OPHTHALMIC CONDITIONS
Glaucoma
The silent thief of vision
What exactly is glaucoma?
Glaucoma is a serious eye disease, commonly known as the «silent thief of vision», which if not diagnosed and not treated promptly, it can become an irreversible condition with severe consequences for vision. Glaucoma is primarily caused by increased intraocular pressure (either due to excessive production of aqueous humor, the fluid that is continuously produced by the eye, or due to reduced drainage of this fluid). The elevated intraocular pressure progressively damages the optic nerve. It is worth mentioning that an increased intraocular pressure does not necessarily indicate glaucoma if no damage to the optic nerve is detected. This special condition is referred to as ocular hypertension. Risk factors for glaucoma include heredity, aging, diabetes, hypertension, and ocular inflammations.
What are the main symptoms of glaucoma?
In its early stages, glaucoma may be completely asymptomatic. This is why the condition is so insidious and preventive screening (with tonometry examination) is so important. Some key symptoms that may raise suspicion include:
Mild eye pain with headache
Reduced visual acuity
Nausea and tendency to vomit
Appearance of halos around lights
Damage to peripheral vision (in advanced stages)
What are the main types of glaucoma?
The main types of glaucoma are the following:
Open – angle (chronic simple) glaucoma: The most common and insidious form as it is asymptomatic. It occurs when the angle between the peripheral cornea and the iris is open. While the angle is open, there is a resistance to the drainage of aqueous humor through the trabecular meshwork, causing increased intraocular pressure
Closed – angle (acute) glaucoma: Occurs when the angle between the peripheral cornea and the iris is closed. The iris can completely block the drainage angle, leading to a sudden increase in intraocular pressures
Congenital glaucoma (early childhood)
Normal – tension glaucoma
Pseudoexfoliative glaucoma
Post – traumatic glaucoma
What examination tests are done to diagnose glaucoma?
The essential diagnostic tests that a patient should undergo include:
Measurement of visual acuity
Measurement of intraocular pressure (tonometry)
Assessment of the drainage angle of the eye (gonioscopy)
Examination of the optic nerve (fundoscopy)
Visual perimetry testing (visual fields)
Corneal pachymetry
Optical coherence tomography (OCT) for qualitative and quantitative analysis of the optic nerve fibers
Can glaucoma be treated?
The primary goal in treating glaucoma is to reduce intraocular pressure. Treatment options include the following:
Medication: Antiglaucoma drugs help better regulate intraocular pressure.
Laser: Technologies such as ALT (Argon Laser Trabeculoplasty) and SLT (Selective Laser Trabeculoplasty) can help remove aqueous humor from the eye, lowering intraocular pressure levels.
Surgical procedures: Modern techniques include trabeculectomy, implantation of artificial valves, canaloplasty, and the use of drainage stents
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