This article has been provided by Dr. Huseyin ACAR to give information about ‘Glaucoma and Its Treatment’ in general terms.
HOW IS THE STRUCTURE OF OUR EYES ?
Our eyes perceive the light and transmit it to the visual cortexes of the brain via optic nerves. In order to perform this function, eye structures work in harmony. Intraocular fluid are also part of this harmony. The produced fluid is discharged from the eyes by means of filter system after they complete their function. Under normal conditions, the production rate of eye fluid and discharge rate from the eyes is in equilibrium. Thus, a normal intraocular pressure is formed relying on such balance state.
WHAT IS GLAUCOMA AND WHAT ARE THE CAUSES ?
Glaucoma can roughly be defined as increase of the intraocular pressure more than it is required and thus harming optic nerve. Main reason of increase in intraocular pressure is the prevention of discharge of the produced eye fluid from the eyes for some various obstacles. The most frequently observed situation is the obstruction of pores in the filter system enabling fluid to be discharged from eyes. In this case, intraocular pressure increases gradually and it insidiously decreases sight. Apart from this case, circulation of intraocular fluid is interrupted suddenly and thus eye intraocular pressure to very high levels in a short time. This situation is called as glaucoma crisis. Glaucoma crisis is an emergency and it must be treated immediately in a short time.
Image 1: Glaucoma can roughly be defined as increase of the intraocular pressure more than it is required and thus harming optic nerve
WHAT ARE THE SYMPTOMS OF GLAUCOMA?
Glaucoma is an insidious illness. Patients in general notice accidentally that one eye has less sight when they close the other well sighted eye. It is the most accentuated issue by us as ophthalmologists due to the fact that this illness does not cause any complaints in early stages. Sometimes the disease is diagnosed by doctor suspecting the situation during routine eye examination. It is very crucial to make an early diagnosis to this illness as the damage of glaucoma is not reversible.
HOW TO DIAGNOSE GLAUCOMA ?
To diagnose glaucoma may be challenging for ophthalmologists sometimes. One of the most important reasons for this case is that we do not have any standard normal eye pressure level for everyone and the second reason is tests applied in early stages do not provide any indication. Consequently we as ophthalmologists demand some tests and analysis for the suspicious patients whether they have complaint about it or not. In case that these investigations support our suspicions, we diagnose it and begin for the treatment. If these investigations do not support our suspicions, then we start to follow up the patient and we repeat these tests in certain intervals. If a worsening in the results of the repeated tests is available, we diagnose the glaucoma and begin for the treatment. In case that those results of the repeated test are normal, then we increase the intervals of follow up or we quit the follow up process. As for the glaucoma crisis, which is another type of glaucoma, it is relatively easy to diagnose it. In these patients; sight loss, redness and eye pain occur because of eye pressure reached to very high levels in a short time. Nausea and vomiting can also be added to the clinical picture for the patients
Image 2: Vision field analysis is used to diagnose and follow up of glaucoma
Image 3: Retina nerve fiber analysis with OCT is used to diagnose and follow up of glaucoma
HOW TO TREAT GLAUCOMA ?
Treatment of glaucoma illness is administered by decreasing intraocular pressure into the level where it does not harm the optic nerve. For this purpose, the first choice is the eye drops. In the cases that drops do not suffice and damage on the sight remains prevailed, laser or surgery options step in. As for the treatment of glaucoma crisis, oral and intravenous drugs are used in addition to the eye drops. A laser treatment can be applied to avoid recurrence after intraocular pressure turned into normal levels.
Glaucoma can be defined as the increase of the intraocular pressure to higher levels than normally accepted value and thus the harm to the optic nerve. Generally it does not lead to any complaint until advanced stages. Early diagnosis is a crucial since the occurred damage cannot be recovered. Aim of the treatment is to decrease intraocular pressure into the levels so that it cannot harm optic nerve. For this purpose, eye drop comes in the first choice. Laser treatment and surgery are other options in which eye drops do not suffice for the treatment