The silent blindness disease

What is glaucoma?

Glaucoma is an optic neuropathy which affects the papilla or optic nerve and causes other specific visual field defects, generally as a consequence of high intraocular pressure, but not always.

It is a disorder with a series of symptoms that cause degeneration of sensitive eye tissues, retinal nerve fibers and specifically of the optic nerve, which carries visual information to the brain. In most cases this is a consequence of high intraocular pressure.

If aqueous humor drainage from the anterior chamber of the eye is limited, intraocular pressure will raise, giving place to irreversible damage of the optic nerve causing permanent vision loss.

Normal eyeBlocked drainage channel

People at risk

  • Aged 40 and over
  • People with severe myopia, diabetes or family history of glaucoma
  • People taking corticosteroids for long periods of time
  • African-Americans, especially after the age of 35
  • People who have had an ocular traumatism

Which symptoms are present?

Glaucoma is often diagnosed in advanced stages, as symptoms do not usually appear until then.

This is why it is so important to have regular ophthalmological checkups, especially those who are at risk. If glaucoma is diagnosed in early stages, it generally responds well to treatment and it is possible to reduce irreversible damage.

In some cases, especially if there is a rapid increase in intraocular pressure, the following symptoms may be experienced:

  1. Gradual loss of peripheral vision (tunnel vision)
  2. Periocular pain when moving from a dark area to a well illuminated area
  3. Headache and eye redness
  4. Nauseas and vomiting
  5. Vision of halos
  6. Blurred vision

Detection and prevention

There are three basic tests for detecting glaucoma:

  1. Tonometry - Intraocular pressure (IOP) measurement
  2. GDX and OCT - Optic nerve and retina inspection
  3. Computerized or automated perimetry - Visual field examination

Genetic test - Nowadays, glaucoma can be prevented before it appears if genetic tests that measure the predisposition of each patient to develop a pseudoexfoliation syndrome (PXF) are performed. 50% of patients who have this syndrome end up having glaucoma. The test is carried out using a saliva sample in order to analyse a set of high reliability biomarkers.

Glaucoma treatment

Glaucoma does not have a cure, so regular checkups are necessary to preserve residual vision and avoid further damage.

Medication reduces the formation of aqueous humor inside the eye or facilitates its drainage. For most patients with glaucoma, regular use of antihypertensive drugs is enough to control intraocular pressure. However, if intraocular pressure control is not adequate, other treatments such as SLT laser (selective laser trabeculoplasty) or surgical procedures such as valve implant or trabeculotomy may be considered.

There is not a single type of glaucoma, so treatment must be adapted to each type of glaucoma and other characteristics of the eye.

Dr. Luis Alonso | Ophthalmologist

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