wilmer/

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