Glaucoma is the name given to conditions in which eye-pressure related optic nerve damage occurs


• glaucoma surgeries
• visual field test
• retinal nerve fibre layer tomography
• corneal pachymetry (corneal thicknessanalysis)

Glaucoma is the name given to conditions in which eye-pressure related optic nerve damage occurs
The eye produces a fluid that nourishes the eye. This fluid runs through the draining channel of the eye and is discharged. When this drain becomes clogged, then this fluid can not leave the eye as fast as it is produced, causing the fluid to back up. The backed up fluid increases the eye pressure and the eye nerves start to dye slowly as a result of this high pressure.
What is the normal eye pressure level?
Normal eye pressure level is between 9 and 20 mmHg. There are various medical devices to measure the eye pressure. The measurements with air-puff device may be faulty. Measuring after applying anesthetic drops to the eye may give precise results (applanation).


What are the types of glaucoma?
There are 2 types of glaucoma.
Primary open-angle glaucoma: This type of glaucoma is the most common type. The eye pressure is a little higher than normal level. There are no symptoms. It Is insidious and causes the patient to lose vision slowly. This type of glaucoma  can be diagnosed at later stages.

Angle-closure glaucoma: It is a rearely seen glaucoma type. The eye pressure increases rapidly to hgh levels. It may cause severe headache and eye pains (glaucoma attack). This type of glaucoma  can be diagnosed at early stages.

What are the symptoms of glaucoma?
There are no smptoms at early stages of open-angle glaucoma. When the glaucoma advances and the optic nerves are damaged, symptoms such az narrowing in vision field, loss in vision, may be detected. There is no irritation, itching, or rash .
Angle-closure glaucoma is a rare form of glaucoma with symptoms such as intense headache and eye pains, nausea, vomitting, blurred vision, visual halos around light and eye rash.

How is glaucoma diagnosed?

Glaucoma is usually diagnosed incidentally. Most of the time, the patients visit us for an optalmological examination to get eye-glasses and diagnosed with high eye pressure. In case of glaucoma suspect, eye pressure is measured again at various frequency.
Besides eye pressure measuring, measuring central corneal thickness by pachymeter, is another method. A tomography scanning is performed to scan the visual field and optic nerve fibres (Rnfl).
It is not right to diagnose glucoma without performing these tests. The patient can be diagnosed with glucoma only if the tests support our suspect.

Is the corneal thickness important to diagnose glucoma?

If the central corneal thickness of the eye is thicker than the regular size, then the measured eye pressure would be higher than actual eye pressure, in error. If the central corneal thickness of the eye is thinner than the regular size, then the measured eye pressure would be lower than actual eye pressure, in error. The thickness of the cornea is measured with pachymeter. If there is any glaucoma suspect, the central corneal thickness should definitely be measured.

Who is at risk?
1. People who have a family history of glaucoma
2. People who have long-term cortisone use
3. People who have diabetes
4. People who have high level of myopia (nearsightedness) – hyperopia (farsightedness)
5. People over the age of 40
Since glaucoma has symtoms, people at risk should get their eye pressure checked, once a year.

How is glaucoma treated?
1. By medication: If glaucome is diagnosed at early stage, treatment can be started with eye drop. There are many types of eye drops. Your doctor shall prescribe you the best eye drop for your case. Sometimes, if only one drop is not sufficient, applying two or three drops may be required.
2. Laser theraphy (SLT): It can be applied if the medication is insufficient. Its affect is temporary.
3. YAG laser: It can be applied to open-angle glaucoma patients.
4. Surgical therapy (trabeculotomy): If the gaucoma cannot be treated by medicine, than surgery is necessary. The backed up eye fluid is discharged by surgery.

Life time follow up of the patient is necessary after all of these treatments.

What are the side-effects of eye drops?
Eye pressure eye drops have side-effects. Some drops cause rash, itching, dryness, growth in eye-lashes, change in eye clolor and some may cause cardiac arrhythmia or asthma attacks.

Living with glaucoma
1. Glaucoma is not related to what you eat or what you drink, watching TV or making a craft work.
2. The glaucoma patients should apply the drops on time. If there are more than one type of eye drop, then apply the second one, 20 minutes after applying the first.
3. If there is any rash or itching, consult your doctor before stopping using it.
4. Glaucoma patients should visit their doctor frequently. Please apply your eye drop before visitng your doctor.



Ada Eye Clinic and Surgery Unit