When we talk about glaucoma we refer to a heterogeneous group of eye diseases in which the pressure inside the eye is high enough to damage the optic nerve and therefore the visual field. The most common form is open-angle glaucoma, which affects around 80 percent of cases.
What is open angle glaucoma due to?
Under normal conditions inside the eye there is a liquid (aqueous humor) that is continuously produced and made to flow through a filtering structure (trabeculate). If the exhaust system is blocked, the eye tension increases, which over time damages the optic nerve.
What are your symptoms?
In the initial phase it does not give appreciable symptoms. Nothing is noticed until the damage to the optic nerve is at an advanced and irreversible stage. This disease involves a gradual loss of the visual field up to the tubular vision, like looking through a rolled sheet of paper. Then also the central vision disappears.
Who risks more?
The chances of developing open-angle glaucoma increase in the presence of a family predisposition, with aging, if you have high visual defects ( myopia , astigmatism and hypermetropia) and if you have vascular disorders (for example related to diabetes ).
How can you find out?
The only way is to perform periodic eye checks that include measuring the pressure inside the eye and observing the bottom of the eye. If one of these parameters is altered, other more specific tests are performed, such as the visual field and morphological investigations to analyze the optic papilla or nerve fibers.
When should the checks be done?
Before the age of 45 it is advisable to have an eye examination every 4-5 years. After this age the checks should be closer, at least every 2 or 3 years. In case of familiarity with glaucoma it is recommended to make regular visits even at a more early age, to be agreed from time to time with the specialist.
How can it be treated?
Current therapies aim to curb the course of the disease by reducing eye pressure. Usually in the first instance, specific eye drops are used which give good results if the treatment is followed consistently. If this approach is not sufficient, laser treatment can be used to widen the channels from which the aqueous humor flows, thus restoring the pressure inside the eye.
When do we need a scalpel?
Open angle glaucoma surgery is based on filtering procedures, the most common of which is trabeculectomy. The goal is to create, by practicing a “hole” in the eye, an alternative pathway to the aqueous humor that carries it into the subconjunctival space. In general, this approach tends to be reserved for more advanced cases that no longer respond to medical therapy.
Are new therapies being studied?
In recent years, new, less invasive surgical approaches are being tested, in which the area of intervention is reached through an incision of the cornea, similar to that performed for cataracts, and not through the conjunctiva and sclera as occurs in trabeculectomy. The results seem encouraging.
Can glaucoma lead to blindness?
Yes, it is one of the main causes of blindness in the world. It is estimated that around 6 million are blind due to unrecognized and untreated glaucoma. However, the blindness and low vision caused by this disease can be prevented. The best tool is early diagnosis that allows you to identify the initial signs and start a targeted therapy to avoid deterioration.