Glaucoma - a deceitful disease
Glaucoma is a disease in which the balance between eye pressure and the blood perfusion of the nerve fibres of the optic nerve is disturbed. This imbalance causes a slow loss of nerve fibres. The destruction of the nerve fibres is painless and does not cause any alarm signals from the body.
50% of people that suffer from glaucoma are unaware of the diagnosis. Up to 1/3 of glaucoma patients have normal eye pressure (less than 21mmHg). In an early stage, glaucoma does not cause any symptoms and only at a very advanced stages the patient does notice visual field defects. Increased eye pressure is not synonymous with glaucoma.
Risk factors for the development of a glaucoma are predominantly age and the genetical background. In many cases it occurs secondarily from another ophthalmologic disease. There are twice as many people with increased eye pressure then people suffering from glaucoma. Therefore, the critical parameter to make the diagnosis of glaucoma is the reduction of nerve fibers at the optical nerve. At IROC eye clinic in Zurich suspect patients are scanned by a high-precision laser scanning system to detect even very small changes at the optical nerve. If a reduction is observed, the ophthalmologist suggests different option for the prevention of a further irreversible reduction due to glaucoma.
The aim of glaucoma treatment is to stop the further reduction of nerve fibers. Functional damage such as visual field defects are irreversible even with adequate treatment.
In order to prevent glaucoma, individual target pressure is determined on the basis of anatomical and functional damage and risk factors. At present, we have no remedy that effectively improves blood circulation or stabilizes the nerve fibers, so elevated pressure does not cause damage to the nerve cells. The therapeutic target pressure can be achieved by eye drops, laser treatment or surgery.
In an early stage, glaucoma laser surgery (SLT) offers an efficient and comfortable solution to reduce the intraocular pressure, because it's a painless one-time procedure, that is not invasive to the eye.
For additional information about glaucoma and glaucoma laser surgery (SLT), feel free to contact our Zurich eye clinic for an appointment. The IROC ophthalmologists will give their best to determine together with you the optimal treatment for your eyes.
Glaucoma treatment procedure
The laser treatment of the glaucoma (SLT) is the option of first choice in the treatment of ocular hypertension or glaucoma. The laser does not induce marks on the tissue or scars. The treatment only causes a reaction of the body to the laser pulse and, therefore, SLT is a very patient-friendly treatment.
The SLT treatment is performed in the anterior chamber angle of the eye by means of a contact glass at the slit lamp. The anterior chamber angle is the sink of the eye. The SLT is performed with a frequency-doubled Nd: YAG laser (532nm). The pulse induces a body-own reaction, which promotes the outflow. The treatment is painless and has no complications. Only a foreign body sensation might occur within the first 24 hours after the SLT treatment.
In the treated patients, an improvement of drainage of about 40% and an intraocular pressure reduction of up to 30% can be achieved after SLT. This effect is equivalent to the most effective eye drops. Unfortunately, the effect of the SLT diminishes over time. The success rate after one year is 80%, after 5 years only about 50%. The SLT application can be repeated.
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