February 17, 2024

Glaucoma

What exactly is glaucoma?

Glaucoma is a serious eye condition, widely known as the “silent thief of vision”. If not diagnosed and treated promptly, it can become an irreversible condition with tremendous consequences for vision. Glaucoma is primarily caused due to increased intraocular pressure, either due to high production of aqueous humour (the fluid which is continually produced by the eye) or reduced drainage. High intraocular pressure progressively damages the optic nerve. It’s worth mentioning that increased intraocular pressure doesn’t necessarily mean glaucoma if there is no damage to the optic nerve. This specific condition is called ocular hypertension. Predisposing factors for glaucoma are mainly heredity and aging, diabetes and hypertension.

What are the main symptoms of glaucoma?

In its early stages, glaucoma can be totally asymptomatic. This is why the condition is so insidious. Preventive screening, using tonometry examination, is considered  important. Key symptoms are the following:

  • Headaches
  • Mild ocular pain
  • Decreased visual acuity
  • Peripheral vision loss (in advanced stages)

What are the types of glaucoma?

The main types of glaucoma are:

  • Open – angle glaucoma (chronic simple glaucoma): The most common and insidious form (it is asymptomatic). It occurs when the angle between the peripheral cornea and the iris is open. While this angle is open, there is resistance to the outflow of aqueous humor through the trabecular meshwork, leading to an increase of the intraocular pressure
  • Closed – angle glaucoma (acute angle – closure glaucoma): Occurs when the angle between the peripheral cornea and the iris is closed. The iris may completely close the drainage angle, causing a rapid increase in intraocular pressure

Other glaucoma types are: congenital glaucoma (early childhood), normal – tension glaucoma, pseudoexfoliative glaucoma and traumatic glaucoma.

What diagnostic tests are performed for glaucoma?

Patients with glaucoma should undergo the following:

  • Visual acuity measurement
  • Tonometry (measurement of intraocular pressure)
  • Gonioscopy (examination of the drainage angle of the eye)
  • Visual fields examination (optical perimetry)
  • Ophthalmoscopy (examination of the optic nerve)
  • Corneal pachymetry
  • Optical coherence tomography (OCT) for optic nerve analysis (RNFL)

Can glaucoma be treated?

The primary goal in glaucoma management is to reduce the intraocular pressure. Treatment options include:

  • Medication to help regulate intraocular pressure
  • SLT (Selective Laser Trabeculoplasty to assist removing aqueous humour from the eye, lowering intraocular pressure
  • Surgical procedures via modern techniques including trabeculectomy, valves implantation and use of i-stents