The main cause of blindness in people over 60 years of age is glaucoma. It is important to emphasize that, if treated early and appropriately, it is possible to prevent it.
What is glaucoma?
It is a lesion in the optic nerve fibers, caused by an increase in ocular pressure. This is due to an imbalance between the production and drainage in the anterior chamber of the eye of aqueous humor, a transparent liquid that is responsible for oxygenating and nourishing the structures of the ocular globule.
There are two types of glaucoma:
- Primary open-angle glaucoma: this is the most frequent, where vision is lost progressively. Most glaucomas are asymptomatic in advanced stages of the disease, but not all of them.
- Acute angle-closure glaucoma: occurs when eye pressure rises suddenly in patients with a narrow angle. The following symptoms can be detected: blurred vision, severe eye pain, headache and color vision.
How can glaucoma be treated?
Since the disease usually has no symptoms and is not detected with the naked eye until it has already developed, prevention is essential. This prevention is especially important if there is a history of glaucoma and, in this sense, annual check-ups can be of great help.
At the Institut d’Oftalmologia Clínica Girona different treatments are carried out, depending on the patient’s needs:
- Topical or systemic hypotensive treatment: this consists of a pharmacological treatment that helps to reduce intraocular pressure.
- Argon laser iridoplasty: consists of a laser with thermal effect that retracts the peripheral iris, in order to increase the space of the anterior chamber angle, without the need for surgery.
- Argon laser trabeculoplasty: the thermal laser is applied to the pigmented trabeculae, increasing the aqueous humor drainage pathway and reducing intraocular pressure.
- Peripheral iridectomy with Nd-YAG laser: through YAG laser a small hole is made in the iris, to allow the flow of aqueous humor between the posterior and anterior chamber. It is used as a preventive method in patients with narrow chamber.
- Cataract surgery: the opaque crystalline lens is removed and replaced by a clear intraocular lens, with the optical power required in each case. It is a quick and painless procedure, with a short visual recovery. It is especially indicated in patients with a narrow angle.
- Trabeculectomy: suitable for open and closed angle glaucoma. It consists of establishing a communication between the anterior chamber and the subconjunctival space through a regulated surgical fistula, which allows the flow of the acoustic humor.
- Deep non-perforating splenectomy: indicated in glaucoma with open angle, as an alternative to trabeculectomy, being safer and more effective. An intrascleral implant is applied and the postoperative period may require a YAG laser goniopuncture to stimulate drainage of the aqueous fluid.
- Drainage implants: they are used to treat secondary or complex glaucoma, when the traditional techniques mentioned above fail. They are implanted under local anesthesia and sedation.
For more information about glaucoma and its possible treatments, consult an Ophthalmology specialist.