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Glaucoma is a term describing a group of eye disorders that result in optic nerve damage, often associated with increased intraocular pressure. Its upper limit differs from patient to patient. Treatment stops or at least slows down the disease progression. If glaucoma is discovered soon enough, a good vision function and consequently also the quality of life can be preserved.
On the first medical examination we discuss about the situation, determine visual acuity, measure the eye pressure, perform a detailed examination of the eye with the biomicroscope, anterior chamber angle examination and examination of the optic nerve to look for any visible damage to it. The patient undergoes the examination of the field of vision where the possible visual function loss because of collapse of the nerve tissue is evaluated. According to results, it is evaluated if eyes are healthy or if there is an increased eye pressure, if the disease has already developed.
The purpose of the primary treatment of glaucoma is to decrease the eye pressure with eye drops that decrease the eye pressure in various ways. The doctor decides which eye drops are required for a certain patient. Frequently, a combination of different eye drops is required to achieve the wanted eye pressure decrease. Patients usually take them once or twice a day for all life.
In open-angle glaucoma, selective laser trabeculoplasty (SLT) is used. This newer procedure is according to the European glaucoma society guidelines adequate for initial treatment of eye hypertension or glaucoma, and for patients for whom the treatment with eye drops is not efficient. The invasive surgical procedure can be postponed with the use of laser. It is adequate for patients who are allergic to eye drops, for those who have a sensitive eye surface, and for those who do not want to use eye drops or have difficulties with eye drop application. Newer lasers are safe because of lower therapeutic energy, but are also efficient. The initial treatment with SLT decreases the eye pressure for approximately 30%. When patients already use eye drops, it decreases eye pressure for approximately 12 – 25%. The procedure of laser treatment is painless. The eye is numbed with eye drops, the contact lens is placed into the eye, and laser ray is directed in the angle and canals. With this treatment, function of the trabecula improves, aqueous humor flow improves, and eye pressure decreases. Side effects are rare (mild inflammation, mild bleeding, increase of pressure) and are mild and transitional.
In closed-angle glaucoma, YAG laser iridotomy is used. The eye is numbed with eye drops, contact lens is placed into the eye, and a small hole is made in the iris with the laser. This enables aqueous humor to reach the canals in the eye angle. In this way aqueous humor flow improves, and eye pressure is normalized.