Glaucoma

Glaucoma is perhaps one of the most insidious diseases that threaten our vision. In the early stages of this illness, there may be no symptoms.

That is why it is estimated that 50% of those who have glaucoma may not even be aware of it.

Glaucoma is perhaps one of the most insidious diseases that threaten our vision. In the early stages of this illness, there may be no symptoms.

That is why it is estimated that 50% of those who have glaucoma may not even be aware of it.

What is Glaucoma?

Studies have shown that glaucoma affects about 3% of the population. Beware, if not diagnosed in time and not treated properly, it may lead, slowly but steadily, to blindness.

The term glaucoma refers to eye diseases associated with optic nerve damage. Think of the optic nerves as electrical cable, with over one million wires. These "cables" are responsible for transferring images from the eye to the brain, and then transferring images from the brain back to the eye.

The main cause of optic nerve damage is high pressure in our eyes, but we now know that even people with "normal" eye pressure levels can also get glaucoma.

 

Who can it affect and what causes Glaucoma?

glaucoma stages

Some groups of people are at higher risk of glaucoma.

Individuals over the age of 60, are six times more at risk.

Also, people with a positive family history of glaucoma have a four to nine times higher risk of glaucoma. It is important to emphasize that primary open-angle glaucoma, which is one of the most common types of glaucoma, is inherited.

Steroid users (cortisone), people with eye injuries, African Americans and Asians are also more likely than others to have glaucoma.

Prevention - Diagnosis

One way to prevent glaucoma is to diagnose high pressure in our eyes as the earliest stage possible. A visit to the ophthalmologist, every two years from the age of 40 to 50 and then a yearly visit for those over the age of 50, is usually enough. More frequent monitoring may be needed for people with a family history of glaucoma.

However, measuring the pressure alone is not enough for a proper diagnosis (normal values: between 10-21 mmHg).

We must bear in mind that there is also low-pressure glaucoma and secondary glaucoma's that appear as a result of an ophthalmic injury, inflammation, tumor or in advanced stages of cataracts or diabetes. Glaucoma can also be caused by certain drugs such as steroids.

Therefore, in order to have a complete examination, our ophthalmologist also conducts additional diagnostic examinations.

Regular eye examinations and routine tests that can help determine whether an individual has glaucoma include tonometry which helps measure the eye's internal pressure, and funduscopy which examines the inside of the eye, particularly the optic nerve.

These next two tests mentioned are performed if the results of the above tests do not meet the requirements of a healthy eye. Testing of the circumference which is basically an examination of the field of view, and gonioscopy which is a painless examination that checks if the angle where the iris meets the cornea is open or closed.

New technology like OCT and OCTA help us in the early diagnosis and follow up of the progression of glaucoma.

OCTA (1) has a high repeatability and reproducibility, (2) has good discriminatory power to differentiate normal eyes from glaucoma eyes, (3) is more strongly correlated with visual function than conventional OCT, (4) has good discriminatory power to differentiate early-glaucoma eyes from normal eyes (i.e., at least equal to that of OCT), (5) reaches a floor effect at a more advanced disease stage than OCT, and (6) is able to detect progression in glaucoma eyes.

CONCLUSION:

OCTA shows potential to become a part of everyday glaucoma management.

Treatments

Glaucoma may be mild or severe, and an individual must be examined to determine whether they have an open or closed angle glaucoma.

Damage created by glaucoma is not reversible; early diagnosis and treatment may delay the progression of the disease, otherwise treatment is intended to maintain and stabilize the remaining vision.

For these reasons, periodic examinations are very important.

Treatment with medication

glaucoma internal eyeIt is possible to treat glaucoma with medication, and it is also quite effective. If with this treatment, intraocular pressure remains at normal levels, pills and/or eye-drops, with the doctor's instructions, can be used as life-long treatment, since they can reduce the production of aqueous humor or improve its natural flow.

Also, alternative means, such as taking supplemental antioxidant vitamins, proper nutrition, smoking and coffee and prolonged sunlight are avoided, improve better circulation and blood supply to the retina and the optic nerve, which also helps and supplements medication.

Since the damage caused in the case of glaucoma is irreversible, frequent eye examinations once glaucoma has been established (every 3-6 months) are critical to monitoring any changes that can affect your eyesight.

If intraocular pressure does not adjust well or there is a progressive deterioration of the condition, then surgery should be performed since it is more effective.

Surgery with Laser

If therapy with medication cannot cope with the progression of glaucoma, or if you are you don't want to use eye drops every day, then proceed to LASER (SLT) - selective laser trabeculoplasty treatment. This can reduce intraocular pressure from 4 to 8 units.

In open-angle glaucoma, laser is used to widen the drainage aperture in the iris, whereas in acute glaucoma (where the angle is closed) the LASER is used to open a hole in the iris so that the aqueous humor emerges from a lateral drainage.

 

Surgical Treatment

When the above methods are insufficient to stabilize the condition of the patient, surgery is recommended, as to create a new drainage pathway of the aqueous humor of the eye. 

Alternatively, a small prosthetic valve is placed to help drain the aqueous humor.