Glaukoma treatment

What is Glaucoma?

Glaucoma is an illness in which ocular hypertension occurs. The reasons for the increase of intraocular pressure can vary, and their joint characteristic is the production of more liquid in the eye (aqueous humour) than the systems for its elimination can drain. This results in the rise of intraocular pressure to over 18mmHg or 20mmHg. The high pressure leads to the necrosis or damage of the optic nerve and gradual loss of vision. The ocurrence tendency rises with age, and it is considered that each person over 40 years of age should have his/her intraocular pressure measured during an ophthalmic checkup.

Signs and symptoms

A slight rise in the intraocular pressure will have no symptoms in the patient. Long-term occurrence of pressure leads to gradual damage of the optic nerve which cannot be detected subjectively. The only form of diagnosis is the measuring of intraocular pressure and computerised perimetry (computerized visual field), which can indicate changes in the optic nerve in the earliest stages of the illness. Left untreated, the illness advances and the patient starts experiencing spots or blurs in the visual field. When the illness reaches an advanced stage, therapy is limited only to the preservation of the existing visual acuity, without the possibility of regaining lost vision. In certain cases the rise in intraocular pressure can be sudden, when it is also followed by sudden loss of vision, extreme redness of the eyes and severe headaches. In such cases it is necessary to seek immediate medical attention.

Treatment

The aim of the treatment of patients with glaucoma is to reduce intraocular pressure. This is achieved with different types of medications and eye drops. In order for the pressure to remain within normal physiological range for as long as possible, it is necessary to stricly respect the doctor's advice and intructions for use of eye drops (use at specific time, without individual discontinuation of treatment...). The mechanisms of action of eye drops used is different. Some cause less production of acqueous humour, while others increase its drainage from the eye. The effectiveness of one specific type of eye drops can decrease in time, when pressure will gradually rise despite the use of eye drops. This especially occurs due to inadequate application, individual discontinuation of therapy and not respecting the doctor's intructions. In such case it is necessary to introduce other forms of drops to return the pressure to normal. Considering that in today's world of medicine the number of different types of eye drops is limited, our goal is to maintain the pressure within normal range for as long as possible by avoiding the variation of different types of drops. With specific types of glaucoma laser treatment is applicaple for the reduction of intraocular pressure or for ridding the patient of eye drop use. Laser interventions do not require prior preparation of the patient. They are performed in clinical conditions, are painless and patients are discharged quickly. In cases when intraocular pressure cannot be reduced either with eye drops or laser intervention, operative treatment is applied. Glaucoma surgeries require local anesthesia and are performed at the day clinic. The patient is discharged the same day and further checkups are done as agreed by the patient and doctor. In some cases local therapy (eye drops) is needed even after surgery in order to keep the pressure within the normal range.