Glaucoma surgery or Argon Laser Trabeculoplasty by Dr Hartog

What is Glaucoma?

Glaucoma is an asymptomatic condition that affects the nerve of the eye ( optic nerve ), and leads to irreversible visual loss. Due to the fact that this condition seldom causes pain, and causes a gradual loss of initially only peripheral vision, it is often only diagnosed late.

Where the pressure inside the eye normally varies between 10 and 21 mmHg, the pressure in glaucomatous eyes increases to above 21 mmHg. This pressure rise is caused by an imbalance between the rate of secretion and absorption of the fluid in the eye.

Glaucoma Causes

People at an increased risk of developing glaucoma, e.g. previous eye trauma or inflammation, a family history of glaucoma, older than 65 years, nearsighted, use of steroid medication etc., should have regular eye examinations to exclude glaucoma. The diagnosis of glaucoma is not always easy to make, and depends on information attained from various examinations.

The measuring of the intra-ocular pressure and examination of the optic nerve for damage are essential, but also very important is the visual field examination that clearly indicates the blind areas in grey and black. Sometimes more specialized equipment like Ocular Coherence Tomography ( OCT ) and the Heidelberg Retinal Tomograph ( HRT ) is utilized to help in the diagnosis.

Glaucoma Treatment is very effective, and involves the lowering of the pressure inside the eye with eye drops. In instances where this is ineffective in preventing further visual loss, laser treatment and surgery is utilized.

Argon Laser Trabeculoplasty or ALT involves the application of laser burns to the drainage apparatus of the eye, thereby increasing the aqueous outflow and therefore lowering the intra-ocular pressure. The procedure is painless and done in an outpatient setting. It is used in isolation where it is not possible for the patient to use topical medication, or as an adjunct to topical medication where the latter does not give an optimal pressure lowering effect.

With effective treatment, any further visual deterioration can be prevented. It is essential that this condition be diagnosed early, since damage to the optic nerve can not be reversed, but only further damage prevented.

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