Glaucoma Treatments, Costs and Insurance Explained

Glaucoma, the silent thief of sight, often goes unnoticed until irreversible damage occurs. As the second leading cause of blindness, it has cast its web across 3 million American lives, yet half of those affected remain woefully unaware. If it's caught early enough, however, it is possible to prevent the disease from causing vision loss.¹

There are several types of glaucoma, but all of them damage the eye's optic nerve — a bundle of fibers that connects the retina to the brain and is essential for good vision. Below, we dive into an overview of the disease, tips for identifying it, the cost of treatment options available, if insurance covers such options and how financing can help.

What Is Glaucoma?

Glaucoma is a group of eye diseases caused by an increase in pressure within the eye, also known as intraocular pressure. This condition can affect one or both of your eyes and permanently lead to blindness. It affects 1% to 2% of the population around the world, and while it's most common in those over age 40, it can affect people of all ages, including infants.²

Many people who have this condition may not even realize it because symptoms can be mild and include a gradual loss of peripheral vision over time. While there is no cure for glaucoma, treatment and surgery can stop further damage to your eye(s) and preserve your vision.³

Anyone can get glaucoma, but certain people are most likely to be affected, including those:³

• Having a family history of the disease, as glaucoma can be inherited
• Of African, Asian or Hispanic heritage
• Over age 40
• Using steroid medications over a long-term period
• Who are nearsighted or farsighted
• Who have had previous eye injuries
• With diabetes

Types of Glaucoma

There are two common types of glaucoma, both of which increase the pressure in your eye and can lead to blindness:³

• Open-angle glaucoma. As the most common form of glaucoma, this condition occurs slowly over time when the eye does not properly drain fluid, leading to a buildup of pressure. Those with open-angle glaucoma are typically symptom-free until the optic nerve becomes permanently damaged.
• Angle-closure glaucoma. Also referred to as closed- or narrow-angle glaucoma, this form occurs when your iris is close to the eye's drainage angle, eventually blocking it. This can lead to an acute attack of pressure buildup, resulting in blurry vision, headaches, nausea or eye pain, and is a medical emergency that requires immediate care.

Diagnosis of Glaucoma

One challenge with glaucoma is that it often presents no early symptoms. Yet catching it early is critical to prevent vision loss — especially since there is no cure for the disease.

Visiting your doctor regularly for a comprehensive dilated eye exam is the best way to identify glaucoma before symptoms start.¹ Exams can also reveal hidden susceptibility factors, such as thin corneas, high eye pressure or an abnormal optic nerve.³

How to Treat Glaucoma

There are several treatments available to treat glaucoma, but the only permanent solution is surgery.

Some common treatment options for glaucoma include:

Medicated eye drops

Medicated eye drops help reduce intraocular pressure in the eye without surgery. There are various types of eye drops, and each works differently.⁴

Your ophthalmologist may prescribe eye drops for your glaucoma, giving precise directions to follow. They will also determine which eye drops are appropriate for your specific case, including:⁴

• Alpha agonists. These deliver a double whammy by both decreasing the amount of fluid and increasing drainage.
• Beta-blockers and carbonic anhydrase inhibitors. These work by reducing the amount of fluid in the eyes of patients with glaucoma and consequently lowering pressure in the eye. (Carbonic anhydrase inhibitors are also sold as pills.)
• Combined medication. These medications, typically Cosopt® and Combigan®, contain two different drugs to reduce pressure through multiple mechanisms.
• Prostaglandin analogs. These medications lower the pressure by increasing the drainage of fluid from the eye.
• Rhopressa®. This rho-kinase inhibitor lowers the pressure within your eye by increasing fluid drainage.
• Vyzulta®. This dual-mechanism eye drop works by relaxing the trabecular meshwork, or the channels that help with eye drainage, to reduce pressure.

