Eye Treatments

WHAT IS GLAUCOMA?

Glaucoma is also called “eye pressure” or “black water disease” among the people. Glaucoma is the condition where damage occured to the optic nerve due to frequent elevations of intraocular pressure. This situation narrows the person’s field of vision. It is an insidious disease that can be noticed in the last stage of the disease. When it is noticed lately, it can cause irreversible damage to the optic nerve.

People with higher than normal intraocular pressure are more likely to develop glaucoma. However, this does not indicate that everyone with high intraocular pressure will develop the disease. Glaucoma may be associated with a genetic predisposition. People with a family history of glaucoma are at higher risk of exposure. This means that one or more genes may be damaged, which may make individuals more susceptible to the disease.

Glaucoma manifests itself in the late period with the following symptoms:

• Blurred vision at times
• Worsen Headaches in the morning
• Seeing rings around lights at night
• Pain around the eyes while watching TV

Eye pressure is divided into two groups:

• Open angle glaucoma
• Narrow angle glaucoma

How Is Glaucoma Treatment Performed?

Glaucoma is a disease that can be diagnosed after a detailed eye examination. The following tests are performed for diagnosis:

• Intraocular pressure (IOP) measurement
• Computerized visual field measurement
• Corneal thickness (pachymetric) measurement
• Optic nerve head and nerve fiber measurement (Scanning Laser Ophthalmoscopy)

Glaucoma is a very common disease. Early diagnosis is very important to avoid vision loss as a result of this disease. Unless there is an obvious damage to the patient’s visual field due to glaucoma, it is not possible to realize the losses. Therefore, it is of great importance to perform eye examinations regularly.

How Is Glaucoma Treated?

There are three options for the treatment of glaucoma:

1. Medication

In the first stage, the patient’s eye pressure is lowered by reducing the secretion of eye fluid or increasing its output. There are drugs used for these two treatment methods. These medications, which are taken regularly every day, must be continued to take throughout life. If drug treatment does not reduce the patient’s eye pressure and the visual field continues to narrow, surgical intervention is usually preferred at this stage.

2. Surgical treatment

During the intervention, a hole is made in the white part of the eye. This hole is too small to be noticed from the outside. Excess fluid in the eye is drained through this hole. After the operation, glaucoma usually disappears. However, full recovery is not possible for all patients.

3. Laser Therapy

Laser beam is primarily preferred in the treatment of acute glaucoma crisis and to prevent the healthy eye from entering the glaucoma crisis.

In addition, in patients with chronic glaucoma, laser is applied to outflow channels like a filter to facilitate the evacuation of the fluid produced in the eye. Glaucoma treatment is also performed by applying laser to the white area around the colored area in the outer part of the eye. The purpose of this application is to destroy the area in the inner part  that secretes eye water and thus to reduce the production of eye water.

CATARACT

Cataract is the opacity of the natural lens of the eye, which is located behind the pupil and makes it possible to see, as a result of losing its transparency. With this disease, the vision occurs as if looking through a fogged glass.

Cataract can be treated neither with medication nor with glasses. Since there is no effective method to stop the progression of cataract, the only treatment option is surgery. With the developments in medical technology, cataract surgeries can be performed without the use of narcosis and needles. After the painless operation, the patient can return home the same day.

Who Would Contract Cataract?

Cataract is more commonly seen in middle-aged people. However, it is also seen:

• In diabetics
• In newborn babies
• In those who use cortisone drugs for a long time
• In those who receive physical blows to the eye

How Does the Treatment Process Proceed?

Before being taken for cataract surgery, the patient should first go through a detailed eye examination. Not every patient’s eye is suitable for this intervention. Variables such as age, occupation, social activity, reading habits, and intellectual level are also important in the determination of patients with cataract disease. Suitable patient, right technique and correct lens preference make medical success possible as well as the experience of the health institution and doctor where the operation is performed.

Cataract treatment is carried out with microsurgery. The success of this important operation is directly affected by the experience of the doctor, the sterilization of the instruments and the operating room, and the quality of the instruments.

Cataract surgery is performed with different techniques depending on the type of discomfort in the eye. These techniques are:

• Femtosecond Laser
• PHACO Method
• Lenses Used in the Eye

How is Femtosecond Laser Cataract Surgery Performed?

During the surgery in which this technique is applied, the eye is locally anesthetized by means of drops. Thus, the operation is performed without the use of narcosis, needle and knife. The patient does not feel pain during the femtosecond laser operation, which is also called “bladeless cataract surgery”. Thanks to laser technology, the most important steps of the operation are performed without using a knife. This technique greatly reduces the risk of complications.

How is Cataract Surgery Performed with PHACO Method?

While performing cataract surgery with the PHACO technique, a 2.2 mm incision into the eye is used to undertake the operation. A special liquid called viscoelastic gel is used during the surgery. Thanks to the viscoelastic gel, the natural lens is separated from the other layers of the eye without damaging it. This disposable gel is special for each patient.

With a special device emitting ultrasonic sound waves, the intraocular lens, which has lost its transparency, is broken into pieces in the eye and absorbed. A collapsible artificial lens is attached to the eye. Since the incision is small, no stitches are required. Both eyes are not operated on the same day because there is a possibility of infection. It is recommended that both eyes to be operated at least 2 days apart.

How is Cataract Treatment Performed with Intra-Eye Lenses?

In this type of cataract treatment, the lens in the eye is removed and replaced with a lens with more than one focus capability. These lenses have various rings. Some of these rings in lenses make it possible to see near and some make it possible to see far. Thus, both near and far images can fall on the yellow spot in the eye that provides vision. After adapting to this situation, patients’ need for glasses may decrease.

