Glaucoma is a group of diseases that are characterized by producing damage to the optic nerve, this is a very specific damage that will result in a loss of visual field. To explain it in another way, the optic nerve would be the cable that communicates the eye with the brain and transmits all the information that we see, glaucoma will produce a defect by which the visual field will be contracting, we will be losing the periphery of the visual field until we are left with only the central part of it. This damage is very specific and can be diagnosed with a series of tests that we will discuss later. Glaucoma does not have a single cause, there are several risk factors and the most important one is intraocular pressure, although there are other factors such as vascular factors, family history and some anatomical characteristics of the eye. Of the factors that exist, the one that we can modulate in some way is intraocular pressure, which is why it is the factor to which we attach most importance.
How does it manifest itself and how can it be prevented?
As we have already mentioned, there are different types of glaucoma. The best known is open-angle glaucoma, in which there is silent damage in which we lose the visual field from the periphery to the center, that is why it is called the silent thief, we do not notice it at first, because this loss is very slow, until the final stages when the visual field is so reduced that we realize that we have an inability to move well. When that happens and one goes to the ophthalmologist the damage is already done and it is difficult to treat it, normally we cannot recover this vision that we have lost. There is another type of glaucoma, closed-angle glaucoma, which produces a very sudden increase in blood pressure with pain and loss of vision, and we notice it immediately and go to the ophthalmologist, but these are the most infrequent cases. What is really important and the real health problem is open-angle glaucoma. For a good prevention what we have to do is to go to the ophthalmologist, routinely we should go in the different decades of life, from the age of 40 there are a series of changes, including an increase in the incidence of glaucoma. Of course, if there has been any previous trauma or if there has been a family history of glaucoma, you should go to the ophthalmologist for check-ups.
What is the treatment?
For the different types of glaucoma, which also have different stages of evolution, we have different treatments. The most common are eye drops that are put in the eye to lower the intraocular pressure and practically the majority of patients are controlled with these drops. Lasers can also be used for the treatment of glaucoma, especially some types, such as the angle-closure glaucoma we have mentioned. And then there are the surgical techniques, the classic techniques that are very effective for various types of glaucoma and we are currently advancing towards minimally invasive techniques, techniques in which we use small, biocompatible devices that, when placed in the eye, will facilitate the outflow of the aqueous humor to lower the tension of the eye, minimizing the damage we do to its structures and minimizing the patient’s discomfort. These are very easy techniques, practically all of them ambulatory, and they will allow us to control glaucomas that a priori are difficult to control in a relatively simple manner.