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Glaucoma (Eye Pressure) Treatment

Glaucoma (Eye Pressure) Treatment

What is Glaucoma?

Glaucoma starts mostly after the 40s without any symptoms and increases the eye tension. It is especially a condition of the optical nerves which transacts the images from the eye to the brain. Optical nerves are combined forms of the multiple nerve tendons. If those nerval tendons are damaged somehow, blind spots in the visual field might occur. Those blind spots mostly cannot be early diagnosed and when the nerval tendon is too much damaged; it’s too late which might lead to total blindness. Early diagnose of the glaucoma is very important in order to prevent any nerval tendon damages and blindness.

Why Do We Have Glaucoma?

There is a transparent liquid at the front side of the eye called Aqueous Humour. In order to keep the eye pressure balanced, this liquid is produced by the eye and same amount is ejaculated simultaneously. Aqueous Humour is ejaculated from a microscopic channel system out of the eye which is totally different than tears. Since the eye is a closed system, when this microscopic channel (drainage angle) is blocked, the extra amount of liquid cannot be sent out; the intraocular pressure increases, stresses the optical nerves and damages it.

DIFFERENT TYPES OF THE GLAUCOMA

Open Angle Glaucoma: It’s the most encountered type of the glaucoma. It develops with the age. By time the microscopic channel system gets deficient, increasing the intraocular pressure and damaging the optical nerves. Sometimes optical nerves get highly sensitive even to the normal pressure of the eye. A treatment is highly recommended in order to prevent visual impairment

Closed Angle Glaucoma: When the Iris (the part which gives colour to the eye) blocks the microscopic channel system, “Closed Angle Glaucoma” occurs. This might be observed more likely with smaller eyes and eyes with hypermetropia. The Iris blocks the drain angle, the intra ocular liquid cannot be evacuated, creating the glaucoma.

Findings:

Blurred Vision
Headache
Nausea and sickness
Pain in the eye
Rainbow alike waves around the sources of light
These are the sign of an emergency for your eye, and you should contact your ophthalmologist immediately. If not cured, this type of glaucoma might lead to visual impairment

Unfortunately, early diagnoses in 2/3 of closed angle glaucoma patients are not possible.

Risk Factors of the Glaucoma

Older Ages
High Intra Ocular Pressure
Myopia, Hypermetropia or Traumas
 Thin Cornea
Diabetes, migraine, circulatory problems
Your ophthalmologist will evaluate all the factors to see if you will need a treatment against glaucoma or a follow-up. A suspicion for a glaucoma shows that you are in the high-risk group, and you will need regular follow ups in order to prevent potential damages in optical nerves.

How is the Glaucoma Detected?

Regular checks with your ophthalmologist are the best way to detect Glaucoma. The measurement of your intra ocular pressure is not enough to detect the glaucoma. A full check-up of the eye should be performed.

What will your ophthalmologist be controlling during your examination?

Intra ocular pressure (Tonometry)
Drainage Angle (Gonioscopy) What
Damages on the optical nerves (Ophthalmoscopy)
Visual Field Evaluation (Perimetry)
It is recommended to have a computer assisted screening and photography of the optical nerves. Those methods might not be necessary for everyone however, those tests might be repeated for follow-up

How is glaucoma treated?

Glaucoma related damages in the eye are irreversible. Eye drops, laser surgeries or surgical interventions are performed to prevent any further defects and sometimes oral medication can be applied

Medical treatments of glaucoma

Glaucoma can be controlled with daily eye-drops. Those medication can decrease the intra ocular pressure, the production of aqueous humour liquid or helps the evacuation of the liquid. It Is important to listen to the instructions of the ophthalmologist and not to change and stop your medication. If your medication is running low, you should consult your ophthalmologist for further treatments.

Possible Side-effects of some eyedrops

Burning or itching
Changes in the heartrate
Changes in your energy level
Changes in breathing
Dry mouth – changes of taste
Headache
Blurred vision
Changes in eye-colour
Longer eyelashes
Please don’t forget to inform your ophthalmologist about the other regular medications you are taking.

Laser Surgery for The Treatment of Glaucoma

Laser treatment can be recommended for various types of Glaucoma. The microscopic channel system can directly be treated by laser in the open angle glaucoma. Laser is used to control the intra-ocular pressure by creating changes in the channel system (Trabeculoplasty). By the closed angle glaucoma, the laser is used to open a hole on Iris (Iridotomy) so that the drainage of aqueous humour liquid can be corrected.

Surgical Intervention

A new channel is created by the surgeon using very thin & unique surgical equipment so that the aqueous humour liquid can be ejaculated from the eye (trabeculectomy). A surgical intervention might be recommended by your ophthalmologist in order to prevent further damage to the optical nerves. Like laser treatment, the surgical interventions also don’t need hospitalization.

What Is Your Role in The Treatment?

Glaucoma treatment is a teamwork with the patient and the doctor. The doctor might recommend a treatment however, it is the patient’s duty to apply and stick to the instructions.

