Let's talk about glaucoma


Published in: Today Digital
Author: Dr. Katia Cabrero, Ophthalmologist micro-surgeon, Sub-specialty in glaucoma, Ophthalmology of the General Hospital of the Plaza de la Salud.

Glaucoma is a progressive optic neuropathy that silently causes gradual loss of vision if not treated.

The absence of symptoms in the previous phases of this disease means that visual loss can occur suddenly.

Glaucoma is the leading cause of blindness worldwide after cataracts. According to statistics from the World Health Organization (WHO) for 2009 there were 4.5 million patients with glaucoma, with projections of 11 million affected by 2020.

The term optical neuropathy indicates that there is a lesion in the nerve cells of the optic nerve, which is responsible for connecting and carrying the visual information from the retina to the brain. Due to the accelerated death of these highly specialized cells, the outcome is an irreversible loss in the visual field.

There are different types of glaucoma, but the open angle primary is the most prevalent worldwide, and the most studied.
In this, the main risk factor is elevated intraocular pressure (IOP), whose average values are between 10 and 20 mmHg. Several multicenter studies have shown a directly proportional relationship between glaucoma and IOP.

Other risk factors are: family history of glaucoma, age (higher age, higher incidence), race (Hispanic and African-American descendants are three times more likely to suffer from it than non-Hispanic whites, also the risk of blindness is six times higher in African Americans) than in white whites.

Intraocular factors such as fine corneal thickness, low ocular perfusion pressure (calculated with blood pressure and intraocular pressure values), type 2 diabetes and its duration have shown that it increases the chances of suffering it.

A possible explanation is associated with damage to the microvasculature of the optic nerve, which increases its susceptibility. We also have myopia, migraine, high blood pressure, cerebrospinal fluid pressure.

In early stages of glaucoma, the optic nerve can be clinically normal and there may be no damage to the visual field, so ophthalmological evaluation is so important.

During a routine clinical examination, the doctor will take the visual acuity, measure the intraocular pressure, examine the drainage of the eye to see if it is open, closed or with any abnormality, analyze the health or not of the eye tissues and make a fund of the eye, where you will see the retina, the blood vessels and the optic nerve. If there is any alteration, it will proceed to perform complementary images studies.

Currently, the importance of genetic influence is being increasingly granted. Patients with certain mutations can develop glaucoma early in their lives, have a more progressive and aggressive evolution, or be more susceptible to damage to the optic nerve.

As soon as a patient is diagnosed with the disease, treatment is started, which usually consists of topical therapy with drops. If an ideal pressure is not reached, in which the progression of glaucomatous damage is avoided, then surgery is performed.

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