Laser Treatment Offers Hope for Glaucoma

What is glaucoma?

Glaucoma is actually a fairly common group of diseases and ranks second among the causes of blindness in the world. By definition, glaucoma is a disease that progresses with high eye pressure; it causes progressive, irreversible damage to the optic nerve and ultimately results in blindness. In another, more rarely seen type of glaucoma, a glaucoma clinical picture can be observed while the eye pressure is at normal values. In addition, different forms of glaucoma clinical pictures can emerge due to various eye and systemic diseases.

What are these diseases?

First of all, glaucoma can occur due to high myopia, eye inflammations, eye injuries, after eye surgeries, along with migraine disease, in the advanced stages of diabetes, and due to systemic hypertension causing bleeding in the eye.

Is glaucoma only seen at advanced ages?

The open-angle glaucoma picture, which we see most frequently, generally appears over the age of 45. However, when we look at the patients followed up in glaucoma clinics in a general sense, we can see that it includes various age groups from newborn babies to a very advanced age group. In infancy, the picture we call congenital glaucoma emerges as congenital. Due to the high rate of consanguineous marriages under the conditions of our country, congenital glaucoma is seen more frequently in our country.

What are the symptoms of glaucoma?

In the open glaucoma type, which constitutes a very important part, a symptom cannot be perceived by the patient at the beginning, and the disease progresses insidiously. Since destruction generally begins in peripheral vision; unless it reaches a very advanced point, there is no significant loss in visual acuity, and no significant finding that can be perceived by the patient occurs. In the closed-angle glaucoma type, the picture can emerge much more seriously. Symptoms such as severe pain around the head and eyes, decreased visual acuity, redness in the eye, and even nausea and vomiting can be seen. In the congenital glaucoma type seen in babies, the eye is larger than normal. There is whitening in the transparent part, which is like a watch glass, called the cornea, in the front part of the eye, and babies cannot look at the light.

How is glaucoma diagnosed if there are no symptoms?

The diagnosis of glaucoma is usually made as a result of the procedures performed during an eye examination. Since genetic predisposition is very important in this disease, especially people with a family history of glaucoma need to be more careful and have routine eye check-ups. Measuring the patient’s eye pressure and analyzing it according to the corneal thickness is the first step in the diagnosis. Using devices that measure eye pressure without being affected by corneal thickness is an important advantage. Again, the anterior chamber angle, retina, and optic disc need to be evaluated. By detecting the damage that occurs according to the results of the visual field, which measures the sensitivity of visual cells, the retinal nerve fiber layer, and optic nerve head analyses, we make the diagnosis of glaucoma.

Could you also provide information about laser treatment in glaucoma?

Although glaucoma treatment varies depending on the type and stage of glaucoma, the general health status of the patient, and the compliance they will show to the treatment; it is primarily in the form of medical treatment application. If the desired result cannot be achieved with medical treatment, laser or surgical treatments are applied. In advanced glaucoma patients where sufficient results cannot be obtained from these treatments either, we can also apply special laser techniques, which we call “Endoscopic Cyclophotocoagulation,” aimed at destroying the fluid-producing cells inside the eye. The biggest advantage here is; eliminating the patient’s pain complaints, trying to preserve the current visual acuity, and helping patients in cases where a new surgical procedure is now very difficult.