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What is Glaucoma?
Glaucoma, also colloquially called “hypertension of eye”, is a condition that ultimately leads to blindness by damaging the optic nerve. Vision loss can be prevented with early diagnosis and treatment.
It is more common in people older than 40 and in both eyes. The risk for glaucoma is higher in people with family history of glaucoma and patients with diabetes, high or low systemic blood pressure, high myopia or hyperopia, migraine and eye trauma as well as smokers and people who use cortisone therapy for long term. Therefore, such people should have eye exams regarding glaucoma regularly every year to ensure early diagnosis and treatment.
Many factors play a role in glaucoma-related damage to the optic nerve, especially including increased intraocular pressure. Intraocular pressure increases, when the fluid that is continuously secreted in the eye to feed the eye tissues cannot be properly drained and accumulates in the eye. Increased intraocular pressure damages the cells of the optic nerve. Physiological range of intraocular pressure is 12 to 20 mmHg, while it is above 22 mmHg in patients with glaucoma. However, optic nerves can be damaged in some people with vulnerable optic nerves, even if intraocular pressure is normal. This picture is called “low-tension glaucoma”. On the contrary, “ocular hypertension” is characterized by lack of optic nerve damage despite high intraocular pressure; this condition is left untreated and followed up regularly. In such patients, severity of elevation in intraocular pressure dictates whether glaucoma will develop and whether the optic nerve can tolerate the pressure without getting damaged. Some people can better tolerate the high intraocular pressure.
nTypes of Glaucoma
Open-angle glaucoma: It is the most common type of glaucoma in the general population. It usually occurs at an advanced age. It is completely asymptomatic in the early stage; it is insidious and progresses slowly over years. It causes enlargement cupping at the central zone of the optic nerve, resulting in damage to the optic nerve. Ultimately, loss of vision and visual field defects develop. Since the optic nerve damage is irreversible, early diagnosis and treatment is critically important.
Angle-closure glaucoma: In some people – especially hyperopic patients with smaller eyes , the angle is structurally narrow at the location of canals that drain the eye fluid. Iris (the color part of the eye) closes the drainage angle and canals due to some reasons and the intraocular pressure elevates very quickly to very high levels (60-70 mmHg). In this case, a very severe eye pain is felt that may be associated with nausea and vomiting. Eye redness, loss of vision and blurred cornea are other potential symptoms. Patients specify colored halos around lights. This condition, called “Acute Glaucoma Crisis” requires treatment right away. Vision is lost if treatment is delayed.
Congenital Glaucoma: The condition exists at birth. Since the eye wall of infants is flexible, increase in intraocular pressure enlarges the eyes. Cornea becomes blurred. It causes watering and light sensitivity. It requires emergency operation.
We measure intraocular pressure and examine the optic nerve using specialized lenses routinely for all adult patients in the ophthalmology clinic of İzmir MedicalPoint Hospital. In case of a glaucoma suspect, we use high-tech devices for detailed examinations.
Pachymetry (measurement of central corneal thickness): Intraocular pressure will measure higher if corneal thickness is above normal limits, and vice versa. We can determine true intraocular pressure relative to the corneal thickness.
OCT (Optical Coherence Tomography): (tomography scan of optic nerve) We can quantify the glaucoma-related damages and thinning in nerve fibers by conducting optic nerve analyses.
Computerized visual field test: We detect gradual loss of peripheral visual field and glaucoma-related defects. These tests play a very significant role in diagnosis and follow-up of the disease.
Treatment of Glaucoma
In Ophthalmology Clinic of İzmir MedicalPoint Hospital, we can control glaucoma and prevent vision loss by decreasing the intraocular pressure efficiently with medications (drops), SLT (Selective Laser Trabeculoplasty) and glaucoma surgery with or without implant (tube)
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