Glaucoma Treatment

Glaucoma is an eye disease in which the optic nerve is gradually damaged. The condition may develop for a long time without causing noticeable symptoms, and vision that has already been lost is usually irreversible. For this reason, the main goal of glaucoma treatment is not to restore lost vision, but to prevent or slow further damage to the optic nerve as much as possible.

The choice of treatment depends on the type of glaucoma, the stage of the disease, intraocular pressure, and the condition of the optic nerve. Treatment may include medications, laser procedures, or surgery.

What Is Glaucoma?

Glaucoma damages the fibers of the optic nerve that carry visual information from the eye to the brain. In the most common forms of the disease, this damage develops gradually, and patients may not notice any changes for a long time.
Peripheral vision is often affected first. A person may continue to see clearly straight ahead while the field of vision gradually narrows from the sides.

Types of Glaucoma

There are several types of glaucoma, and their course and treatment can differ considerably.

Primary open-angle glaucoma is one of the most common forms. Drainage of fluid from the eye gradually becomes less effective, and over time this may lead to optic nerve damage. In the early stages, there are usually no noticeable symptoms.

In angle-closure glaucoma, the drainage pathway for fluid inside the eye becomes narrowed or blocked. During an acute attack, intraocular pressure may rise rapidly, causing severe eye pain, redness, blurred or reduced vision, headache, nausea, or vomiting.

In normal-tension glaucoma, optic nerve damage develops even though intraocular pressure remains within a range usually considered normal.

Secondary glaucoma may develop as a result of another eye disease, trauma, inflammation, certain medications, or other causes.

Congenital and childhood glaucoma are less common and are associated with developmental abnormalities of the eye structures.

Main Causes and Risk Factors for Glaucoma

Elevated intraocular pressure is one of the most important risk factors, although glaucoma can also develop without an obvious increase in pressure.

Factors that may increase the risk include:

• elevated intraocular pressure;
• family history of glaucoma;
• increasing age;
• certain anatomical characteristics of the eye;
• some forms of high myopia;
• previous eye injuries;
• certain inflammatory and vascular conditions;
• long-term use of corticosteroids in some patients.

Therefore, properly assessing the causes of glaucoma and selecting the appropriate treatment requires more than simply measuring eye pressure. The optic nerve, visual field, and anterior structures of the eye also need to be evaluated.

Signs and Symptoms of Glaucoma

In the early stages of open-angle glaucoma, there are often no noticeable symptoms. The disease may progress for years before a patient begins to notice changes in the visual field.

Possible symptoms of glaucoma include:

• gradual loss of peripheral vision;
• blind spots in the visual field;
• reduced vision in more advanced stages.

During an acute angle-closure attack, the symptoms are very different and may include:

• severe eye pain;
• redness of the eye;
• sudden blurred or reduced vision;
• colored halos around lights;
• headache;
• nausea or vomiting.

These symptoms require urgent ophthalmologic evaluation.

Intraocular Pressure and Glaucoma

Intraocular pressure results from the continuous production and drainage of fluid inside the eye. When drainage becomes impaired, the pressure may rise.

High intraocular pressure increases the risk of optic nerve damage, but a single elevated measurement does not necessarily mean that a person has glaucoma. The opposite is also possible: some people develop glaucomatous optic nerve damage even when their pressure remains within the usual range.

For this reason, measuring eye pressure is an important part of glaucoma assessment, but diagnosis does not rely on pressure alone. When necessary, the optic nerve, visual field, corneal thickness, and the angle of the anterior chamber are also evaluated.

Glaucoma Treatment

The aim of glaucoma treatment is to lower intraocular pressure to a level that reduces the risk of further optic nerve damage. Vision that has already been lost generally cannot be restored, which makes early diagnosis especially important.

Medical Treatment

Eye drops are the most commonly prescribed treatment for glaucoma. They either reduce the production of fluid inside the eye or improve its drainage.

Common medication groups include prostaglandin analogues, beta-blockers, carbonic anhydrase inhibitors, and alpha-adrenergic agonists. In some cases, combination drops containing more than one active ingredient are used.

Eye pressure-lowering medications should be used exactly as prescribed. Changing the dose or medication without medical advice may result in inadequate control of intraocular pressure.

Laser Treatment

The purpose of laser procedures is to improve fluid drainage from the eye and lower intraocular pressure.

In open-angle glaucoma, laser trabeculoplasty may be performed. In angle-closure glaucoma, different laser techniques are used to relieve the blockage affecting fluid circulation.

Surgical Treatment

Surgery may be necessary when eye drops or laser treatment alone do not provide sufficient control of intraocular pressure.

Surgical options include trabeculectomy, drainage implant surgery, and, in selected cases, minimally invasive glaucoma surgery (MIGS). The aim is to create a new or more effective pathway for fluid to drain from the eye.

Glaucoma Treatment at Nairi Medical Center

At Nairi Medical Center, patients can undergo the ophthalmologic examinations required for glaucoma diagnosis and receive medical, laser, or surgical treatment depending on the type and stage of the disease.

Glaucoma assessment may include:

• visual acuity testing;
• measurement of intraocular pressure using tonometry;
• gonioscopy to assess the angle of the anterior chamber;
• examination of the optic nerve and retina;
• optical coherence tomography (OCT);
• perimetry to assess the visual field;
• pachymetry to measure corneal thickness.

These examinations make it possible not only to confirm or rule out glaucoma, but also to determine whether the disease is progressing and how the condition of the optic nerve changes over time.

Diagnostic Equipment Used for Glaucoma

At Nairi Medical Center, glaucoma assessment may include OCT, computerized perimetry, different methods of tonometry, pachymetry, and gonioscopy.

To schedule an appointment, call 89 00 or visit Nairi Medical Center at 21 Paronyan Street.