Update on the diagnosis and treatment of glaucoma


Dr. Katia Cabrero Feria, Micro-surgeon Ophthalmologist, sub-specialty in glaucoma Ophthalmology of the General Hospital of the Plaza de la Salud.

Glaucoma is currently the leading cause of irreversible blindness worldwide. According to the World Health Organization, 4.5 million people are blind due to it, 60 million people suffer from it and it is estimated that by 2020 the figure will amount to 80 million.

Glaucoma is a disease that silently and progressively deteriorates the fibers of the optic nerve, resulting in visual loss. The main risk factor in this pathology is the increase in intraocular pressure. It has been shown through epidemiological investigations, trials and clinical studies that optimal control of intraocular pressure (IOP) reduces the risk of damage to the optic nerve and slows progression. The decrease in intraocular pressure is the only proven prevention intervention and that the deterioration does not continue, or that this is slowed down.

The goal in treatment is to preserve the patient's long-term visual function and look for that alternative that is the most effective. In other words, prevent additional loss of the visual field, maintain the structure and function of the optic nerve as well as the patient's quality of life.

Early detection and timely treatment are the key to preventing vision loss.

The only way to diagnose it is through a complete eye exam. During the evaluation, the ophthalmologist will not only measure the intraocular pressure, since, in some patients in even advanced stages, it can be within normal limits.

During the checkup, the drainage of the eye will be checked to see if it is open or closed, the optic nerve will be examined to verify that there is no damage and imaging tests that complement the information will be performed.

Within the advances in recent times we have new tomographs that make possible measurements of small changes in the loss of fibers that make up the optic nerve and allow to detect patients in very early stages of the disease. Currently we also have contact lenses that carry a sensor to detect variations in intraocular pressure. It is also possible to monitor it at home or wherever the person is using devices (tonometers) so that the same patient is able to measure it. The use of these devices allows to have the IOP registry of the patients for 24 hours.

Among the important risk factors we have to mention a family history of glaucoma, so genetics play an important role. The discovery of responsible genes is leading to the development of new diagnostic methods based on DNA.

Using new technologies, people at risk can be examined for mutations before irreversible nerve damage occurs and develop new methods of therapy.

Recommendations to prevent disease progression

The continuous control of glaucoma depends on the ability to evaluate the response to treatment and detect the progression and stability of the disease.

A routine review is recommended that includes the measurement of intraocular pressure (IOP) from the age of 40, but in those patients with risk factors, this check should be from the age of 35. One of the causes that causes most Patients do not advance is the cost of medications, rejection of treatment, poor compliance and lack of information and awareness.

The remoteness of health care centers and insufficient health professionals and equipment in certain regions, increase the difficulty for the treatment of glaucoma.

A more frequent follow-up is suggested in the presence of advanced damage, multiple risk factors, or progression in a short period. Because it represents the leading cause of irreversible blindness worldwide, information and screening campaigns have been created where many asymptomatic patients are usually detected.

Posted in: Hoy Digital newspaper.

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