Glaucoma is a progressive optic neuropathy (a disease of the optic nerve) characterized by a specific pattern of optic nerve head and visual field damage. Damage to the visual system in glaucoma is due to the death of the retinal ganglion cells, the axons of which comprise the optic nerve and carry the visual impulses from the eye to the brain. Glaucoma represents a final common pathway resulting from a number of different conditions that can affect the eye, many of which are associated with elevated IOP. It is important to realize that elevated IOP is not synonymous with glaucoma, but rather is the most important risk factor we know of for the development and/or progression of glaucomatous damage.There may be no symptoms until vision is lost in the later stages of the disease. Experts estimate that half of the people affected by glaucoma may not know they have it.

There is no cure for glaucoma—yet. However, medication or surgery can slow or prevent further vision loss. The appropriate treatment depends upon the type of glaucoma among other factors. Early detection is vital to stopping the progress of the disease.

It was once thought that high pressure within the eye, also known as intraocular pressure or IOP, is the main cause of this optic nerve damage. Although IOP is clearly a risk factor, we now know that other factors must also be involved because even people with “normal” levels of pressure can experience vision loss from glaucoma. Other risk factors for glaucomatous damage besides elevated IOP, or non-IOP-dependent risk factors, still largely remain to be explored. Much remains to be discovered, so that new approaches to treatment can be devised.

The two main types of glaucoma are primary open angle glaucoma (POAG), and angle closure glaucoma. These are marked by an increase of intraocular pressure (IOP), or pressure inside the eye. POAG has been called the most common "form" of glaucoma. It is a diagnosis of exclusion, in that the diagnosis is made when nothing else is visible, such as pigment, exfoliation, or inflammation, to which to attribute the glaucoma. It is the most common because patients with elevated IOP but no visible damage (glaucoma suspects, ocular hypertension) are included in the category. POAG is most common among persons of African descent, who are affected about 4-5 times as commonly as Caucasians. Nearsighted persons are also more commonly affected.

Angle-closure glaucoma is basically an anatomic disorder and can be considered a structural problem of the eye. It is most common in Asia, particularly in such countries as China and India, where it is more common than open-angle glaucoma. The angle formed where the iris and cornea meet varies in its width from individual to individual. People of Japanese, Chinese, Eskimo or Asian Indian are more likely to have narrow angles. In angle-closure glaucoma, the trabecular meshwork is normal, but the iris is pushed against it, blocking the flow of fluid (aqueous humor) from the eye.

Depending upon the type of glaucoma, treatment may include medication, usually prescription eye-drops, laser surgery, or operative surgery to lower the pressure in the eye and prevent further damage to the optic nerve. While there is no cure as yet for glaucoma, early diagnosis and continuing treatment can preserve eyesight. The main purpose is to lower the IOP.

*First line treatment – eye drop or systematic medication

A number of medications are currently in use to treat glaucoma. Your doctor may prescribe a combination of medications or change your prescription over time to reduce side-effects or provide a more effective treatment. Typically medications are intended to reduce elevated IOP and prevent damage to the optic nerve. The most common medications used for initial treatment are prostaglandin analogs.

*Second line treatment – laser surgery

Laser surgery is important in the treatment of several different eye diseases.
During laser surgery, the eye is numbed so that there is little or no pain. The eye doctor then holds a special lens to the eye. The laser beam is aimed into the eye, and there is a bright light, like a camera flash. i.e. ARGON LASER TRABECULOPLASTY (ALT) and SELECTIVE LASER TRABECULOPLASTY (SLT) is for the treatment of primary open angle glaucoma (POAG). And LASER PERIPHERAL IRIDOTOMY (LPI) is for the treatment of angle-closure glaucoma.

*Third line treatment – trabeculectomy (filtration microsurgery)

When medicine and laser treatment do not lower IOP adequately, doctors may recommend a procedure called filtering surgery (sometimes called conventional or cutting surgery). In filtering surgery, a tiny drainage hole is made in the sclera (the white part of the eye) in a procedure called a trabeculectomy. The new drainage hole allows fluid to flow out of the eye and helps lower eye pressure. This prevents or reduces damage to the optic nerve. ologen™ is applied in the stage to prevent scar formation effectively.

