New light on glaucoma

A specialist in glaucoma management, Ms Madhu Nagar has undertaken several studies to test the efficacy of selective laser trabeculopasty (SLT) for glaucoma. She is a leading proponent of SLT, with more than 10 years’ experience of administering the procedure.

Glaucoma is a common and potentially blinding condition, caused by elevated intraocular pressure (IOP) in the eye, usually reflecting no symptoms until in an advanced stage. Very few patients are aware there is a problem until severe visual damage has occurred. Although glaucoma-induced visual loss is preventable and can be treated with medication, laser and surgery, it is still one of the leading causes of blindness.

Risk factors associated with glaucoma include:

  • Raised IOP – exceeding healthy pressure.
  • Race – African Americans present higher risk for glaucoma than White Europeans.
  • Heredity – family history increases the risk of glaucoma by four to nine times.
  • Age – those aged 60 plus are six times more likely to suffer from glaucoma. 

Early detection and treatment

Discovering glaucoma at an early stage is crucial in the management of the disease and a variety of treatment options are available; namely eye drops, laser procedures and surgery. The aim of treatment is to preserve visual function with a minimum of side effects, at an affordable cost. Approximately 10% of UK blindness is attributed to glaucoma. An estimated 480,000 are currently affected by primary open angle glaucoma in England, with figures expected to rise. 

Eye drops and topical medications have been the preferred treatment, but are not always the best solution. A patient’s failure to take medication correctly is a major barrier to successful treatment. 

Laser treatment for glaucoma 

Reasons vary – from forgetting to take medicine, to intolerance to eye drops. Physical problems such as arthritis make using drops difficult, therefore laser surgery is an excellent alternative. Argon laser trabeculopasty (ALT) and selective laser trabeculopasty (SLT) have both been used in treating glaucoma. Unlike ALT, SLT facilitates aqueous flow through the trabecular meshwork without causing any significant damage to it and it is effective at reducing IOP. 

SLT is now recommended because:

  • It replaces traditional treatment of eye drops and can reduce or eliminate oral medications.
  • SLT treatment has minimal, transient side effects.
  • SLT long-term clinical studies show sustained pressure-lowering effects in 50-60% of patients.

What to expect

SLT is performed by ‘selectively’ targeting pigmented cells of trabecular meshwork, making it a repeatable procedure if needed. It may also be an alternative for those who have been treated unsuccessfully with traditional laser surgery or with pressure-lowering eye drops.The laser treatment is virtually painless. Being an outpatient procedure, SLT takes less than one minute to treat each eye.‘SLT has proven to effectively reduce intraocular pressure with minimal and transient side effects and no compliance issues,’ says Madhu. If you or a loved one are suffering from glaucoma, visit or contact your ophthalmologist to ask about SLT treatment.

Consultant ophthalmologist and glaucoma specialist, Ms Madhu Nagar MBBS, MS Ophth, FRCS Ophth (Ed) consults at Pinderfields General Hospital at Mid Yorkshire Hospitals NHS Trust and Spire Methley Park Hospital, Leeds.

Recommended links about information on SLT: &pageID=2 

Click here to see Ms Madhu Nagar's Spire profile with information on how to book an appointment

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New light on glaucoma

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