When you start the treatment for the glaucoma, your ophthalmologist will call you more often for follow up controls. You should be ready to have control appointments every 3 or 4 months. This might be changed due to the course of your treatment. These regular controls & follow-ups will prevent any potential impairment risks.

Recommended Checks for Different Ages

Between 20 - 29 Years Old: Every 3 - 4 Years if a family member has Glaucoma history.

Between 30 - 39 Years Old: Every 2 - 3 Years if a family member has Glaucoma history.

Between 40 - 64 Years Old: Every 2 years

65 Years old and older: Once in a year.

OUR DOCTORS

He graduated from the Faculty of Medicine at Hacettepe University (Medium of education: English) in 1997. He completed his specialty in Ophthalmology at Ege University Medical School, at the Ophthalmology Department. He became an Assistant Professor in 2006, and an Associate Professor, in 2010 and received the Professorship title in 2016. In 2003, he received a training on retinal and vitreoretinal surgery at the University of Helsinki's Cornea and Refractive Surgery and in 2017 as a visiting physician at the retinal section of George Washington University in the USA. His main areas of interest are Cataract, Retinal Diseases (Diabetes, Yellowhead Disease, Retinal Vein Diseases etc.), Corneal Diseases (Keratoconus, Dry Eye, Conjunctival Surface Diseases), Uvea (Behçet's Disease) Diseases. He scored over 6000 surgical cases in these areas. He has 36 scientific articles which have been published in international scientific indexes. He has over 80 presentations in various congresses. He has worked as a chapter writer and book editor in Turkish ophthalmology books. He has attended many national and international scientific meetings as a lecturer and panel speaker. He is an active member of the Turkish Ophthalmology Association (TOD) Cataract and Refractive Surgery Unit (2010), Turkish Ophthalmology Association (TOD) Cornea and Ocular Surface Unit (2010), TOD Uvea Unit (2010). Prof. Dr. Sinan EMRE can speak English. He is married and has one child.
He was born in Ankara in 1945. He attended TED Ankara College, İzmir Bornova Anatolian High School and Ege University, Faculty of Medicine between 1963 and 1969, respectively. Upon his graduation, he started his specialization at Ege University, Faculty of Medicine, Eye Diseases Department and assumed the title of Eye Diseases Specialist in 1971. Between 1974 and 1975, he performed his military service as an ophthalmologist in Hatay Military Hospital in İzmir. After that, he was educated on Retinal Diseases and Lasers in Ophthalmology Clinic of the Faculty of Medicine at University of Gant, Belgium for 1 year. In 1977, he assumed the title of Associate Professor of Ophthalmology, and he founded and operated Retina and Contact Lenses units in Ege University, Faculty of Medicine, Department of Eye Diseases. In 1982 he became a Professor of Eye Diseases. Between 1992 and 2000, he served as the Head of Department of Eye Diseases, Faculty of Medicine, Ege University. In the meantime, he published 3 books and more than 150 domestic and foreign scientific papers, and about 170 papers in national and international congresses. He is married to Dr. Nigar Erbakan and has two sons.
Dr Esat Çınar was born in Diyarbakır in 1976. He started İstanbul University, Faculty of Medicine in 1997 and graduated in 2003. He completed his speciality degree between 2003 and 2009 at İzmir Ege University, Faculty of Medicine, Ophthalmology Department. He was in charge of Glaucoma and Cornea Departments as a Deputy Associate Professor in İzmir University Hospital Faculty of Medicine, Department of Ophthalmology. He studied “Keratoplasty” in Ege University, Faculty of Medicine for 6 months (also known as “eye transplant”). He also was in charge of the controls of the premature babies’ in İzmir University Ophthalmology Department. He attended the course for vivisection both in clinical and laboratory fields for one month. His special interests are; Cataract surgery (multifocal, trifocal and thoric intraocular lenses), Cataract surgery with laser (Femtosecond Cataract), Keratoplasty, glaucoma surgery (non-penetrant surgeries such as viscocanalostomy, deep sclerotomy), Excimer Laser Surgeries (Lasik, Lasek, PRK), medical retinal diseases. He has many published articles in international indexes. He has many verbal and written presentations in national and international scientific meetings. He is an active member of the Turkish Association for Ophthalmology. He speaks fluent English and has one child.
He was born in Izmir, in 1971. He attended summer school at Mids School of English, Eastbourn, England for learning a foreign language while he was in Bornova Anatolian High School and graduated with a high degree. He started his medical education at Ege University and continued with his specialization at JL Uni-Giessen, Germany, where he had the chance of working peer to peer with names such as Prof. Dr. Karl W. Jacobi, Prof Dr. Herbert Kaufmann, Prof. Dr. S. Pavlovic. Then, he found the opportunity to further his education in the field of refractive surgery by working with the most important names, such as Prof. Dr. T. Kohnen, JWG Uni-Frankfurt, Prof. Dr. I. Pallikaris, University of Crete, Prof Dr. Mahmut Kaşkaloğlu, Ege University Faculty of Medicine and Kaşkaloğlu Eye Hospital. Besides, he did scientific studies about medical glaucoma treatment, which is his other field of interest, with Ass. Prof. Dr. Karl Georg Schmidt, CGC Uni-Dresden. He is a member of DOG, ESCRS, ISRS of the AAO and TOD. He is married and has one child.