Laser glaucoma surgery

Laser procedures can be performed in an ophthalmologist's office or ambulatory surgical center. They include:⁵

• Minimally invasive glaucoma surgery (MIGS). Microscopic-sized equipment and a laser are used to make tiny incisions within the eye to enhance drainage and reduce pressure. Procedures include microtrabeculectomies, trabecular surgery, suprachoroidal shunts and milder versions of laser photocoagulation.⁶
• Laser peripheral iridotomy. A laser is used to make an incision in your iris to improve eye drainage.
• Laser trabeculoplasty (including selective laser trabeculoplasty). A laser is used to make tiny incisions within the trabecular meshwork.
• Laser cyclophotocoagulation. A laser is used to target and lower the flow of fluid into the eye from the ciliary body, which lies behind the iris.⁷

Incisional glaucoma surgery

These surgeries, which are not laser-based, are typically performed in a hospital or outpatient surgical center. During surgery, which requires anesthesia, a doctor will make incisions or implant tubes into the eye to help drain excess fluid and reduce intraocular pressure. These procedures include:⁵

• Drainage tube insertion (also known as glaucoma implant surgery). Small tubes are implanted within the eye to help with drainage.
• Filtering surgeries (trabeculectomy/trabeculotomy). Your doctor will either remove part of your trabecular meshwork (trabeculectomy) or make very small incisions in the white of your eye to help with eye drainage (trabeculotomy).

Cataract surgery

In some cases, cataract surgery, which involves the removal of the lens of the eye, can help with glaucoma by reducing your intraocular pressure, primarily for those with a narrow drainage angle.³

Glaucoma Treatment Costs

Glaucoma treatment costs vary by the type of treatment your doctor recommends. They can also vary by the location of your doctor, their skill level and how complex the required treatment becomes.

Average cost of non-surgical glaucoma treatment

Here is a look at the national average cost* and cost ranges of common medicated eye drops used to treat glaucoma:⁸

Average cost of glaucoma surgery

The national average cost* of glaucoma surgery can vary between $425 and $7,395, depending on the type of surgery.⁸

Below is a breakdown of average costs* and cost ranges for different types of glaucoma surgery.⁸

Average cost of trabeculectomy by state/district

A trabeculectomy is considered the most common glaucoma surgery.⁹ Below is a breakdown of the average cost* of a trabeculectomy for all 50 states and the District of Columbia.⁸

Additional cost considerations

When it comes to glaucoma treatment, there are several things to consider when it comes to the costs involved:

• Although eye drops cost much less than surgery, keep in mind that you'll need to administer the drops several times a day for the rest of your life. This can become costly over time.
• Laser surgery may cost less than traditional surgery because it can be done in an outpatient surgery center or even a doctor's office.¹⁰
• Traditional incisional surgery may require a hospital stay, which can greatly increase the cost of treatment.¹⁰
• Where your doctor is located and their skill level can affect the cost of your treatment. For example, those in larger metropolitan areas may charge more than those in smaller areas.

Is Glaucoma Treatment Covered by Medical Insurance?

Glaucoma is a medical condition and the costs of glaucoma treatments are usually covered by medical insurance or Medicare when considered medically necessary.¹¹ However, you may have to try pressure-lowering eye drops prior to surgery to see if they can successfully treat your glaucoma.

Your vision insurance may not cover glaucoma surgery but your health insurance typically can.¹⁰ The out-of-pocket costs you may incur depend on your plan and provider but may include copays, deductibles or coinsurance costs.

Candidates for Glaucoma Treatment

If you have been diagnosed with glaucoma, you are a good candidate for treatment. Your doctor will usually prescribe eye drops to help lower the pressure in your eyes. These drops typically control your glaucoma and prevent it from getting worse.³

If your glaucoma is not being properly controlled or you are suffering from severe side effects of your medication, your doctor will usually recommend surgery. Those with open-angle glaucoma may benefit from laser trabeculoplasty; those with angle-closure glaucoma are ideal candidates for a laser iridotomy.³

If laser surgery isn't an option for your particular case, traditional filtering surgery or drainage tube insertion may be the answer. And if you have narrow drainage angles, cataract surgery might be suggested by your doctor to help relieve the pressure in your eyes.³

How Does Glaucoma Surgery Work?

While you can start taking glaucoma medications immediately, surgery options require some preparation depending on the type of procedure.

