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Glaucoma

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Glaucoma is a group of chronic eye conditions that damage the optic nerve, which is vital to good vision. This damage is often caused by an abnormally high pressure in the eye.

Glaucoma is one of the leading causes of blindness in the world. Vision loss due to glaucoma can’t be recovered.

So it’s important to have regular eye exams that include measurements of eye pressure. If glaucoma is recognized early, vision loss can be slowed or prevented. The treatment in this condition is generally needed for the rest of the life.

Unfortunately, glaucoma is a widespread condition.  It can occur at any age but is more common in adults over the age of 40. Glaucoma can also affect young people (juvenile glaucoma) and even neonates (congenital glaucoma).

If left untreated, glaucoma will eventually cause blindness. Even with treatment, about 15 percent of people with glaucoma become blind in at least one eye within 20 years.

 

Causes of glaucoma

Elevated eye pressure is due to a buildup of a fluid (aqueous humor) that flows throughout the eye. This fluid normally drains into the front of the eye (anterior chamber) through tissue (trabecular meshwork) at the angle where the iris and cornea meet. When fluid is overproduced or the drainage system doesn’t work properly, the fluid can’t flow out at its normal rate and pressure builds up.

Glaucoma tends to run in families. In some people, scientists have identified genes related to high eye pressure and optic nerve damage.

People who have close relatives diagnosed with glaucoma are at greater risk of developing this disease.

Symptoms of glaucoma

Glaucoma can be asymptomatic for a long time. The most common form of glaucoma has no warning signs. The effect is so gradual that one may not notice a change in vision until the condition is at an advanced stage.

Rarely, in advanced phases of glaucoma, headaches, and pressure in the eye area and when the optic nerve is almost completely destroyed, there is also a decrease in vision.

The signs and symptoms of glaucoma vary depending on the type and stage of the condition. Patients may experience:

– Patchy blind spots in their side (peripheral) or central vision, frequently in both eyes

– Tunnel vision in the advanced stages

– Severe headache

– Eye pain

– Nausea and vomiting

– Blurred vision

– Halos around lights

– Eye redness

Evolution of glaucoma

Glaucoma is the result of damage to the optic nerve. As this nerve gradually deteriorates, blind spots develop in the visual field.

Glaucoma treatments can be highly effective if used early on in the development of the disease. If diagnosed early enough, there are several treatments that can slow or even stop the disease altogether. That’s why it’s important for everyone over 40 to see an eye specialist for regular check-ups, especially if they come from families with glaucoma.

Diagnosis

Regular comprehensive eye exams can help detect glaucoma in its early stages before irreversible damage occurs. As a general rule, one should have comprehensive eye exams every four years beginning at age 40 and every two years from age 65.

Glaucoma is suspected when a routine eye control reveals an intraocular pressure that exceeds 21 mmHg.

Diagnosis of glaucoma is confirmed by other investigations that can reveal optic nerve damage:

–  funduscopy (including optic nerve look)

–  Checking for areas of vision loss (visual field test)

– Testing for optic nerve damage by means of Optical coherence tomography scanning

– Measuring corneal thickness (pachymetry) – this is important because intraocular pressure measurement is made by applying pressure on to the cornea; the results of these measurements can be influenced by cornea thickness

–  Inspecting the drainage angle (gonioscopy)

The Optisan clinic is equipped with state-of-the-art equipment that enables to carry out all investigations necessary for accurate and timely diagnosis of glaucoma.

Treatment of glaucoma

The damage caused by glaucoma can’t be reversed. But treatment and regular checkups can help slow or prevent vision loss, especially when started in early stage of the disease.

The goal of glaucoma treatment is to lower intraocular pressure. Depending on the situation, the options may include eye drops, laser treatment or surgery.

Glaucoma treatment often starts with prescription eye drops. These can help decrease eye pressure by improving how fluid drains from the eye or by decreasing the amount of fluid the eye makes.

If needed, two or even three drugs may be associated, acting by different mechanisms, and potentiating the hipotensive effect.

After confirming the diagnosis of glaucoma, regular checkups by an ophthalmologist from six to six months to follow the prescribed treatment are needed. The ophthalmologist will take the intraocular pressure, will see the eye fundus and decide whether computerized visual field test or optic nerve tomography should be repeated. Also, only the ophthalmologist can decide to modify the treatment protocol.

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