Today, it is estimated that there are about 70 million glaucoma patients worldwide. Nearly half of these patients are unfortunately unaware that they have glaucoma. Due to the rapid increase in the elderly population, blindness due to glaucoma reaches about 6.7 million, ranking second among the causes of glaucoma blindness.

Could You Briefly Describe the Occurrence of Glaucoma?

Glaucoma, also known as eye pressure among the public, is a common eye disease that affects millions of people. Normally, there is a fluid continuously produced in the eye to feed the intraocular tissues, and after this fluid completes its function, it leaves the eye through microscopic channels. Glaucoma occurs as a result of insufficient discharge of fluid due to structural obstruction in the channels that drain the intraocular fluid out, and accordingly, the pressure of the fluid in the eye increases. Rising intraocular pressure compresses and damages the optic nerve, causing the death of the cells of the optic nerve. When the optic nerve cells die, permanent vision loss occurs.

What Can You Say About the Condition of Glaucoma in the World and Turkey?

Today, it is estimated that there are about 70 million glaucoma patients worldwide, almost half of whom are unfortunately unaware that they have glaucoma. Due to the rapid increase in the elderly population, blindness due to glaucoma reaches about 6.7 million, ranking second among the causes of glaucoma blindness.

Drug Therapy

First of all, the eye pressure of the patient; the pressure in the eye can be controlled. It is reduced by reducing the production of fluid or increasing its output. There are drugs used for these two methods. These drugs are taken at regular intervals every day and used throughout life. If the eye pressure of the patient does not decrease and the visual field narrows despite the drug treatment, the treatment method to be applied is mostly ophthalmology and surgery in the Hospital of eye pressure with laser Glaucoma treatment.

Laser Treatment

Laser beams are used for various purposes in the treatment of eye pressure. In primary closed-angle glaucoma cases or acute glaucoma crises, he also worked as an eye nerve observer. In 1995 and in the past, a hole is made on the surface of the iris, that is, laser iridotomy is performed to facilitate the passage of intraocular fluid from the place where it is produced to the exit channels.

Secondly, in chronic open-angle glaucoma cases, a laser is applied to the outflow channels to facilitate the outflow of the fluid produced within the eye, and is called laser trabeculoplasty. Of these, the process in selective laser trabeculoplasty targets the tissues more specifically and can be repeated several times.

Finally, in the laser cyclophotocoagulation method, fluid-producing cells can be damaged in advanced glaucoma cases who have undergone more than one eye surgery. Thus, it may be possible to reduce intraocular pressure without the need for a very advanced surgical method.

Surgical Treatment

The purpose of surgical treatment of glaucoma is to ensure that the fluid produced within the eye leaves the eye by forming a fistula. This is called fistulizing surgery. With this surgery, a hole is opened in the white part of the eye. With this hole, which is too small to be seen from the outside, an excess fluid inside the eye is formed and ejected. In cases where classical fistulizing surgeries fail, tube implants are also used to ensure this opening continuously. As a result of important innovations in the shapes and functions of tube implants in glaucoma, much smaller implants can be placed in the eye and permanent intraocular pressure control can be achieved.

What Are the Advances in Neuron Protection in Glaucoma? How Important Is This Issue in Glaucoma and Is It Known Enough Among Physicians?

Although eye pressure is reduced with treatment in glaucoma, vision loss may continue in some patients. Glaucoma is actually a disease of the optic nerve. Therefore, it is a known fact that keeping eye pressure under control alone is not enough as a result of large clinical studies, but also eye nerve cells should be protected. At this point, neuroprotective drugs come into play. Any treatment that delays protects, or reverses neuronal cell death is called neuroprotection. The path to clinical use of neuroprotectors is long and difficult. So far, more than 500 agents have been used as neuroprotectors in various stages of various diseases. Anti-oxidants are anti-excitotoxic agents, apoptosis (programmed cell death) Inhibitors L neurotrophic factors; ion-channel modulators’ stem cell transplantation and gene therapy are the main research points mentioned in neuroprotection. However, today there is no neuroprotective drug that has been proven by clinical studies that we will recommend to our patients. Nevertheless, among the supporting factors that the patient can correct in his/her daily life counted as quitting smoking, balanced and healthy nutrition, and daily exercises.

What Awaits Us in the Future in the Treatment of Glaucoma?

In the medical treatment of glaucoma in the future, there may be improvements in the use of new alternatives and perhaps some neuroprotective drugs in the form of drugs for skeletal structure. We know that Rho kinase inhibitors, which increase fluid output by changing the skeletal structure of the outlet channels, are used in clinical treatment in Japan and the USA with FDA approval. Experimental studies for other alternatives are ongoing.