Glaucoma surgery in Iran

What is glaucoma?

The vision loss due to glaucoma is irreversible and the only way to prevent or diagnose it is by regular visits to the doctor. Appropriate treatment should be carried out immediately to slow down or stop its progress without delay.  

Normally, a meshwork drainage system drains out the fluid produced in the eye. Glaucoma is the condition in which the drainage system is clogged and unable to remove excess fluid. The accumulated fluid can lead to abnormal pressure in the eye and can possibly damage the optic nerve. Optic nerve is the cord that transmits image and plays a vital role in our ability to see. In some cases, the person's optic nerve is so sensitive that it can be damaged even with normal eye pressure.

Although glaucoma can happen at any age, it mostly occurs in older adults. Ethical roots or hereditary factors are considered risk factors as well. In most cases, symptoms do not occur and when they do, it is usually after some extent of vision loss. Therefore, we suggest that you visit an ophthalmologist at least once a year; particularly if you have a family history of glaucoma. 

Types of glaucoma and symptoms

Glaucoma has several types with various symptoms, effects, and best possible treatments. There are three main types of glaucoma:

• Open-angle glaucoma: Approximately, 9 out of every 10 people with glaucoma suffer from open-angle glaucoma. In this condition, although a wide angle exists between the iris (the pigmented section in the eye that determines the color of our eye) and the cornea, the buildup fluid is not properly drained out either as a result of clogs or other reasons that might block the drainage. The symptoms and damages of this type of glaucoma are not noticed until the irreversible black spots appear.Open-angle glaucoma is more likely to occur in people with African-American or Hispanic origins.
• Angular closure glaucoma: Also known as narrow-angle glaucoma, this condition involves an abrupt or gradual closure of the angle between the iris and the cornea. As a result, the drainage system is blocked and fluid is accumulated behind the cornea leading to excess eye pressure and optic nerve damage. In the case of sudden angle closure, severe symptoms including unbearable pain and eye redness occur immediately. In Asian countries and among Eskimos, angular closure is more common than open-angle glaucoma while in the rest of the world, only 10% of people suffering from glaucoma are diagnosed with the angular closure type.
• Normal-tension glaucoma: Sometimes, the person's eye pressure is no more than within a normal range. Yet,their optic nerve is damaged leading to partial or complete vision loss. The exact cause of normal-tension glaucoma is not yet clear. Still, studies show people of Japanese ancestry and those with a history of heart disease are more likely to experience the condition.To treat normal-pressure glaucoma, doctors lower the eye pressure as much as possible.
• Congenital glaucoma: This very rare type of glaucoma is a result of incomplete or incorrect development of eye drainage and happens in babies or young children. The condition is typically inherited and symptoms includephotosensitivity (sensitivity to light) or enlarged eyes.

How glaucoma is treated

Glaucoma can be treated using medications, surgery, medical procedures or a combination of them. Sometimes medications are adequate; in other cases, they are followed by surgical procedures. It is important to note that these treatments can slow down the development of glaucoma; they are not, however, considered a cure for the condition. You are to entrust your doctor in the course of fighting glaucoma and consult with specialists to figure which method is best for you.

Medications

The doctor uses medications such as eye drops or pills to treat glaucoma. Typically, medications are prescribed initially prior to switching to other forms of treatment to help lower the eye pressure. These medications may result in severe side effects such as high blood pressure or rapid heartbeat. In addition, anti-glaucoma medications can interfere with the medications you already take. Therefore, although medications can be effective for slowing down the process, they might not work for everyone. Some doctors suggest other alternatives to treat glaucoma.

Laser surgery

laser trabeculoplasty treatment uses laser beams to treat the trabecular meshwork and streamline the process of draining out excess fluid. It is a highly effective procedure, particularly for open-angle glaucoma. Laser surgery treatment for glaucoma is less invasive than other surgical procedures.

Laser surgery can be done at the doctor's office or an outpatient clinic. The process takes about 2-3 hours while your eyes are numb but experiencing a slight sting is normal too. After the surgery, you may experience a little soreness or blurry sight. You can continue your daily activities in a few hours after the procedure. The results can be observed in a few weeks.

