Glaucoma Department

What is glaucoma?

glaukoma

Glaucoma is a serious, chronic progressive disease of the optic nerve and optic fibers of the eye, leading to morphological changes of the optic nerve and visual field.

Glaucoma occurs when fluid that circulates inside the eye, due to poor drainage or overproduction, results in increased intraocular pressure.

Increased pressure within the eye can damage the optic nerve and can lead to blindness.

Types of glaucoma

Open angle glaucoma (most common form of glaucoma).
Closure angle glaucoma (acute or chronic).
Congenital glaucoma (appear in childhood).

People with higher risk of developing glaucoma:
People with high intraocular pressure.
People who have high myopia.
People who suffer from diabetes mellitus, hypertension or migraines.
People with a family history of glaucoma.
People who take for al long period of time cortisone.
Black people especially Africa-Americans origin.

How is the diagnosis of glaucoma

The diagnosis of glaucoma is provided through a detailed eye examination:

By measuring the intraocular pressure (tonometry).
With the gonioscopy.
By examining the visual field examination.
With the optical coherence tomography (OCT) of the optic nerve fibers.
With the corneal pachymetry.

The Tonometer

tonometrisiThe Tonometer measures the pressure of the eye. By putting anesthetic eye drops the doctor measures with the Goldman tonometer the eye pressure through applanation of the cornea.

Gonioscopy

The gonioscopy is an examination test to determine the angle where the iris meets the cornea to judge the drainage of aqueous fluid (closed or open, and various degrees).

Visual Fields

optika pediaThe visual fields test (automatic perimeter) is an examination test which checks the status of the optic nerve. The patient is called to fix a point and press a button when a light flashes (bright or faint).

Optical Coherence Tomography (OCT)

OCT

The rapid advances in ophthalmology led to diagnose and monitor glaucoma lesions using the Laser (optical coherence tomography).

The OCT-Spectralis represents the newest technology of imaging using a scanning laser ophthalmoscope (scanning laser ophthalmoscope) and not a conventional camera.

Corneal pachymetry

paxymetreia keratoeidous

The corneal pachymetry is an examination test which measures the thickness of the cornea. The ultrasonic pachymetry is done using a swab touching the surface of the cornea and requires the local anesthesia with eye drops.

Glaucoma treatment

Conservative: Drugs are the most common treatment for glaucoma. In form of eye drops or tablets to reduce the aqueous fluid.

Laser:
– ALT (Argon Laser Trabeculoplasty) the Laser is trying to facilitate the drainage of fluid from the eye which results in a lower intraocular pressure.
– SLT (Selective Laser Trabeculoplasty) is a new type of Laser, which leads to significant improvement of the fluid drainage of the eye.

Surgery: When the conservative treatment fails or the laser becomes insufficient to treat glaucoma, then surgery is needed. The most common surgery is Trabeculectomy with Mitomycin that creates a new drainage channel for the aqueous liquid.