Treatment Services

Glaucoma (Eye Pressure) Treatment and Surgery

What is Glaucoma (Eye Pressure)?

It is a disease that causes vision loss due to the intraocular pressure rising to a level that damages the optic nerve. It is medically defined as a preventable cause of blindness. In a normal eye, the eye fluid is continuously produced by muscles called ciliary muscles, which hold the natural lens behind the iris (the colored part of the eye), and is absorbed through the channels in the iridocorneal angle, where the cornea (the transparent part of the eye) joins the white vascular part, and drained through the small blood vessels of the eye. Thus, intraocular pressure remains at normal levels. Eye pressure below 20 mm Hg is considered normal. Higher intraocular pressure puts pressure on the optic nerves and the blood vessels that nourish them, causing damage to the optic nerves and leading to vision loss, including blindness. Here, there is a blockage in the channels that allow the eye fluid to reach the blood vessels, and the accumulated eye fluid increases intraocular pressure.

Glaucoma is one of the most common causes of permanent vision loss worldwide. It occurs in approximately 1 in 40 people over the age of forty, and in 1 in 20 people who develop the disease, it causes permanent vision loss in both eyes, i.e., total blindness.

There are different types of glaucoma (high eye pressure).

Open-angle glaucoma: Although the iridocorneal angle is wide, there is narrowing in the channels that allow the eye fluid to reach the blood vessels in the angle. This is the most common type. It often appears after the age of 40. It has a genetic component; if there is a history of it in the family, there is a possibility that other family members will also have it. It is an insidious disease. Initially, there are usually no symptoms, no visual disturbances, and no pain. Therefore, it is necessary to have an eye exam at least once a year after the age of 40. During the examination, intraocular pressure can be measured and detected. If the disease is not diagnosed early and progresses, it causes decreased vision and blind spots in the visual field due to damage to the optic nerve. Later, objects in the surroundings become invisible, as if looking through a tube.

Low-tension glaucoma: In this type, intraocular pressure is below 20 mmHg, meaning it is normal. It is difficult to detect. However, it can be detected with a careful examination and some tests. Like open-angle glaucoma, it usually has no symptoms. If not diagnosed early and allowed to progress, damage to the optic nerve leads to decreased vision and blind spots in the visual field. Later, objects in the surroundings become invisible, as if looking through a pipe. Closed-angle glaucoma: This is a rare type. Due to various reasons or genetics, the iridocorneal angle closes, causing the intraocular pressure to rise very rapidly. It is painful, and the decrease in vision is sudden. Therefore, the chance of early diagnosis is high, and early treatment is possible. It is often seen in hyperopic patients due to the narrow iridocorneal angle. Congenital and juvenile glaucoma: This is mostly due to genetic causes. In children, it may be a sign that the eyes are larger than average for their age.

Factors that increase the risk of glaucoma:

• Advanced age, family history of glaucoma (genetic predisposition)
• Smoking,
• Diabetes, migraine
• Myopia
• Long-term cortisone treatment,
• Eye injuries. Individuals with these characteristics should have regular eye examinations for glaucoma.

Treatment:

Glaucoma is a treatable disease once diagnosed. However, if it is not diagnosed in time and is only diagnosed after the disease has damaged the optic nerve and reduced visual acuity, the treatment will only help preserve existing vision. It cannot reverse vision loss. Therefore, if patients are caught early, before vision loss occurs and the optic nerve is damaged, they can be treated by preventing further vision loss. After a diagnosis of glaucoma, the goal of current treatment is to lower eye pressure to stop damage to the optic nerve and prevent the progression of vision loss. Glaucoma treatment methods vary depending on the cause and degree of the disease.

• Medication/eye drops (first-choice method)
• Various laser treatments (ALT, SLT),
• Surgical methods (Glaucoma Surgery)

Drug Treatment:

Currently, drug/eye drop treatment is generally the first method chosen after diagnosis. Significant advancements have been made in drug treatment for glaucoma in recent years, and effective new drugs have greatly increased the success of treatment. The most important aspect of drug treatment is that the patient uses the medication continuously and regularly and attends their follow-up appointments as recommended by their doctor. Medications must be used for life. In patients who do not respond adequately to drug treatment, or in cases where continuous medication use is not suitable, direct laser interventions or surgical methods may also be used.

