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Aim: The aim of the study was to evaluate patient cooperation in glaucoma treatment., Methods: We evaluated data collected by an anonymous questionnare from 98 glaucoma patients who answered 6 questions regarding their compliance and persistence in glaucoma treatment., Results: Study results revealed 50% of patients to fail taking their antiglaucoma therapy regularly. Patients on monotherapy showed better compliance and higher level of satisfaction with treatment than those on combination antiglaucoma therapy consisting of 2 or 3 eyedrops. Discontinuation of persistence was recorded in 31% of patients, whereas 51% of patients did not present for control visits every six months as suggested by their ophthalmologist., Conclusion: Patients are more compliant and persistent with antiglaucoma monotherapy than with combined therapy. Greater compliance and persistence with ocular hypotensive therapy may improve the outcomes in glaucoma.

Secondary glaucoma is a relatively common complication after pars plana vitrectomy and silicone oil injection for repair of complex retinal detachment. The aim of this study was to evaluate the influence of silicone oil tamponade on intraocular pressure elevation and to identify the mechanism of this elevation. The study included 45 eyes of 45 patients who had undergone pars plana vitrectomy and silicone oil tamponade for repair of complex retinal detachment. Ophthalmic examination was performed before vitrectomy, and one and six months after vitrectomy. The increase in intraocular pressure was measured one month postoperatively in 37.77% of patients. The mechanism of intraocular pressure increase was silicone oil emulsification in 52.98%, closure of Ando's iridectomy in 23.54%, and idiopathic angle closure glaucoma in 23.54% of patients with elevated intraocular pressure. After silicone oil removal, elevated intraocular pressure persisted in 7 (15.55%) patients; in 5 patients it was controlled medically, while two patients underwent glaucoma surgery. Six months postoperatively 3 patients developed secondary neovascular glaucoma due to the prolipherative ischemic disease. Elevation of intraocular pressure following vitrectomy with silicone oil tamponade had a temporary effect, as it did not lead to permament intraocular pressure elevation but regressed after silicone oil removal from the eye.

Normal intraocular pressure (IOP) glaucoma is a clinical condition characterized by pathologic optic nerve excavation and visual field impairment, defined as optic neuropathy with certain features of a disease known as glaucoma. Glaucomatous optic nerve lesion is characterized by optic disk excavation or depression, however, this feature may greatly vary. The level of IOP is considered only one of the multiple risk factors involved in the disease development. In normal IOP glaucoma, papillary lesions and visual field impairments may differ from those occurring in primary open-angle glaucoma. In modern ophthalmology, the terminology has been modified, so the term low IOP glaucoma has been replaced by the term normal IOP glaucoma. It is now believed that various factors play a role in the development of glaucomatous optic neuropathy in normal IOP glaucoma and show variable interference depending on IOP level. Additional studies are needed to define these interactions and their impact on the mechanism of glaucomatous excavation. This will hopefully pave the way to new therapeutic approaches and help in clinical decisions concerning the prognosis and treatment of individual patients.

Achievement of target intraocular pressure is the goal of every efficient antiglaucoma therapy. Target intraocular pressure is the level of intraocular pressure which is associated with minimal likelihood of visual field or optic nerve lesion, or an existing lesion progression due to elevated intraocular pressure. Results of large clinical studies which have offered some new concepts on target intraocular pressure in the management of glaucoma are reviewed. An association between the curve of intraocular pressure decrease and glaucoma progression was demonstrated in these studies. Generally, a lower value of target intraocular pressure implies better protection from the loss of vision and visual field impairment in glaucoma patients. In advanced glaucoma, the greatest possible reduction from the initial intraocular pressure should be attempted. A 20% reduction from the initial intraocular pressure or decrease to < 18 mmHg in advanced glaucoma has been recognized as a favorable strategy to reach target intraocular pressure. In normal tension glaucoma, a lower value of target intraocular pressure is associated with a slower disease progression. In patients with initial glaucoma, 25% reduction from the initial intraocular pressure will slow down the disease progression by 45%. The value of target intraocular pressure depends on the pretreatment level of intraocular pressure, optic nerve condition, glaucoma disease state, rate of glaucoma progression, patient's age, and other risk factors for the development of glaucoma.