Glaucoma

What is glaucoma?

Glaucoma is a progressive (neurodegenerative) disease of the optic nerve which, if left untreated, can lead to narrowing of the visual field, damage to the optic nerve, and significant, even permanent, vision loss. The condition is usually asymptomatic, which is why it is known as the “silent thief” of vision.

How common is glaucoma?

Glaucoma is the second leading cause of blindness worldwide. According to studies, about 2-3% of people over the age of 40 suffer from some form of glaucoma. Estimates indicate that up to 50% of cases go undiagnosed. Projections show that by 2030 the number of people with glaucoma will increase to 79.6 million, and by 2040 to 111.8 million. Currently, more than 6 million people globally are blind due to glaucoma.

What causes glaucoma?

The main risk factor for glaucoma is elevated intraocular pressure. Normal intraocular pressure values range from 8 to 21 mmHg. However, elevated pressure alone does not guarantee that a person has glaucoma. For instance, people with ocular hypertension may have high pressure readings without noticeable damage to the optic nerve.

Early detection of glaucoma

Glaucoma can be detected early through regular check-ups. It is recommended:

• For people with a family history of glaucoma: regular glaucoma screenings.
• For people over the age of 65: intraocular pressure checks at least once every two years.
• If the disease is already diagnosed: regular check-ups and strict adherence to the prescribed treatment.

Types of glaucoma

• Open-angle glaucoma: The most common type, in which the drainage of intraocular fluid is slowed without visible anatomical abnormalities of the eye’s angle.
• Angle-closure glaucoma: This form occurs due to anatomical features of the eye’s angle that hinder the drainage of intraocular fluid.
• Congenital glaucoma: Appears at birth or early childhood and has a worse prognosis.
• Secondary glaucoma: Develops as a result of other conditions such as diabetes, eye surgery, or the use of corticosteroids.

Symptoms of glaucoma

• In open-angle glaucoma, symptoms are often absent initially, and the condition may be detected during a routine examination.
• In angle-closure glaucoma, the symptoms are more pronounced, including eye pain, headache, reduced visual acuity, nausea, and vomiting.

Laser methods for glaucoma treatment

• YAG laser iridotomy: Used for acute angle-closure glaucoma.
• Selective laser trabeculoplasty: Improves drainage of intraocular fluid in open-angle glaucoma.
• PLT Pattern laser trabeculoplasty: A newer, more effective version of the SLT laser.

Surgical treatment of glaucoma

Glaucoma surgery includes trabeculectomy (creating a new channel for intraocular fluid drainage) or placing glaucoma shunts (drainage implants).

Glaucoma examination

A comprehensive glaucoma examination includes:

• Checking visual acuity and measuring intraocular pressure.
• Visual field testing.
• Pachymetry (measuring the thickness of the cornea).
• Gonioscopy (examining the angle of the eye).
• OCT (optical coherence tomography) to assess optic nerve damage.

Glaucoma treatment

There is no way to restore vision lost to glaucoma, but treatment can slow the progression of the disease. Treatment includes eye drops to reduce intraocular pressure, laser procedures, and surgical interventions, which can be combined depending on the case.Synonyms: Eye pressure measurement, Eye perimetry, Optic nerve damage