Treatment of glaucoma
At our ophthalmology centre, we treat glaucoma using the following methods: anti-glaucoma implants and micropulse anti-glaucoma laser therapy. These are solutions for patients for whom standard pharmacological treatment does not work.
What is glaucoma?
Glaucoma is a group of diseases leading to damage to the optic nerve and retinal ganglion cells. Consequently, this leads to a deterioration of vision and its irreversible loss. Glaucoma can even develop asymptomatically even for a long time, which is why regular ophthalmological check-ups are so important.
Glaucoma causes gradual atrophy of the nerve fibres and consequently reduces the field of view until it is completely lost. We can describe the optic nerve as the link between the eye and the brain. To see the image registered by the eye, it must be transmitted to the brain. This is what is possible, thanks to the optic nerve.
What are the causes of glaucoma?
Glaucoma is a multifactorial disease. The proper functioning of the optic nerve is made possible by adequate intraocular pressure. The continuous inflow and outflow of aqueous humour is responsible for maintaining this pressure. Abnormalities in the outflow of the aqueous humour can lead to increased pressure in the eyeball.
People who are particularly at risk of glaucoma include:
- people with diabetes mellitus
- people with hyperlipidaemia
- patients with atherosclerosis
- patients with hypertension
- people struggling with excessive stress
- people with migraine
- people with a family history of glaucoma
Glaucoma is most common in older people over 40 years of age. The incidence of disease increases with age – approximately 0.5% of 40-year-old persons suffer from the disease, while in 70-80-year-olds, the figure increases to almost 10%.
What are the types of glaucoma?
There are different types of glaucoma:
Primary open-angle glaucoma is one of the most common types of glaucoma. Primary open-angle glaucoma develops asymptomatically for a long time. In this case, the outflow of aqueous humour is difficult at the trabecular meshwork level.
Angle-closure glaucoma (closed angle glaucoma) – this type of glaucoma results from the closure of the canal through which aqueous humour drains from the eye. Complete closure of the canal causes the so-called “acute attack of glaucoma”, which manifests itself in nausea, headaches, increased pressure in the eye, pain in the eyeball and vomiting.
Congenital glaucoma – this is the least common type, which unfortunately most often leads to significant vision loss. Congenital glaucoma has a genetic basis and develops in infants and young children.
Secondary glaucoma – is a type of glaucoma that occurs as a result of other diseases, such as cancer or trauma to the eye.
Normal tension glaucoma – these are cases where, although the pressure in the eyeball is normal, there is nerve damage and loss of vision.
The most common symptoms of glaucoma
Very often, glaucoma does not produce any symptoms for a long time. This is why regular consultations are recommended – they should take place once a year or once every two years.
Signals that should prompt us to visit the ophthalmologist’s office include:
- eye pain
- reduced field of view
- seeing halos around light sources
- redness of the eye
- narrowing of the field of view – tunnel vision
How does the diagnosis of glaucoma proceed?
For a specialist to diagnose glaucoma, he or she must take into account changes that have occurred in the appearance of the optic disc, as well as visual field loss.
For this purpose, a number of tests must be performed:
- Eye fundus examination – during the examination, the doctor assesses the condition of the optic disc.
- Imaging evaluation – this enables the assessment of the condition of the optic nerve and layers of nerve fibres. After performing the evaluation, the specialist can assess the advancement of the disease. The evaluation can be performed using various methods, including OCT and HRT.
- A visual field test – allows the visual field to be checked in an area thirty degrees from the centre of the eye fundus. In the process of glaucoma treatment, the examination is performed several times – approximately every 6 months, because it allows to assess the effectiveness of the treatment and monitor the progression of the disease.
- Intraocular pressure measurement – specialized tonometers are used here: Goldmann applanation clinometer, iCare tonometer, and air-puff tonometer.
- Filtration angle measurement – by performing such an evaluation, the specialist can observe the outflow path of the aqueous humour, and thus recognize the type of glaucoma and select the appropriate treatment route.
- Imaging examination of the anterior segment of the eye using OCT enables the diagnosis of the mechanism of angle closure in the eye and the planning of optimal treatment.
How is glaucoma treated?
The choice of glaucoma treatment depends on the individual case and, of course, on the severity of the disease. This mainly consists of lowering the pressure in the eye, i.e. by taking special drops.
1. Pharmacological treatment – a very common solution in the treatment of glaucoma is the use of antiglaucoma drops, which are intended to lower the pressure in the eye.
2. Laser procedures – among the laser procedures used in the treatment of glaucoma, we can mention YAG iridotomy, i.e., a laser making a hole in the iris, and laser trabeculoplasty, which attempts to unblock the holes in the trabecular meshwork.
3. Surgical procedures – the third option in the treatment of glaucoma is surgery, which aims to reduce the pressure in the eyeball.
Can glaucoma be completely cured?
A cure is possible in primary angle-closure glaucoma (PACG). The anatomical structure of the eye is then the cause of the disease. By detecting the specific cause and carrying out the appropriate treatment, it is possible to open the natural outflow pathway of the aqueous humour.
Complete cure is impossible in primary open-angle glaucoma (POAG). Primary open-angle glaucoma is an idiopathic disease whose causes are not fully known – there are various factors involved, including genetic factors. Treatment involves inhibiting the disease and ensuring the patient has the best possible visual acuity.
What is micropulse anti-glaucoma laser therapy?
This is a repeatable procedure. This involves stimulation of the ciliary body, which produces aqueous humour. During the treatment, the tissue is stimulated by slight heating. This triggers its regeneration process. This leads to a reduction in intraocular pressure. This procedure is used in open-angle glaucoma, which cannot be controlled even with intensive pharmacological treatment, in patients who do not tolerate ophthalmic drops well or do not follow pharmacological recommendations. It is worth knowing that previous anti-glaucoma procedures do not exclude the possibility of micropulse laser treatment.
The SPEKTRUM Clinical Ophthalmology Centre is a comprehensively equipped centre for diagnostics and individually tailored therapy: pharmacological, laser and surgical treatment in all types of glaucoma. Patients are given the opportunity to assess the status of their disease based on a comprehensive initial examination. During follow-up visits, they learn how the progression of the disease is being slowed down and what diagnostic tests need to be performed before the next consultation.
Glaucoma surgery – price
The SPEKTRUM Clinical Ophthalmology Centre is a comprehensively equipped centre for diagnostics and individually tailored therapy: pharmacological, laser and surgical treatment in all types of glaucoma.
Patients are given the opportunity to assess the status of their disease based on a detailed initial examination. During follow-up visits, they learn how the progression of the disease is being slowed down and what diagnostic tests need to be performed before the next consultation. Depending on the choice of glaucoma treatment (laser treatment, surgery), the final cost varies.
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