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Glaucoma is a term describing a group of eye disorders that result in optic nerve damage. The most significant factor associated with glaucoma is increased intraocular pressure, the upper limit of which differs from patient to patient. With treatment, disease progression may be stopped or at least significantly slowed. If glaucoma is discovered sufficiently early, we can preserve good vision and consequently, also quality of life.
At the first medical eye examination, we discuss the situation, determine visual acuity, measure the intraocular pressure, perform a detailed examination of the eye using a biomicroscope and assess the angle of the anterior chamber and optic nerves to find any visible damage. The patient undergoes an examination of the field of vision, during which we evaluate a possible loss of vision due to collapse of nerve tissue. Based on our findings, we evaluate whether the eyes are healthy, if there is increased intraocular pressure and whether disease has already progressed.
The primary treatment of glaucoma is directed towards decreasing intraocular pressure using eye drops that reduce the pressure in various different ways. The doctor determines the types of eye drops that are required by each individual patient. A combination of different eye drops is frequently required in order to achieve the desired results. Patients usually take the eye drops once or twice a day for their entire life.
Selective Laser Trabeculoplasty (SLT) is used to treat open-angle glaucoma. According to the latest European Glaucoma Society Guidelines, this procedure is appropriate for the initial treatment of eye hypertension or glaucoma and for patients for whom treatment with eye drops is not sufficiently effective. More invasive surgical procedures can be postponed with the use of laser therapy. SLT treatment is appropriate for patients who are allergic to eye drops, have a sensitive eye surface, do not want to use eye drops, or have difficulties with eye drop applications. Due to using lower levels of therapeutic energy, newer lasers are safe and also efficient. Initial treatment with SLT decreases intraocular pressure by approximately 30%. In patients who already use eye drops, intraocular pressure is reduced by approximately 12 – 25%. The laser treatment procedure is painless. The eye is numbed using eye drops, a contact lens is placed into the eye and a laser ray is directed at the eye's angle and canals. This treatment results in improving the trabecular function and the flow of aqueous humor and also reduces intraocular pressure. Side effects are rare (mild inflammation, mild bleeding, increase of pressure), mild and transitional.
In closed-angle glaucoma, YAG laser iridotomy is used. The eye is numbed using eye drops, a contact lens is placed into the eye and a small hole is made in the iris using a laser. This treatment enables aqueous humor to reach the canals in the eye's angle so that the flow of aqueous humor is improved and the intraocular pressure normalized.