Two main types of Laser trabeculoplasty to modify the trabecular meshwork include:

• Argon Laser Trabeculoplasty (ALT): As the name suggests, this procedure uses Argon Laser beam to create tiny burns on the surface of trabecular meshwork and facilitate the fluid outflow. ALT has been successful for more than 75% of people suffering from the most common cause of glaucoma.
• Selective Laser Trabeculoplasty (SLT): In this method, the doctor specifically uses Nd: YAG laser beams to target the spots where there is pressure. It also creates less thermal damage than ALT.
• Laser peripheral iridotomy (LPI): This method involves creating a tiny hole in the iris using a laser beam. This technique is highly efficient for angle-closure glaucoma.
• Cyclophotocoagulation: this technique can help ease the pressure inside the eye but may need to be repeated over time.

Other surgical procedures

When medications are followed by severe side effects; and laser surgery procedures are not considered effective, your doctor might decide to go with more invasive surgical procedures:

• Trabeculectomy: The surgery involves creating a small hole on the wall of the eye while making a flap over this hole so that the fluid can escape in a controlled way.
• Glaucoma Drainage Valve: Also known as glaucoma implant surgery, this procedure implants drainage devices or tubes called shunt that could channel the fluid out of the eye.
• Trabeculotomy: This procedure is similar to trabeculectomy designed to treat children who suffer from congenital glaucoma and have a cloudy cornea.

Before you get Glaucoma treatment in Iran

Iran is home to many famous ophthalmologists who carry out numerous glaucoma treatment surgeries annually. If you are considering to team up with proficient doctors in the battle against glaucoma, Iran has many things to offer. read more to find out what you need to do before getting the surgery done in Iran.

• Choose an ophthalmologist who has the right experience and expertise.
• Consult with the doctor about all the possible options and choose one wisely.
• Get a general health assessment a few weeks before the surgery.
• Learn about possible side effects such as eye redness, irritation, eyelash growth and thickening, and change in the color of the iris due to some medications.
• Consult with your doctor about the medications you take routinely.
• Restrain from food and liquids at least 6 hours before the surgery.
• Do not drink alcohol for 24 hours before the surgery.
• On the day of the surgery, do not wear any makeup and put on loose-fitting clothing.

Glaucoma treatment cost in Iran 

Iran's medical services are highly qualified as well as exceedingly affordable.Average glaucoma costs in various countries including Iran are:

• Laser surgery: 

UK: $1800India: $1250  Iran: $900

• Incisional surgery:

UK: $2,548 India: $2000 Iran: $1000

What should glaucoma patients avoid?

It is suggested that glaucoma patients avoid sun exposure and smoking as much as possible. As for the foods that need to be avoided, patients should reduce their caffeine intake and foods that might lead to high blood pressure.

Risks and side effects of glaucoma treatment

Eye drops, pills, and other medication are generally followed by mild to severe side effects. Every individual could experience different side effects. they include: 

• Blurred vision
• Eye redness
• Itching and stinging sensation
• Changes in blood pressure and heart rate
• Depression and fatigue
• Headache

Glaucoma treatment surgeries are generally very successful and severe side effects rarely occur. Still, this type of treatment is a surgical procedure and as with any other type of surgery, some potential side effects are inevitable.

• After glaucoma surgery, a temporary vision loss is considered normal. But in some very rare cases, partial or complete vision loss could be permanent.
• Bleeding inside the eye
• Infection
• Low eye pressure (hypotony)
• Scarring
• Cataract

Furthermore, with the constant development in glaucoma treatments, any risk or sever side effect can be prevented. In addition to that, people who are in the initial stage of glaucoma condition can benefit from more recent types of surgery called MIGS (Minimally Invasive Glaucoma Surgery). The techniques used in these procedures are much safer than those of traditional surgeries. However, not everyone could be qualified to undergo more modern surgeries. Your ophthalmologist will perform an evaluation and you can find out if MIGS is the right choice for you.

FAQ

Does glaucoma cause blindness?

Although many would link glaucoma to blindness, it is not always the case. Only 5% of those who are diagnosed with glaucoma will end up blind. However, some visual impairment is typical in about 10% of the patients. 

How long does glaucoma treatment last?

Medications are normally for life. You should apply the eye drops and take the necessary pills for a very long time.

Is glaucoma genetic?

Your family history definitely plays an important role. When someone is diagnosed with glaucoma, the doctor suggests that other members of the family get checked as well. Generally, African-Americans and Hispanic people are more likely to develop glaucoma. 

Can you get LASIK surgery if you have glaucoma?

You can undergo LASIK surgery if you have glaucoma but you should certainly consult with your doctor concerning the situation. 

Are glaucoma and diabetes related?

Diabetes complications are numerous. In some cases, Glaucoma is One of these complications.