He graduated from Hacettepe University Faculty of Medicine in 1998. He completed his speciality in İzmir Dokuz Eylül University Faculty of Medicine Department of Eye Diseases between 1998 and 2002. He studied Retinal Surgeries in Munich Ludwig – Maximillian University Faculty of Medicine, Department of Eye Diseases. Special Interests: Cataract Surgeries (Multifocal, Trifocal, Toric Intraocular Lenses), Laser Cataract Surgeries (Femtosecond, Laser Cataract), Excimer Laser Surgeries (Lasik, Lasek, PRK) and Medical & Surgical Retinal Surgeries, Eyelid Surgeries. He has many articles published which were also scientifically indexed. He has oral and poster presentations in national & international science meetings. He is an active member of Turkish Society of Ophthalmology. He speaks English & German well, and married with 2 children.
He graduated from Istanbul University, Faculty of Medicine and completed his specialty training in S.S.K Istanbul Hospital in 1984. He worked at Çanakkale State Hospital between 1984 and 2007. After 2007, he worked in private sector health units. He is an active member of The Turkish Ophthalmology Association and American Cataract and Refractive Association. Anterior segment (cataract) medical retina, glaucoma and contact lens are his areas of interest. He has a good command of English.
He was born in 1977. He graduated from Ege University. Fields of Interest: Cataract Surgery (Monofocal, Multifocal, Trifocal, EDOF, Toric Lenses) Excimer Laser (Femtosecond LASIK, PRK, No-Touch) ICL Keratoconus - Crosslink, Hard Contact Lens Application, Intrastromal Corneal Ring Strabismus Surgery Oculoplastic Surgery (Eyelid Aesthetic Surgery, Ectropium, Entropium, Ptosis, Probing, Tear Duct Obstruction) Pterygium Surgery (with Autograft) Glaucoma Medical and Laser Therapy Retinal Diseases (Intraocular Drug Injections, Diabetic Retinopathy, Yellow Spot Disease, Retinal Tears) Soft Contact Lens Inspection and Application He is a member of Turkish Association of Ophthalmology. He is married.
Dr. Kaan Okan Erdem was born in İzmir, in 1968. He finished middle school in Private İzmir Türk College and high school in Atatürk High School. He studied medicine in Selçuk University Faculty of Medicine. He is an active member of European Association of Cataract and Refractive Surgery, European Association of Ophthalmic Plastic and Reconstructive Surgery. He is interested in cataract, refractive surgery, oculoplastic and reconstructive surgery (upper and lower eyelids, tumour removals around the eye, entropium, ectropium ptosis, blepharoplasty), eye ultrasound, medical retinal and glaucoma. He speaks fluent English and married with 2 children.
He graduated from Dokuz September University Faculty of Medicine in 1996. He completed his specialized education in the Department of Ophthalmology of the Faculty of Medicine of the Aegean University between 1996-2001 and earned the title of ophthalmologist Dec. He has published numerous scientific articles that fall into international scientific indexes. There are numerous oral and poster presentations to national and international scientific meetings. He is an active member of the Turkish Ophthalmology Association (Tod). He speaks good English, Opr. Dr. Uğur Karagöz is the father of 2 children. Special interests: Cataract surgery (multifocal, trifocal, Toric intraocular lenses) Cataract surgery with laser (Femtosecond Laser Cataract) Excimer laser surgeries (Lasik, Lasek, PRK) Medical and surgical Retina Eyelid Surgeries
Born in Cyprus Serdarlı, he graduated from Nicosia Turkish High School. He graduated from Dokuz Eylul University Faculty of Medicine. He completed his specialization in Atatürk Health Site Yeşilyurt State Hospital with his thesis on the comparison of the rear camera lens application and the front camera lenses, which was started to be applied for the first time in the clinic under the management of Zühal Çakırca, the clinical chief. She worked as a contact lens center in İzmir for three years and then as chief physician at Karşıyaka Kızılay Fatma Kutluay Dispensary. He continued to work in Karşıyaka by establishing the Private Yalı Polyclinic in 2005 and the Private Yalı Eye Health Branch Center in 2007, his special interests are refraction and contact lenses. He is a member of the Turkish Ophthalmology Association.
He graduated from Ege University Faculty of Medicine in 1989. Specialization he completed his education in Izmir Education and Research between 1991-1994. He completed his Ophthalmology Department at the Hospital. International A large number of scientific articles included in scientific indexes have been published. Numerous oral and poster presentations to national and international scientific meetings has a presentation. He is an active member of the Turkish Ophthalmology Association (TOD). Fluent in English, Opr. Dr. Gazi Duman is married and has two children. Special interests: Cataract Surgery (multifocal, trifocal, toric intraocular lenses) Cataract Surgery with Laser (Femtosecond Laser Cataract) Excimer Laser Surgery (Lasik, Lasek, PRK) Medical and Surgical Retina Eyelid Surgery Strabismus Surgery
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