Glaucoma is an irreversible optic nerve disease which may be due to several causes, and whose most important risk factor is elevated intraocular pressure (IOP). It is the second cause of blindness in the Western world and 50% of people who suffer from it in developed countries do not know it.
We talk about glaucoma when we find that the optic nerve is affected (the nerve acts as the driver of the information from the eye to the brain). On the other hand, ocular hypertension occurs when only IOP is elevated.
The IOP is determined by the rate of production of the aqueous humour (liquid responsible for the ocular tone), and by the resistance and difficulty in its drainage.
There are a wide variety of types of glaucoma, although in general terms we can classify it according to its origin (primary or secondary) and according to the angular amplitude (open angle or closure angle).
How is it diagnosed?
- With the IOP
- With the visual field
- With an optical coherence tomography (OCT)
The diagnosis is of vital importance since most affected glaucoma usually do not have symptoms until advanced stages of the disease, when the damages in the eye are serious and irreversible.
Risk Factors for Glaucoma
Factors that can condition the evolution of glaucoma
What treatments are there now?
Most treatments are aimed at increasing drainage and in some cases decreasing the production of aqueous humour.
The main therapeutic pillars are three, from less to more invasive:
- Medical-pharmacological treatments (hypotensive eye drops and in very specific cases tablets).
- Outpatient laser treatment. There are three modalities, laser iridotomy, trabeculoplasty and transescleral cyclophotocoagulation with laser diode.
- Surgical treatment:
o Microinvasive Surgery (MIGS)
o Invasive surgery for more advanced cases: filtering surgery (trabeculectomy and nonperforating sclerectomy). There are also drainage devices, Ahmed valve and Baerveldt as the most used.