WHAT IS LASIK?

Laser therapy is widely used all over the world for the removal of myopia, hyperopia and astigmatism in the eye. It is one of the most popular applications of refractive surgery. If the eyes are not suitable for laser surgery, a patient-specific intraocular lens exchange is performed.

Refractive corneal defects such as myopia, hyperopia and astigmatism can be treated with excimer laser. This intervention is called LASIK treatment. It is also known as “eye drawing” among the people. Myopia is farsightedness and hyperopia is nearsightedness. Astigmatism occurs if the light coming into the eye falls on more than one point on the retina, resulting in broken and distorted vision. During eye laser surgery, the corneal layer is reshaped by laser. Thus, refractive errors such as myopia, hyperopia and astigmatism are treated.

LASIK technique is one of the most preferred laser treatment applications of today. Before this operation, a large-scale diagnostic study is performed.

The following steps are taken in the examination phase before surgery:

1. Initial Inspection
2. Examination
3. Drop eye examination
4. Surgery decision

How Does the Process Proceed in LASIK Treatment?

The patient should pay attention to the following before the operation:

• not wearing eye makeup
• not using perfume
• Not taking blood thinners

 The Patient is allowed to eat and drink on the day of surgery.

In LASIK treatment, the process for each eye would take an average of 4-5 minutes. In this period, the patient would not feel any pain. It is very important that the patient is comfortable during the treatment and follows the doctor’s instructions. After the treatment, the patient leaves the laser room without bandaging his eyes.

How Does the Process After LASIK Treatment Proceed?

The patient, whose LASIK application is completed, waits for an average of half an hour. Then a control examination is carried out. After this control, the patient can leave the health institution. Blurred vision, stinging, burning and watering in the eyes for 3 to 4 hours are possible complications for the first day. Medication should be continued as recommended by the doctor. In case of headache after LASIK treatment, painkillers can be taken. However, this pain reliever should not have blood thinning properties.

When can ordinary life be resumed after LASIK treatment?

After the LASIK application, the patient can usually return to his normal life the next day. After the operation, using medication as recommended by the physician is as important as the operation itself. It is strongly recommended that patients use sunglasses for a while after the treatment. In order to protect the eye from infection, it is necessary not to enter the sea or pool for approximately 20 days. After one month, colored lenses, which are a cosmetic product, can be used.

Who Can Be Treated With LASIK Method?

• Those who are over the age of 18, wear glasses or contact lenses,
• Those whose eye grades have not changed more than 0.50 diopters in the last 1 year,
• Those with myopia up to 10 diopters,
• Those with astigmatism up to 6 diopters and with hyperopia up to 4 diopters,
• Those with sufficient corneal tissue thickness,
• Those who do not have systematic diseases such as diabetes, rheumatism,
• Those who do not have any other disease (corneal sharpening, eye pressure, etc.) in their eyes,
• As a result of the preliminary examination and tests, people whose eye structure is suitable for surgery can be treated with laser.

WHAT IS VITRECTOMY?

The vitreous is the gel-dense liquid that fills the inside of the eye. In some conditions, sensitive vessels can cause bleeding in the vitreous. As a result of these hemorrhages, the eyes can completely lose their vision. This blood accumulated in the vitreous may not disappear for a long time. If the blood is not drawn within the prescribed time, vitrectomy surgery is performed.

2/3 of the human eye consists of a gel-dense liquid called vitreous. This liquid also provides benefits in preserving the anatomical structure of the eye. Surgical interventions applied in diseases or bleedings in this tissue at the back of the eye are called vitrectomy surgery (retinal surgery).

Why is Vitrectomy Surgery Performed?

Retinal surgery is performed in cases that require intervention in the vitreous. Conditions such as bleeding, inflammation, and contact with a foreign object in the eye require these interventions.

In case vitrectomy surgery is necessary but not performed, the patient may experience problems such as permanent vision loss.

Disorders that require vitrectomy surgery are as follows:

• intraocular bleeding
• eye injury
• Holes in the visual center
• Removal of foreign body in the eye
• Wrinkles in the visual center
• Breaks in the nerve network (retina) layer of the eye
• The membrane formed in the neural network (retina)
• Eye diseases in diabetic patients
• Infections after cataract surgery
• Remaining of lens fragments in the eye after cataract surgery

How Does the Process Proceed in Vitrectomy Surgery?

In vitrectomy operations, vitrectomy instruments produced in accordance with the objectives of the surgery are widely used today. By means of contact and non-contact imaging systems and laser devices, it is ensured that the eye under the operating microscope can be seen comfortably.

Vitrectomy is a surgical procedure that can be performed under general or local anesthesia. Retinal surgery is performed with incisions made in the layer called the sclera, located in the white part in front of the eye. In this surgical procedure, it may be necessary to drain the vitreous material. With the help of one of these incisions, a fluid flow is realized in order to balance the intraocular pressure. With the vitrectomy operation, the humorous gel called “intraocular secretory fluid” is filled into the place emptied from the vitreous gel.

How is the Recovery Process After Vitrectomy Surgery?

After the vitrectomy operation, the patient’s recovery takes place within 2 to 6 weeks, depending on the type of gas given. During the weeks after the intervention, the visual field increases day by day and the eye regains its health.

What are the complications that can be seen after vitrectomy surgery?

The following may occur after vitrectomy surgery:

• Blindness
• Acceleration in cataract development
• Re-bleeding
• Detachment of the retina
• Occlusion of retinal vessel

It is very important for the patients to follow the recommendations of the physicians in order to prevent complications after the surgery and to make the recovery process faster. Patients should use the prescribed drugs correctly and avoid eye trauma.