Laser treatment (ALT, SLT):

In glaucoma treatment, laser therapy is a treatment option that can be applied before surgery for patients who do not respond adequately to medication. Laser pulses are applied to the cornea via a special lens placed over the narrowed channels in the iridocorneal angle to slightly widen these channels. Laser treatment can lower moderately high intraocular pressures to normal levels. The effect usually lasts for about a year. After that, intraocular pressure may rise again. In suitable patients, laser therapy can be an effective treatment alternative. It has no significant risks. 

Surgical Treatment (Operation):

If, in a patient with glaucoma, intraocular pressure cannot be reduced to normal levels with all medications and/or despite treatment, and if optic nerve damage is progressively worsening and the visual field is deteriorating, surgery becomes necessary.

Since you cannot wash your face or shower after surgery, it is advisable to shower on the morning of the surgery. You will be given a sedative before the surgery. If that is insufficient, it may also be administered intravenously. This reduces anxiety about the surgery and improves compliance. Immediately before the surgery, anesthetic drops will be instilled into your eyes; rarely, an anesthetic injection may be given if necessary. In most cases, general anesthesia is not required. This ensures you do not experience significant pain or discomfort. General anesthesia may be preferred if medically necessary or if the patient is excessively anxious.

The procedure performed during surgery aims to facilitate the outflow of intraocular fluid, which has difficulty exiting the eye and thus causes increased intraocular pressure. Various techniques exist for this. The surgery usually takes 30-45 minutes. In some special cases, this time may be longer. Sometimes, after surgery, intraocular pressure may rise again. In that case, a second glaucoma surgery may be necessary. In some persistent types of glaucoma, standard surgical techniques are ineffective. In such cases, tubes (valves) are inserted into the eye to lower the high intraocular pressure. These types of surgeries can take longer than 30-45 minutes. Patients are usually discharged the same day.

Post-operative and recovery process

The recovery process after glaucoma surgery is generally rapid, and patients can return to their daily lives within a few days. The recovery time may vary depending on the patient's general health and the procedure. Protective glasses may be given on the day of surgery, or an eye bandage may be applied depending on the procedure. Antibiotic, corticosteroid, and artificial tears are prescribed. These will be used as directed by your doctor.

In the first 24-48 hours, there may be discomfort, mild pain, tearing, redness, or blurring in the eye, but this is usually temporary and resolves on its own. Depending on the situation, this period may be slightly longer. Most patients notice a significant improvement in vision within the first week after surgery. It may take up to several weeks to achieve full recovery and final visual clarity.

Routine check-ups are usually on day 1, week 3, and month 3 after surgery, but your doctor may change the frequency and timing of check-ups if deemed appropriate.

Post-operative precautions:

• Rest at home for the first 24 hours is recommended.
• You can return to your daily life after 24 hours.
• Do not rub your eyes. If you were given protective dark-colored glasses to wear while sleeping on the night of the surgery, you should wear them.
• If you were given an eye bandage, you should use it for the time recommended by your doctor.
• Washing your face and showering are not recommended within the first 48 hours.
• You may need to wear sunglasses for 7-10 days. This is necessary to protect you from sunlight, impacts, and foreign objects in your eyes. • Driving is not recommended for the first week.

Rare but Possible Post-Operative Problems

Changes in eyeglass prescription: This is common. A new eyeglass prescription will be issued.

Cornea edema: This can develop if the innermost layer of the cornea is damaged during surgery. It will usually resolve with eye drops prescribed by your doctor.

Intraocular pressure not dropping to the desired level: This is a possible occurrence. It will usually resolve with eye drops prescribed by your doctor. Rarely, additional surgery is required.

Eye infection: Infections after intraocular surgery can occur, although very rarely. This is a serious condition requiring early intervention.

Bleeding: Bleeding may occur in the vessels of the iris tissue or inside the eye. Depending on the severity of the bleeding, medication/eye drops or, rarely, additional surgery may be necessary.

Retinal tear: This is a rare occurrence after intraocular surgery. It should be treated by a retinal specialist.

Cataract may develop: This can develop in the short or long term, depending on the patient's condition or the nature of the surgery, due to the micro-trauma to the eye caused by the operation. It is difficult to predict the timing. Also: Although rare, there may be varying degrees of vision reduction or loss after surgery. Your vision may worsen. It is important to get detailed information about these risks from your doctor.

*Since every surgery carries its own risks, the risks listed above, although rare, must be explained to the patient.

*HOWEVER, IT ENDS WITHOUT PROBLEMS IN A HIGH COUNT.

“The results of any surgical or interventional procedure can vary from person to person. It is recommended that you get a detailed consultation with your doctor before the procedure.”

Publication Date: 20.01.2026

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