Glaucoma is a visual pathology in which the optic nerve is damaged, secondary to elevated intraocular pressure. The loss of optic nerve fibers can be reversible or irreversible, and early diagnosis is important to avoid the definitive loss of these fibers, which would cause a decrease in the visual field that may go unnoticed because the disease does not usually cause discomfort.
In cases of terminal glaucoma, vision would progressively be equivalent to seeing through a shotgun barrel, and finally, blindness.
What is intraocular pressure?
Intraocular pressure is the balance between the formation and elimination of aqueous humor, the clear fluid that bathes the front part of the eye. The formation of this fluid is continuous, and the same must occur with the elimination, otherwise, an increase in intraocular pressure will occur. Elimination occurs in the peripheral part of the iris, in the trabecular meshwork.
Main types of glaucoma: open-angle and angle-closure glaucoma.
- The most frequent form is chronic open-angle glaucoma or chronic simple glaucoma, which affects approximately 3% of the population over 40 years of age. It is due to changes in the trabecular meshwork, whose cells lose their effectiveness to eliminate the aqueous humor. There are some risk factors to take into account, such as myopia, diabetes or hereditary factors.
- Angle-closure glaucoma or acute glaucoma is caused by an abrupt interruption in the elimination of the aqueous humor, causing symptoms of acute and intense pain (nail pain), decreased vision, and sometimes nausea and vomiting. In this case, urgent specialized attention is required.
Other less frequent types are congenital glaucoma and glaucoma secondary to other diseases, ocular malformations and medications.
Glaucoma treatment, is there a solution?
Most cases of simple chronic glaucoma respond to medical treatment with drops. Another frequent and complementary treatment to the drops is laser trabeculoplasty, and in advanced cases or when medical treatment is insufficient, surgical intervention by trabeculectomy is necessary.
In acute glaucoma, it is necessary to act as quickly as possible, lowering intraocular pressure and performing a laser iridotomy in the affected eye, as well as later in the other eye as a preventive measure.
In the treatment of glaucoma, the disease should always be monitored throughout life, since the effectiveness of the treatment may vary. At this point it is essential to perform computerized campimetry and other studies of the optic nerve for the correct diagnosis and follow-up.