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Göz Sağlığı ve Hastalıkları Uzmanı Prof. Dr. H. Zeki Büyükyıldız, 12 Mart Dünya Glokom Günü nedeniyle farkındalık yaratmak adına uyarılarda bulundu. Bin bebekten 1'inde glokom (yüksek göz tansiyonu ) görüldüğünü ifade eden Büyükyıldız, "Doğuştan glokom, tespit edilmesinde gecikilirse kısa sürede körlüğe yol açar. Bu tür glokom aşırı göz sulanması, ışığa karşı aşırı hassasiyet ve bebeğin gözünü kısması ile dikkatleri çeker" dedi.
Glokomun, göz tansiyonunun normalden yüksek olması sonucu ortaya çıkan ve körlüğe yol açan ciddi bir hastalık olduğunu ifade eden İstinye Üniversite Hastanesi Liv Hospital Bahçeşehir'den Göz Sağlığı ve Hastalıkları Uzmanı Prof. Dr. H. Zeki Büyükyıldız, halk arasında 'karasu' olarak da bilinen hastalığın toplumda görülme sıklığının yüzde 2 olduğunun altını çizdi.
"MİYOPLARDA DAHA SIK GÖRÜLÜYOR" Ailesinde glokom olanlarda riskin 5-6 kat daha fazla olduğunu belirten Prof. Dr. H. Zeki Büyükyıldız, ancak hastalığın türlerine göre görülme oranlarının da değiştiğini belirtti. Miyoplarda glokomun daha sık görüldüğünü söyleyen Prof. Dr. H. Zeki Büyükyıldız, miyopinin derecesi arttıkça glokom olasılığının da arttığına dikkat çekti.
"HASTANIN GÖRMESİ BİR ANDA GİDEBİLİR" Glokomun tüm dünyadaki körlüklerin ikinci nedeni olduğunu belirten Prof. Dr. H. Zeki Büyükyıldız, özellikle 40 yaşın üzerindekiler, ailesinde glokom bulunanlar, şekeri, hipertansiyonu, yüksek miyopisi ve damar hastalığı olanlar, uzun süreli kortizon tedavisi alanların risk altında olduğunu söyledi.
Glokomun çok çeşitli türleri olduğunun altını çizen Prof. Dr. H. Zeki Büyükyıldız, en sık bilinen türün 'Birincil (Primer) Açık Açılı Glokom' olduğunu ifade ederek şu bilgileri paylaştı: "Bu glokom türü göz tansiyonu çok yüksek olmadıkça genellikle belirti vermez. Bu yüzden sinsi seyreder. Oysa kapalı açılı (veya açı kapanması) glokomunda tansiyon birden çok hızlı yükselerek hasta glokom kriziyle karşımıza gelir. Bu durumda hastanın görmesi bozulur, baş ve göz ağrısı, mide bulantısı ve kusma görülebilir. Bu nedenle hasta göz doktoru yerine iç hastalıklarına veya acile başvurabilir."
"DOĞUŞTAN GLOKOMA DİKKAT" Prof. Dr. H. Zeki Büyükyıldız, gözdeki diğer hastalıklar, göz tümörleri, ameliyatı gecikmiş şişkin katarakt, travma, göz yaralanmaları, retina toplar damar tıkanıklıkları sonrası, ileri diyabette, uzun süre kortizonlu göz damlaları kullanılmasından sonra da glokomun ortaya çıkabileceğini işaret etti.
Bir diğer ve ciddi glokom türünün ise doğuştan (konjenital) glokom olduğunu belirten Prof. Dr. H. Zeki Büyükyıldız, "Bin doğumdan birinde karşımıza çıkabilen doğuştan glokom, tespit edilmesinde gecikilirse kısa sürede körlüğe yol açar. Bu tür glokom aşırı göz sulanması, ışığa karşı aşırı hassasiyet ve bebeğin gözünü kısması ile dikkatleri çeker. Tek taraflı olabilir. Farkına varılmazsa, göz dokuları henüz çok esnek olduğu için göz tansiyonun etkisiyle göz büyümeye başlar ve 'Büftalmi' adı verilen irileşmiş ve kornea ödeminden dolayı bayat balık gözü gibi bulanık bir gözle karşı karşıya kalabiliriz" şeklinde konuştu.
"GENÇLERDE BİLE GÖRÜLEBİLİR" Glokomun bir türünün de gençlerde görülen 'Jüvenil Glokom' olduğunu aktaran Prof. Dr. H. Zeki Büyükyıldız, bu türe daha seyrek rastlanılsa da gençlerde de glokomun olabileceğinin hatırda tutulması gerektiğini söyledi.
