Glaucoma

Glaucoma

Glaucoma is an injury to the optic nerve that usually accompanies high eye pressure.

In most cases, the disease occurs initially and for no apparent reason.

But in some cases, it occurs secondary to factors such as:

1. Severe trauma
2. Diabetic bleeding
3. Ocular vascular stroke
4. Overuse of corticosteroids

and so on.

treatment

Based on the anatomical condition of the eye,  we can divide the disease into two main categories:

1. Closed-angle glaucoma
2. Open-angle glaucoma.

In terms of creation time, although most occur after the age of 40, it can occur at any time during life.

Therefore two less common categories of the disease are congenital glaucoma and juvenile glaucoma.

Predisposing factors for this disease include:

• Positive family history
• Diabetes
• Old age
• Myopia with high numbers
• Low corneal thickness

and so on.

treatments

Unfortunately, due to the decrease in vision from the field of view, except in a small number of patients such as acute closed-angle glaucoma.

That is accompanied by pain or congenital glaucoma seen with corneal opacity, the onset of the disease, and the destruction of the optic nerve.

Even to the advanced stages of the injury, will not be symptomatic and the diagnosis can only be made by an ophthalmologist’s examination.

Including an examination of the optic nerve, the angle of the eye, and the measurement of eye pressure.

Additional tests for further examination and accurate measurement of the extent of damage include:

• Perimeter or computerized field of view tests
• OCT of the neural layers around the optic nerve
•  Examination of corneal thickness

symptoms

Glaucoma treatment methods

specialists currently focus on treating glaucoma on reducing eye pressure, which involves the use of medication, laser, surgery, or a combination of these methods.

• Use of medication to treat glaucoma

Depending on the amount needed to reduce eye pressure, one or more eye drops may be used.

Medications reduce eye pressure either by reducing production or by increasing the discharge of clear fluid.

In most cases, the use of these drugs is lifelong.

• laser procedures

Different laser procedures are performed to reduce pressure and sometimes prevent glaucoma, including the PI laser, which is used to open the corner of the eye in closed-angle glaucoma, and the SLT laser, which is sometimes used as a substitute or supplement.

It is used to increase the outflow of clear fluid and the CPC laser, which is used in the later stages of the disease to destroy the ciliary body and thus reduce the production of clear fluid.

glaucoma lasers

• Surgical methods

In cases where it is not possible to reduce the eye pressure to the desired level with medication and laser.

Or in cases where the damage is very severe, surgeons will use surgical methods to reduce the pressure.

Surgeons will choose different surgical procedures based on the severity of the injury, the cause of glaucoma, etc.

The common denominator of all of them is ultimately reducing eye strain.

One of the most common methods is Trabeculectomy, in which the opening of a part of the eyewall and the creation of a clear fluid cavity is guided under the conjunctiva, where it is absorbed by the blood vessels.

Another surgical procedure is the placement of an intraocular shunt.

Therefore the shunt is a very small device that has a very narrow tube that enters the eye through a very small hole.

And the clear fluid is directed by this tube to the body of the shunt pressure regulator, from where it will be guided under the conjunctiva.

Another method is less invasive surgery (NPGS), in which fluid is directed out of the eye without opening the anterior chamber.

Other methods include trabeculectomy and goniotomy, which are performed in congenital glaucoma.

The choice of surgery is based on indicators such as the patient’s age, type of glaucoma, the severity of the injury, etc.

And if the patient also has cataract at the same time, it is often possible to have simultaneous surgery for glaucoma and cataract.

recovery

Surgery results and complications

An important point that any patient with glaucoma who is a candidate for surgery should know is that:

Currently, no surgical procedure will restore nerve damage or increase lost vision.

And the role of surgery is simply to maintain the existing condition and vision and prevent Continuity of injury.

So all surgeries, glaucoma surgeries have side effects that are unfortunately not uncommon.

And among all intraocular surgeries, we can commonly see Some of the complications that are postoperative intraocular infection, retinal swelling, and so on.

But some complications are specific to glaucoma surgeries.

Although unfortunately, the chances of postoperative complications are common in glaucoma surgeries.

So, fortunately, medication or surgery can treat most of these complications.

And only a small number of complications are incurable and cause permanent disorders.

The most important complications that can occur in any type of glaucoma surgery during or after surgery include:

• Postoperative infection
• Hypotension
• Severe reduction in postoperative eye pressure
• Corneal problems such as corneal inflammation
• Intraocular inflammation
• Accelerated development.
• Cataract, fluid or blood accumulation between the sclera or mesentery
• Temporary drooping eyelids
• Temporary loss of vision
• Malignant glaucoma
• Ultimately of surgery

So for having more information about eye problems check out our ophthalmology page.

In conclusion in this article, we tried to gather comprehensive information about glaucoma for you.

In order to have more information about glaucoma surgery in Iran please don’t hesitate to contact us.

Author: Maryam Shiani

SEO editor: Samane Nobakhti