Preparation

Prior to surgery, your doctor may ask you stop taking any blood-thinning medications. If you're scheduled for a traditional incisional surgery, they may also recommend you stop eating past midnight the night before your procedure.¹²

In addition, on the day of the procedure, it's a good idea to:¹³

• Arrange for someone to drive you home
• Avoid wearing makeup
• Bring sunglasses for the trip home
• Wear comfortable clothing

Procedure

Depending on the type of glaucoma surgery, these are some of the things you can expect:¹²

• Your doctor will only operate on one eye per procedure so you can have some vision during your recovery.
• Some types of incisional surgeries may involve general anesthesia. On the other hand, many laser-based procedures are performed while you are awake and aware of what is going on.¹³
• No matter what type of surgery you have, your doctor will numb the eye area, so you won't feel pain during the procedure.
• You may receive anti-fibrotic medication to prevent scarring and antibiotics to prevent infections.
• Your doctor will cover your eye with a patch after the procedure, which will typically remain until the following day.

Glaucoma treatment concerns

Prescription eye drops do come with some side effects, including redness, blurry vision, itchiness, changes in your energy level, breathing problems and fluctuations in heart rate.³

Unlike prescription eye drops, glaucoma surgery is a permanent solution to your eye problems, especially if the drops haven't been controlling your glaucoma. But eye surgery may carry concerns of damage to the eye, infections, scarring, cataract formation or blindness.¹⁰

Cataract surgery may also help reduce the pressure in your eye, but like glaucoma surgery, it comes with the chance of infection, damage to the eye or blindness.¹⁴

While these are important considerations, the benefits of treatment usually outweigh them.

Recovery From Glaucoma Surgery

Recovery from glaucoma surgery is generally fairly quick, especially if you've had laser surgery. Those with laser surgery can typically return to their normal activities within a day of the procedure.¹⁰

To promote healing and ensure a smooth recovery process, it's a good idea to:¹⁰

• Avoid wearing eye makeup for a few weeks after surgery
• Avoid strenuous exercise, straining and heavy lifting during recovery, which can affect the pressure within your eyes
• Keep the area clean
• Not wear contact lenses during the healing process
• Take your pain medication as directed by your doctor
• Use an eye shield to protect your eye, especially while you sleep¹⁴
• Use anti-inflammatory or antibiotic eye drops as directed by your doctor
• Wear sunglasses during the healing process to protect your eyes from the sun

Living Healthier With Glaucoma

Glaucoma is a chronic condition that can make it difficult to work, qualifying it as a disability in some cases depending on the severity of your vision loss.¹⁵

Lifestyle changes, along with medication and surgery, can help to keep the condition in check. It's also important to follow your doctor's directions exactly for taking any prescribed medications and not to miss any doses.¹⁶

• Exercise with caution. Aerobic exercise such as walking, biking and swimming may lower eye pressure, but you should ask your doctor if you can lift heavy weights or do certain yoga poses. Headstands and most head-down yoga positions are discouraged.¹⁶
• Eat healthy. A diet rich in fruits and dark, leafy greens may benefit your eye health.¹⁷
• Enjoy caffeine in moderation. Caffeine can increase the degree of pressure in the eye, so don't overdo it.¹⁷
• Use eye protection. Wear sunglasses outside, protective glasses when engaging in contact sports and goggles when swimming.¹⁷
• See your doctor regularly. They will monitor your symptoms and pressure in your eyes, usually every three to six months.³

CareCredit Credit Card Financing for Glaucoma

Whether you’re paying for eye surgery or getting an eye exam, the CareCredit credit card can help you pay for care where your insurance leaves off.** Use our Acceptance Locator to find a vision specialist near you that accepts CareCredit. Continue your wellness journey by downloading the CareCredit Mobile App to manage your account, find a provider on the go and easily access the Well U blog for more great articles, podcasts and videos.

In addition to vision care, you can also use your CareCredit credit card for dentistry, cosmetic, pet care, hearing, health systems, dermatology, pharmacy purchases, spa treatments and so much more within the CareCredit network. How will you invest in your health and wellness next?

Author Bio

Susan Paretts is a freelance writer with 20 years of experience covering health and wellness, pet care and more. Her work has been published by the American Kennel Club, Bayer Animal Health, Elanco, LIVESTRONG.com, The San Francisco Chronicle, Chewy and more.