Glaucoma

GlaucomaEyes are one of the most important parts of the body and we all want them to stay healthy until our old age. Nevertheless, a large number of diseases affect our eyes, among which is also glaucoma. Glaucoma represents a large group of diseases for which damage to the optic nerve occurs due to decay or deterioration of nerve fibers. It is also referred to as a secret thief of vision, because in its early stages it does not cause any pain and is inconspicuous. Glaucoma is one of the leading causes of blindness in the United States and elsewhere in the world. Statistics show that it is present at 12 percent of all persons with irreversible blindness. Weakened vision is detected only after the disease has progressed and due to this it is important to regularly measure the intraocular pressure by ophthalmologists.

The main risk factor for developing glaucoma is elevated intraocular pressure

Intraocular pressure ensures a constant shape of the eyeball, which is made of gelatine substance. In fact, an eye fluid, known as aqueous water, is holding the pressure on the eye. More precisely, eye fluid keeps pressure especially in eye lens, iris and cornea. Its task is to supply nutrients to the eye. The eye fluid is usually regularly secreted to the vascular system, problems however occur, when the fluid starts to accumulate in the eye. Then the intraocular pressure is raised, causing damage to the eyeball or nerve cells in the retina. This leads to progressive deterioration and potential loss of vision. Also sensitivity of the optic nerve is increased with glaucoma, an unbalanced blood flow to the eye, autoimmune reactions, diabetes and other physiological disorders can occur.

The main symptom of glaucoma is worsening of vision or field of vision. Vision will become darker and more and more blurred. Unfortunately, patient experiences this rather late, because the vision starts to deteriorate in the peripheral parts of the visual field. It is therefore very important to detect glaucoma early one, allowing stopping or slowing down of the development of the disease.

Primary glaucoma affects most often elderly people (over 65 years), short-sighted people with diopter greater than minus 4, patients with cardiovascular disease who have poor blood circulation in the body and, consequently, poor blood flow to the eye and to the optic nerve. Those with the disease present in a narrow family circle are four times more at risk in developing glaucoma.

Prevention and therapy

Prevention is primarily aimed at the early detection of glaucoma with preventive eye tests after age 40 in every 2 years.

Consistent treatment of elevated intraocular pressure is also important. Maintaining normal intraocular pressure with drugs slows down or inhibits the progression of the disease for majority of patients.

The diagnosis of this disease requires measurement of intraocular pressure, visual field examination, and ophthalmoscopic examination of the eye. The presence of characteristic changes in the optic nerve and loss of vision confirms the presence of glaucoma. Modern diagnostic methods such as imaging of the retina, allow very early detection of glaucoma and early initiation of treatment.

Treatment of glaucoma focuses on lowering intraocular pressure. Treatment begins with eye drops that reduce intraocular pressure to a value at which we expect the glaucoma damage to stay stable. Level of the target pressure for an individual patient depends on the severity of the disease and on the level of untreated intraocular pressure at which the failure occurred.

According to the recommendations of the European Glaucoma Association, the treatment should begin with drugs from groups of medicaments, such as alpha-adrenergic agonists, beta-blockers, prostaglandins and local inhibitors of carbonic anhydrase.

If drug therapy is not able to reduce intraocular pressure to the target value, then surgical and laser procedures are used to treat glaucoma.