DONATE NOWManaging Glaucoma and Cataracts Together
Glaucoma and cataracts are medical conditions that cause vision loss which both can be treated by our glaucoma eye doctors at Glaucoma Associates of Texas. When glaucoma and cataracts occur simultaneously, they can present a unique set of problems for the patient that requires a doctor experienced at treating both disorders. Cataracts typically come on gradually, causing a change in the eye’s lens over time, resulting in cloudiness which reduces vision. Glaucoma encompasses a group of eye diseases characterized by a buildup of intraocular pressure (IOP) that causes damage to the optic nerve and subsequent loss of vision. Surgery can restore vision lost from cataracts, but glaucoma permanently damages sight and cannot restore lost vision.
Glaucoma and Cataracts May Occur Simultaneously
Glaucoma and cataracts usually develop independently. However, aging increases the risk, and many glaucoma patients over 50 develop cataracts.
Treating Cataracts in Glaucoma Patients
Cataract surgery is usually simple with low risk. However, glaucoma patients require careful planning to avoid affecting eye pressure. Intraocular pressure can rise after cataract surgery in glaucoma patients, but doctors often manage it effectively with medication.
Cataract surgery can change eye pressure, sometimes temporarily and sometimes permanently. Doctors should assess each glaucoma patient individually to choose the safest and most effective cataract treatment.
Glaucoma Associates of Texas provides comprehensive care with the most advanced glaucoma diagnosis and testing technology available.
Some cataract treatment options for glaucoma patients include:
- Cataract monitoring: If cataracts are not significantly interfering with a patient’s daily activities, the ophthalmologist may recommend a wait-and-see approach concerning the cataract while treating the glaucoma with laser treatment for glaucoma patients or glaucoma medications.
- Cataract surgery: In mild, stable glaucoma cases, surgeons can remove cataracts while continuing ongoing glaucoma treatment.
- Combined glaucoma surgery and cataract removal: For patients with severe glaucoma, surgeons may remove cataracts while performing glaucoma surgery simultaneously. Recent advances in glaucoma surgeries have increased the number of options glaucoma surgeons have to treat high intraocular pressure at the same time as cataract surgery. Surgeons often use newer techniques in mild, moderate, or severe glaucoma to lower pressure or reduce medication use.
When performing both cataract and glaucoma surgery, the ophthalmologist always prioritizes controlling the patient’s glaucoma. Due to the possible complexity involved with treating both conditions simultaneously, the ophthalmologists at Glaucoma Associates of Texas recommend using a glaucoma specialist with extensive training and experience in the comprehensive management of glaucoma.
Medicine to Treat Glaucoma and Cataracts
Certain glaucoma eye drops (such as Propine and epinephrine) can dilate the pupils which subsequently allows more light exposure on the cataract. When the pupil is enlarged, glaucoma patients with a cataract may begin to experience an increase in glare.
Vision can also be affected by miotic eye drops (used for controlling IOP) when a cataract is present. These medications often shrink the pupil, lowering light entrance into the eyes, which can worsen vision already clouded by cataracts.
Compliance with glaucoma treatment and medication schedule is imperative for glaucoma patients before and after cataract surgery to control eye pressure. Your ophthalmologist will also want to closely monitor your IOP during this time to ensure successful cataract treatment and glaucoma management.
Can Glaucoma Cause Cataracts?
Glaucoma does not cause cataracts; however, some types of glaucoma surgery or treatment may accelerate cataract formation. Research suggests that tube shunt surgery or a trabeculectomy, as well as certain glaucoma medications, can exacerbate the progression of cataracts. The importance of glaucoma treatment, however, outweighs any risk of cataract development.
Less commonly, a cataract can be a contributing factor to optic nerve damage or elevated eye pressure. Cataracts can also play a role in primary-angle closure glaucoma due to additional narrowing of the drainage angle as the lens thickens from the cataract.
Benefits of Cataract Surgery for Glaucoma Patients
While extra care is required for glaucoma patients before, during, and after cataract surgery in glaucoma patients, the outcome can be an extremely positive one when performed by an experienced eye surgeon. In addition to improving vision, removal of cataracts may also result in a beneficial lowering of eye pressure. Studies suggest that patients with a higher IOP prior to cataract surgery experience the most significant drop in pressure afterward.
Some glaucoma patients are also able to lessen the amounts of glaucoma medication taken after they undergo cataract surgery, especially when combined with glaucoma surgery. The surgeons at Glaucoma Associates of Texas are at the forefront of combined cataract-glaucoma surgical technique and can discuss your options with you.
Glaucoma and Cataracts – Possible Complications with Cataract Surgery
Certain glaucoma treatments can cause smaller pupils, making dilation difficult and increasing the complexity of cataract surgery. In cases where glaucoma is caused by flaky deposits that clog the eye and damage the optic nerve (pseudoexfoliation syndrome), the lens can become unstable, making cataract surgery more difficult.
Other possible complications with cataract surgery in glaucoma patients include:
- Medication problems: Use of some glaucoma medicines, such as pilocarpine, Xalaton, and Propine, can cause difficulties after cataract surgery.
Understanding each patient’s eye condition is vital for successful cataract surgery and helps minimize complications in glaucoma patients. The surgeons at Glaucoma Associates of Texas have over 60 years of combined experience performing glaucoma and cataract surgeries. They understand the risks and benefits of performing both procedures.
Every surgeon at GAT completes fellowship training in glaucoma to provide the highest level of patient care.