What is Glaucoma (Eye Pressure)?
Glaucoma is a serious eye condition that can lead to loss of vision due to damage to the optic nerve caused by chronically high intraocular pressure. The most common type of glaucoma is open-angle glaucoma, which progresses slowly and insidiously. Open-angle glaucoma accounts for 85-90% of all glaucoma cases. The patient's eye pressure may suddenly rise to very high levels, causing severe eye pain, headache, vomiting, nausea, and excessively red eyes. This is an emergency and very severe condition, easily recognized by eye doctors.
Intensive treatment yields immediate results. Treatment is surgical (traditional or laser). Patients at risk for angle-closure can also be easily identified in advance, and preventive measures can be taken. There is also a rare type called secondary glaucoma, where an increase in eye pressure occurs due to another eye disease (cataract, trauma, intraocular inflammation, intraocular bleeding). Treatment involves addressing both the underlying disease and the eye pressure.
The human eye continuously produces a fluid that nourishes the intraocular tissues, which is then drained from the eye through channels into the bloodstream. If these drainage channels are narrow, sticky, or blocked, the outflow of fluid slows, and the intraocular pressure increases. This increases the eye's pressure (tension). Normally, eye pressure ranges from 12-21 mm Hg. When pressure ranges from 25-40 mm Hg, it typically does not cause symptoms, so it is often detected incidentally during an eye exam. Sometimes there may be pain, blurred vision, or other complaints. It is generally seen in people over the age of 40 but can occur even in infants. 2-3 out of every 100 people over the age of 40 have high eye pressure.
Over time, increased pressure damages the optic nerves and tissues, reducing vision and potentially leading to blindness. Diet has no effect on this condition. It is more common in some families, so those with a family history of glaucoma should be more vigilant. It is also more common in people with high myopia (over 5 diopters) and high hyperopia (over 3 diopters). It can also occur in individuals who have sustained eye injuries. Diagnosis involves several pressure measurements and exams. Tests like visual field testing and optic nerve topography are conducted.
Those with borderline eye pressure (20-23) should have more frequent check-ups. If untreated, patients may start to lose peripheral vision, even though they can still see straight ahead. They may not notice people or cars approaching from the sides. Treatment involves the application of drops once or several times a day. Sometimes laser treatment is performed. If these do not lower the pressure and prevent damage, surgery is performed. Since glaucoma often does not show symptoms and can lead to blindness, regular eye exams are important.
Causes and Symptoms of Glaucoma (Eye Pressure)
Open-angle glaucoma, which progresses insidiously or is not advanced, typically does not show symptoms. It is often diagnosed during routine exams for near vision complaints through intraocular pressure measurement. High pressure measurements are a suspicious finding but cannot be the sole basis for diagnosis. Some patients have optic nerve damage with low pressure, while others show no damage despite high pressure measurements.
Damage to the optic nerve is detected through various methods. During the exam, direct examination of the optic nerve with devices like a biomicroscope can reveal signs of damage. In suspicious cases, optic nerve photos may be taken. Additionally, OCT (Optical Coherence Tomography) and NFA (Neuro-Fuzzy Algorithmic) methods can detect microscopic damage to the optic nerve and surrounding nerve fibers. Visual field testing is a must and provides a functional, highly valuable test that maps areas of visual field loss. 90% of patients are over the age of 40. Individuals with a family history of glaucoma have a tenfold increased risk due to genetic predisposition.
Therefore, intraocular pressure should be measured during routine exams at any age. For early detection, an eye exam is recommended annually after the age of 40. If left untreated, this insidious disease can lead to complete loss of light perception within 10-12 years, even requiring surgical removal of the eye in some cases.
Can Glaucoma Be Treated?
Glaucoma is a treatable disease. Early diagnosis makes treatment easier. Late diagnosis results in years of high pressure damaging the eye and reducing its resilience. Even if pressure decreases, visual field losses may continue, and sometimes even maximum treatment cannot save the eye. Therefore, adherence to treatment after early diagnosis, including regular use of drops and attending check-ups, is crucial in this disease.
Treatment of Glaucoma (Eye Pressure)
Glaucoma treatment can proceed in three different ways:
Medication: There are many drops available for glaucoma treatment that work through various mechanisms. Initially, a single medication is used to lower intraocular pressure. If ineffective, a second drop is added. If pressure still does not decrease, a third drop is added, or other treatment methods are pursued.
Laser Treatment: Laser is a last treatment option applied before surgery in patients who do not respond adequately to medication. Laser treatment can reduce intraocular pressure to normal levels in patients with moderately high pressure and can safely reduce medication use in patients for whom medication poses a risk. Its effect typically lasts 2-3 years, after which pressure may rise again.
Surgery: If all options have been tried, and pressure still cannot be reduced or visual field losses continue, surgery becomes mandatory. Glaucoma surgery is performed under local anesthesia in adults. Annual eye exams are necessary for early detection.
Minimally Invasive Glaucoma Surgery
As a new option in glaucoma treatment, the goal of minimally invasive glaucoma surgery is to prevent or reduce optic nerve damage caused by glaucoma. Today, the most commonly performed surgery for glaucoma is trabeculectomy. This surgery is considered a major procedure for the eye. While effective in lowering intraocular pressure, it can have some unwanted complications post-surgery.
In recent years, a technique for minimally invasive glaucoma surgery has been developed. This technique effectively lowers intraocular pressure and significantly reduces post-operative complications.
This procedure, performed under local anesthesia, does not involve sutures. The process takes 20-30 minutes. The eye is covered with a bandage for one day. The patient can return to daily activities the next day. Healing drops need to be used for one month. After surgery, 70% of patients can stop using their glaucoma drops, while 30% may need fewer drops. This technique can be performed alone or in conjunction with cataract surgery.
Which patients do we recommend this surgery for:
How Much Does Glaucoma (Eye Pressure) Surgery Cost?
Glaucoma (Eye Pressure) treatment costs vary depending on the underlying cause and the type of operation to be performed. The treatment plan determined by our specialist eye doctor after a detailed examination can differ from person to person.
For appointment and price information, please click here.The above information is provided for informational purposes only. If you have any medical concerns or questions, please make an appointment with our eye doctors.