What is it?
Glaucoma is defined as an irreversible optic nerve disease which may be due to several causes, and whose most important risk factor is elevated intraocular pressure (IOP). The importance of this disease is evident, as is the second cause of blindness in developed countries.
We speak of glaucoma when we find that the optic nerve is affected (this acts as a conductor of information from the eye to the brain). Furthermore, ocular hypertension occurs only when IOP is elevated.
IOP is determined by the production rate of the aqueous humor (ocular fluid responsible for the tune), and the resistance and difficulty in its drainage.
There are many types of glaucoma, although in general terms it can be classified according to their origin (primary or secondary) and according to the angular amplitude (open or closed angle).
Since the majority of patients suffering from glaucoma often have no symptoms until entering advanced stages of the disease, and taking into account the irreversibility of the damage, it is vitally important to diagnose the disease in its earliest stage.
The predisposing factors are: age over 40, family history, nearsightedness, diabetes, hypertension and cardiovascular diseases, among others.
Most treatments are designed to increase drainage and possibly reduce the production of aqueous humor.
The cornerstones of treatment are three, from least to most invasive:
Medical-Pharmacological: using eye drops, to be applied once a day, two or three depending on each. In very specific cases they may be given tablets.
Laser, very safe and on an outpatient basis. There are three modes. Laser iridotomy, usually preventive. Very effective in acute glaucoma attack. Laser trabeculoplasty for open angle glaucoma treated by developmental stage and patient age. And finally, the transscleral diode cylclophotocoagulation, focused on treating ciliary processes, producers of aqueous humor.
Surgical: The two most common techniques are non-penetrating trabeculectomy and sclerotomy. As a third option there are valve implants. These techniques enhance the filtration of aqueous humor.
It is a chronic disease that requires ongoing reviews and good treatment. Compliance is essential for effective disease control. As an asymptomatic disease in its early stages, early diagnosis is the best ally to control the evolution.
Primary Glaucoma may have a genetic basis, which may or may not manifest. Therefore a very thorough control are advised to children of parents with glaucoma. Moreover, in patients with predisposing factors are recommended to have annual eye tests.