Glaucoma

What is glaucoma?

Glaucoma is an eye disease that manifests in damage to the nerve of the eye, the optic nerve. Following the damage to the nerve, there is a deterioration in vision that can ultimately lead to blindness. There are several different types of glaucoma, the most common in the Western world being open-angle glaucoma.

The different types of glaucoma:

• Open-angle glaucoma
• Angle-closure glaucoma
  • Primary angle-closure glaucoma
  • Secondary angle-closure glaucoma

In this article we will deal mainly with the characteristics of open-angle glaucoma.

What are the symptoms of glaucoma?

The disease is usually asymptomatic, that is, the patient does not feel the disease at all. The initial impairment in vision is usually in the peripheral visual field, that is, the center of the visual field continues to be normal. As the disease progresses, the entire visual field may be impaired.

How is glaucoma diagnosed?

The diagnosis of glaucoma is made by an ophthalmologist. The ophthalmologist uses several tests in order to reach this diagnosis:

1. One of the components of the diagnosis is looking at the optic nerve with the help of a slit lamp and a lens that allows proper focus on the optic nerve. With the help of this tool the doctor can see signs of damage to the optic nerve, which manifest, among other things, in cupping of the disc.
2. Another component in the diagnosis of glaucoma is a visual field test. Since the peripheral visual field is impaired first, with the help of various tools that examine the visual field it is possible to reach a diagnosis and monitor glaucoma.
3. The third component in diagnosing and monitoring glaucoma is intraocular pressure. With the help of a device such as Goldmann tonometry it is possible to measure the intraocular pressure. People with glaucoma tend to have elevated intraocular pressure.

It is recommended to perform a screening test for glaucoma at least once in life. This disease has a genetic tendency, and therefore people with family members who suffer from this disease are also recommended to perform screening tests at a higher frequency. If this disease is identified at an early stage, it is possible to treat it and prevent the deterioration of vision. It is important to note that the damage caused to the optic nerve is irreversible, and therefore it is very important to prevent the damage before it occurs.

What is the treatment for glaucoma?

The treatments for glaucoma focus on lowering the intraocular pressure. There are several different methods, the main ones being:

1. Eye drops that lower intraocular pressure.
2. Laser treatments that lower pressure.
3. Surgeries that lead to a lowering of the pressure.

Which treatment is best for me?

Every patient is different, and therefore for each person the treatment will be unique. It can be said that usually one begins with the simpler treatments that include eye drops to lower intraocular pressure. People who do not lower the pressure with the use of one medication can receive several different drops, where the combination between them can improve the intraocular pressure. One of the reasons for treatment failure is low patient compliance with the treatment, and therefore it is very important to make sure to adhere to the instructions of the ophthalmologist treating the glaucoma. For people for whom the drops are not sufficient to lower the intraocular pressure, there are additional options. For those people, laser treatment or surgery may be more suitable. The advantage of the laser is that the treatment is less invasive and therefore there are usually fewer complications. The advantage of surgeries to lower intraocular pressure is that the effect of surgeries lasts for a longer time.

Again, it is important to note that everyone responds differently to each treatment.