Scar formation over the trabecular flap and subconjunctival space is the common cause of bleb failure.

Pterygium is a raised, wedge-shaped growth of the conjunctiva. It is most common among those who live in tropical climates or spend a lot of time in the sun. Symptoms may include irritation, redness, and tearing. Pterygia are nourished by tiny capillaries that supply blood to the tissue. For some, the growth remains dormant; however, in other cases it grows over the central cornea and affects the vision. As the pterygium develops, it may alter the shape of the cornea, causing astigmatism. If the pterygium invades the central cornea, it is removed surgically.

Since pterygia are most commonly caused by sun exposure, protecting the eyes from sun, dust and wind is recommended. Instilling artificial tears liberally is also helpful to decrease irritation. In some cases, steroid drops are prescribed to reduce inflammation.

A conservative approach is recommended for most people. Artificial tears can be used to relieve the sensation of a foreign body in the eye and to protect against dryness. When a pterygium becomes red and irritated, topical eye drops or ointments may be used to help reduce the inflammation. If you suspect you may have pterygium, be sure to visit your eye doctor for proper treatment and a discussion of available options for you. Evaluation by an ophthalmologist will help determine the most optimal treatment in each case. If a pterygium is small but becomes intermittently inflamed, your ophthalmologist may recommend a trial of a mild eye drop during acute inflammatory flares. If these drops are recommended, you should remain under the care of your ophthalmologist to ensure that you do not develop side effects from the use of these medications. In some cases, your ophthalmologist may recommend surgical removal of the tissue.

Surgery is the only way to remove a pterygium, but the results can be disappointing. Even with modern techniques, the recurrence rate is often as high as 30 to 40 percent, and they tend to come back larger and faster. Surgery for excision of pterygia usually is performed in an outpatient setting under local or topical anesthesia. Pain is uncommon. The pterygium is carefully dissected away. Postoperatively, the eye generally is patched overnight and healing typically takes many weeks with patients applying prescribed topical eye-drops or ointments several times a day. In the early phase of healing, the eye may be slightly swollen and bloodshot in appearance. Eventually the surgical site improves in comfort and appearance.

Although most pterygia are harmless and can be left alone safely; they are surgically removed for the following reasons:
- Discomfort: If a pterygium is causing excessive irritation due to dryness / inflammation or a persistent foreign body sensation.
- Vision: If a pterygium is obstructing vision.
- Cosmetic: If a pterygium is unsightly or cosmetically unappealing.

ologen™ from collagen source, manufacture to finished product is a rigorous production process to guarantee its safety and quality. ologen™ has attended CE mark from Europe and has hundreds of patients successfully experienced its safety and effectiveness worldwide. Moreover, more recognized ophthalmologists have published their clinical studies on ologen™ to prove its promising outcomes.

Usually no special care will take place after applying ologen™; the care after surgery is the same as the ocular surgery. Your doctor may descript antibiotic medications for a week or so, and patients are requested not to wear contact lens on the operated eye for 3 months after surgery. Also, complying with the instruction of your doctor is highly recommended.

There will be no further surgery to retrieve the implanted ologen™ under normal circumstance because eventually ologen™ Collagen Matrix will be biodegraded around 90 days, depending on postoperative medication(s), stress tissue site, predetermined intrinsic inflammatory and remodeling mechanisms.

Yes. No mater what ocular surgery you have done, patient should regularly visit your doctor as scheduled.

ologen™ can be used in various ocular surgeries as follows :
- Glaucoma Surgery
- Strabismus Surgery
- Ocular Surface Reconstruction
- Eye Plastic Surgery
- Grafts Donor Sites
- Pterygium Excision
- Subconjunctival Scar Revision

Patients having the following conditions are not recommended to use ologen™.
- Known allergic reaction to porcine collagen.
- Age under 18 years old.
- Pregnant or breast-feeding women.
- Autoimmune disease or systemic diseases such as coagulation disorders, collagen vascular disease or diabetes mellitus, etc.

ologen™ is designed to normalize wound healing process, randomize the growth of myofibroblasts, regenerate tissue remodeling and prevent scar formation, allowing to enhance the successful rate of ocular surgeries.