Göz tansiyonu 21 mmHg'nın altında olduğu durumda düşük tansiyonlu glokomun da olabileceğinin bilinmesi gerektiğini işaret eden Prof. Dr. H. Zeki Büyükyıldız, bu glokom türü hakkında ise şu bilgileri verdi: "Bu hastalarda göz içi basıncı normal sınırlarda olduğu halde optik sinirde çukurlaşma, OCT (Optik Koherens Tomografi) ve görme alanı tetkiklerinde hasar tespit edilir. Bu yüzden şüphe ve tereddüt hallerinde glokom tetkiklerinin yapılmasında büyük yarar vardır. Düşük tansiyonlu göz tansiyonu (Glokom) hastalığı tespit edilirse, bu glokom türünün de mutlaka tedavi edilmesi gerekir."
"HİÇBİR BULGU OLMAYABİLİR" Prof. Dr. H. Zeki Büyükyıldız, göz tansiyonu nun 21 milimetre civadan yüksek olduğunda görülen 'oküler hipertansiyon' adı verilen ve hiçbir glokom bulgusu olmayan durumlarla da karşılaşılabildiğini sözlerine ekledi.
Glokom hastalığının tespitinde göz tansiyonu ölçümünün büyük önem taşıdığını belirten Prof. Dr. H. Zeki Büyükyıldız, "Göz tansiyonu ölçümünde kornea kalınlığının da mutlaka hesaba katılması gerekir. İnce kornealarda tansiyon düşük, kalın kornealarda ise yüksek ölçülebilir. Kliniğimizde olduğu gibi, bazı ölçüm aletleri kornea kalınlığına göre ölçülen değerin eşdeğerini vermektedir. Eğer böyle bir imkan yoksa özel çizelgeyle skala üzerinden ölçülen göz tansiyonun kornea kalınlığına göre eşdeğeri hesaplanmalıdır" dedi.
"HASTA BORUDAN BAKIYORMUŞ GİBİ GÖRÜR" 'Primer Açık Açılı' glokomun daha çok 40 yaşından sonra görüldüğünü ve sıklıkla pek bir belirti vermediğini de sözlerine ekleyen Prof. Dr. H. Zeki Büyükyıldız, şöyle devam etti: "Uzun süre yüksek seyreden göz tansiyonu, gözün beslenmesini bozar ve optik sinirde gittikçe büyüyen çukurlaşmaya yol açar. Böylelikle glokom kenar görmelerden başlayarak yavaş yavaş görme alanında daralmaya yol açar. Bu dönemde hasta adeta bir borudan bakıyormuş gibi görür. Tedavi edilmediği takdirde sonunda merkezi görme de tamamen kaybolur ve geri dönüşümsüz körlük yerleşir."
"ÖNLENMESİ MÜMKÜN OLMASA DA TEDAVİSİ VAR" Glokomu önlemenin belirli bir yolunun olmadığını ama tedavisinin mümkün olduğunu vurgulayan Prof. Dr. H. Zeki Büyükyıldız, düzenli aralıklarla göz tansiyonu nun ölçülmesi, şüpheli durumlarda OCT, görme alanı gibi glokom tetkiklerinin yapılması sonucunda glokom teşhisi konulduğunda acil olarak tedaviye başlanması gerektiğine dikkat çekti.
Glokomun tedavisi glokomun türüne göre değişiklik gösterdiğini söyleyen Prof. Dr. H. Zeki Büyükyıldız, şu açıklamalarda bulundu: "Birincil (Primer) glokomun tedavisinde göz tansiyonunu düşüren damlalar kullanılır. Göz tansiyonu düşürücü damlaların etkileri türüne göre 12-24 saat sürdüğünden ertesi güne pek bir katkısı yoktur. Bu yüzden bir gün dahi ihmal edilmeden ömür boyu doktorunuzun önerdiği tarzda damlatılmalıdır. Damlalar göz tansiyonunu düşürmede yetersiz kalırsa veya tetkiklerde sinir lifi hasarı artıyorsa, glokom ameliyatı yapılır. Açı kapanması glokomunda YAG lazer uygulaması, ameliyat ve çeşitli ilaçlar kullanmaktayız. İkincil nedenlerle ortaya çıkan glokomlarda nedene göre tedavi planlaması yapılmaktadır. Doğuştan glokomda bebeğe mutlaka doktorunuzun önerdiği tarzda göz tansiyon ameliyatı yapılmalıdır."
"YILDA BİR KERE GÖZ TANSİYONUNUZU ÖLÇTÜRÜN" Hiçbir şikâyeti olmayan kişilerin ve özellikle ailesinde glokom olanların en azından yılda bir göz tansiyonu ölçtürmesinde yarar olduğunu belirten Prof. Dr. H. Zeki Büyükyıldız, "Kliniğimizde bize gelen her hastamıza rutin olarak göz tansiyonu ölçmekteyiz. Tedaviyle körlüğün önüne geçilir ancak tedavide geç kalınmamalı ve verilen ilaçlar düzenli olarak kullanılmalıdır. Damla kullanmayı önemsemeyen veya sıklıkla ihmal eden hastalarda görme kayıpları ve sonunda geri dönüşümsüz körlük kaçınılmazdır" diyerek uyarılarını sonlandırdı.