Glaucoma and Its Treatment

Ten to fifteen years ago, glaucoma was known as glaucoma. When the intraocular pressure was higher than normal values, the diagnosis of “glaucoma” was made and treatment was started. Today, glaucoma is accepted as a disease that occurs when the balance between intraocular pressure and body blood pressure is disturbed, and the irregularity of the blood supply of the eye. Some people have low general body blood pressure. In this case, even if the intraocular pressure is normal, glaucoma treatment is required as if the blood flow in the eye is low, as if it were high. This is called normal pressure glaucoma. These patients have cold hands and feet in summer and winter and migraine attacks are also seen. Sometimes the intraocular pressure may be above normal values ​​but does not require treatment. This is due to the thicker cornea and slightly higher pressure values ​​are due to this. Therefore, corneal thickness should also be measured in patients and intraocular pressure should be evaluated accordingly. In general, the intraocular pressure of glaucoma patients, which is normally 10-20 mm Hg, is above 25-30 mm Hg and requires treatment.

“There are two types of glaucoma: The most common one is insidious and does not show any symptoms without causing damage to the eye. The other gives symptoms such as headaches from time to time, blurred vision, colored rings around the lights at night. In this second type, the intraocular pressure may rise to very high values ​​such as 45-55 mm Hg and a glaucoma attack occurs. The glaucoma crisis requires immediate treatment. This treatment is drug therapy and the intraocular pressure is reduced to normal values ​​and requires laser or surgery. Waiting can be dangerous for the patient.

If the first type of glaucoma, which has an insidious course, has not yet given any symptoms, it is discovered by chance in patients who have had an eye examination for another reason, and treatment is started. When glaucoma damages the eye, the retina containing the optic nerve fibers of the eye is affected, and blind areas occur in the visual field due to nerve cell damage. Damage to the optic nerve also leads to a decrease in vision. The measurement of these damages is done with special tests at regular intervals. This has importance in the follow-up and treatment of glaucoma. In patients with this type of insidious glaucoma, treatment is started with medication. Today, there are various drug groups involved in the treatment. The selection of these drugs is made by the physician according to the general condition of the patient and the effectiveness of the glaucoma treatment. Sometimes one or several groups of drugs are used together. The patient’s compliance with the treatment is of great importance. In cases where there is no effective result from drug treatment, laser or surgery is performed. Today, selective laser application (SLT Laser Application) has a place in the treatment of glaucoma. This is a glaucoma specific laser and can be repeated. Laser therapy reduces the number of drugs used by the patient and increases its effectiveness. If the goal is not achieved with medication and laser treatment, surgery is a must. Sometimes a second or even a third operation may be required. Surgery is sometimes preceded by laser. The doctor decides this. Life-long follow-up of patients with glaucoma at regular intervals is essential. There is no reversal in glaucoma damage. With treatment, glaucoma is tried to be kept at that stage only at which stage it was detected.

Glaucoma can also be congenital. In this case, blood relatives play a big role. The eyes of babies with glaucoma are larger, there is watering, the baby is very uncomfortable with the lights. The transparent layer has partially or completely lost its transparency. Whether the baby sees or not, and if so, the degree of vision cannot be determined. The only treatment method is immediate surgery, and continuous medication may be required after surgery.

In adults, glaucoma can also occur in the eye or generally due to another disease. In these patients, the treatment of the causative disease is important as well as the treatment of glaucoma. Some drugs used by the patient may also cause glaucoma.

In the treatment of glaucoma, the patient’s compliance and cooperation with the physician are of great importance. The necessity of lifelong follow-up of patients with glaucoma should not be ignored. For patients who pay attention to this, glaucoma is not a scary disease, it does not lead to bad consequences.”

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