Glaucoma is an insidious disease that causes permanent vision loss by causing progressive damage to the optic nerve without any symptoms. Kiss. Dr. Nurcan Gürkaynak; He gave information about Eye Pressure.
Glaucoma is one of the preventable causes of blindness in the world. It often progresses without any symptoms until later stages, and diagnosis can only be made with a careful eye examination. Since it is a disease that causes complete loss of vision if left untreated, the seriousness of the disease should be clearly explained to the patient and their relatives when the diagnosis is made. Because the patient usually does not have any complaints, he does not continue the treatment, which causes serious vision loss.
WHAT IS EYE PRESSURE?
and it is renewed every 2 hours. In glaucoma, there is no problem with the fluid entering the eye, but as resistance develops in the channels that allow it to leave the eye, the fluid accumulates in the eye and intraocular pressure (eye pressure) increases. This high pressure causes compression and drying of the optic nerve fibers.HOW IS GLAUCOMA DIAGNOSED?
Glaucoma is usually diagnosed incidentally during an ordinary eyeglasses examination or during an examination of patients who consult a doctor for simple reasons. For this reason, measuring eye pressure should not be neglected at every eye examination. Screening examinations in healthy individuals are very important for early diagnosis. Although it is very rare, in some patients, it manifests itself as severe eye pain, headache, bloodshot eyes, nausea and vomiting due to the sudden increase in intraocular pressure, which is called "acute glaucoma crisis". This situation requires urgent treatment.
Intraocular pressure in normal society is between 10-21 mmHg. Not every person with high intraocular pressure has glaucoma.
During the examination, glaucoma is first suspected by measuring the eye pressure of the patients and looking at the appearance of the optic nerve with the help of special lenses. Another important examination here is the measurement of corneal thickness. Eye pressure is higher in eyes with thick corneas. This causes misdiagnosis.
In order to make a definitive diagnosis of glaucoma, damage to the optic nerve must be proven. When eye pressure is borderline high However, eyes without optic nerve damage are called "ocular hypertension" or "glaucoma suspicion".
Until recent years, we only had "visual field examination" to detect glaucoma damage and monitor the disease. ' method. This test takes about half an hour and may give erroneous results in elderly patients and patients with adaptation problems. With the optical coherence tomography (OCT) device we now have, a complete glaucoma examination and early diagnosis of glaucoma is possible by evaluating the optic nerve, measuring the corneal thickness and anterior camera angle, without being dependent on the patient's expression as in visual field imaging.
OCT scanning is a harmless diagnostic method. It does not emit radiation, has no contact with the eyes, and does not require the application of medication to the eye. With visual field examination, the disease can be diagnosed after 30-40% of the visual nerve cells are destroyed. This For some reasons, visual field examination can only be useful in advanced stages. Today, the main goal is to evaluate glaucoma by taking images with an OCT device for early diagnosis of glaucoma.
WHO IS AT RISK OF EYE TENSION?
The most important cause of glaucoma is genetics. People with a family history of glaucoma are particularly at risk. The frequency of glaucoma is higher in myopic people. As the degree of myopia increases, the frequency of glaucoma also increases.
Narrow-angle glaucoma is more common in individuals with hyperopia. Since the use of cortisone drugs in any way (tablet, ointment, nasal and oral spray, eye drops) can cause high eye blood pressure, these people should have their eye blood pressure checked frequently.
In addition, diabetes, uveitis, retinal vascular occlusions, retinal blood pressure should be checked frequently. Detachment and eye trauma may lead to glaucoma. Glaucoma is also more common in people with migraine.
GLAUCOMA TREATMENT
There are three main ways.
Medication treatment
Laser application
Surgical treatment
DRUG TREATMENT
There are many drops used in treatment. These reduce intraocular pressure in different ways. Early stage glaucoma and in young patients Drop treatment is the first option. The drops should be used as recommended and without interruption. Some of these drugs cause breathing difficulties and heart rhythm disturbances in asthmatic patients. In this regard, patients should be warned and used with caution.
If the intraocular pressure in a patient with glaucoma remains normal with drop treatment and there is no damage to the optic nerve, drop treatment should continue continuously and throughout life. Eye pressure and measurements should be repeated at regular intervals.
LASER TREATMENT
In patients who do not respond adequately to drug therapy in the treatment of glaucoma, laser can be used as a pre-operative treatment. is the treatment option. It is effective in eye pressure that is not too high. Its effect lasts for 2-3 years. It is an effective treatment alternative in suitable patients. It is a painless procedure performed in a sitting position with local anesthesia. It is the first treatment method in narrow-angle glaucoma.
SURGICAL TREATMENT
If the eye pressure in a glaucoma patient cannot be reduced despite all medication and laser treatment, and if optic nerve damage progresses, surgery is inevitable. Surgery is the first option in patients with very high eye pressure and significant damage to the optic nerve. Surgery may also be preferred in elderly patients who cannot take medication regularly.
Glaucoma surgery is performed with local anesthesia. The patient does not need to lie down. Impaired vision does not recover in glaucoma surgeries. Because dead nerve cells cannot renew themselves. Only the surviving nerve is treated with surgery. further damage to cells can be prevented. Thus, the remaining vision is preserved and blindness is prevented.
HOW TO FOLLOW-UP
Ocular pressure, which is controlled with medication, laser or surgery, may increase over time. Therefore, diagnosis Once placed, patients must be followed for life by measuring blood pressure at least 4 times a year and OCT and visual field twice a year.
WHAT SHOULD PATIENTS PAY ATTENTION
With eye pressure reading It does not increase with writing or using the eye. These patients can continue their normal work and work. Physical activity does not need to be restricted, excessive water consumption (more than 2 liters) at a time and in a short time can increase eye pressure. It can kill. A stress-free life, balanced nutrition and regular sleep are important.
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