Glaucoma

Glaucoma is one of the serious eye diseases that can lead to blindness if not treated on time

Types
Simptoms
Treatment
Risk factors
Diagnosis
Prevention
Care

Glaucoma is damage to the eye’s optic nerve, caused by an increase in intraocular pressure (IOP). High IOP puts pressure on the eye’s optic nerve, leading to a risk of permanent damage. Therefore, individuals with elevated IOP are at serious risk of vision loss. The disease usually affects both eyes.
Patients with higher than normal intraocular pressure have a higher risk of developing glaucoma, but this does not mean that all people with high intraocular pressure will develop the disease.
The damage caused by glaucoma is irreversible. That’s why glaucoma is often called the “silent thief of sight.” Lost vision cannot be restored.

As the disease progresses, peripheral vision is lost, and at a later stage, central vision is also affected.
If left untreated, it can lead to complete blindness.

Glaucoma primarily affects people over 40 but can also manifest in young adults, children, and even infants.

Types of Glaucoma

The most common forms of glaucoma are open-angle and angle-closure.

Primary open-angle glaucoma is the most common form of the disease in people over 40. In this type, intraocular pressure increases most often due to impaired drainage of aqueous humor. Damage to the optic nerve occurs slowly – over months to years – and gradually leads to vision loss. Initially, intraocular pressure values are not significantly elevated, making it difficult to determine whether it’s an individually high normal, a temporary increase related to hormonal changes, or the onset of glaucoma.
Angle-closure glaucoma is an acute attack where intraocular pressure suddenly rises, vision deteriorates, and causes severe eye pain. Angle-closure glaucoma is more challenging to diagnose because changes in intraocular pressure values are primarily observed during an attack. During other times, the patient has normal pressure readings. In such a situation, the patient needs to seek immediate help from an eye doctor and start treatment without delay to avoid complete vision loss.

Symptoms

Glaucoma is a disease that presents no symptoms in its early stages. Symptoms appear in the advanced stages of the disease without the person realizing they have the condition, which is why glaucoma is called the “silent thief of sight.” The disease can cause severe, irreversible damage to the optic nerve if diagnosed late.

Symptoms that appear relatively late include:

Severe headache, often appearing in the morning
Sharp pain in one or both eyes
Blurred vision
Nausea and vomiting
Appearance of blind spots

Diagnosis

The only sure way to diagnose glaucoma is a detailed ophthalmological examination using highly specialized equipment. All tests are painless, non-invasive, and brief.

To determine the type of glaucoma, an examination of the anterior part of the eye is necessary. This is followed by computerized perimetry, which is the “gold standard” for functional testing of patients’ peripheral vision, which is the first to be affected by the disease.

The most modern and highly accurate diagnostic method is digital imaging of the optic nerve and retinal nerve fiber layer using the so-called “eye scanner” – Optical Coherence Tomography (OCT). This device measures all structures of the fundus (back of the eye) with micron-level precision. VISION is equipped with the most advanced “eye scanner” – Solix, which captures 3D images within seconds and provides additional information about the progression of glaucoma.

Treatment

Glaucoma is a neurodegenerative disease that leads to optic nerve damage, progressive loss of peripheral vision, and ultimately, complete vision loss. Successful glaucoma treatment involves lowering and controlling intraocular pressure. This is achieved through conservative therapy with regular application of eye drops to reduce IOP, laser therapy, or drainage surgeries.

VISION Clinic is equipped with the most modern laser technology for glaucoma treatment:

SLT (Selective Laser Trabeculoplasty) is a therapy for open-angle glaucoma that reduces intraocular pressure – without pain and without side effects.
LPI (Laser Peripheral Iridotomy) creates discrete openings in the colored part of the eye – the iris – and is used as therapy for angle-closure glaucoma and acute pressure elevations caused by it.
Cyclophotocoagulation is a modern, minimally invasive surgical laser treatment for patients whose intraocular pressure is insufficiently controlled by other therapies, applicable to all types of glaucoma.

Laser treatment for glaucoma yields excellent and long-lasting results and can often replace the need for many years of eye drop use.
Trabeculectomy (TE) is the primary surgical treatment method for advanced glaucoma with insufficient control of intraocular pressure. This intervention aims to create an alternative pathway for aqueous humor to drain out of the eye. Modern surgical practice also includes the placement of various “implants” – miniature tubes to achieve long-term control of intraocular pressure.

Family history of glaucoma (genetic predisposition)
Medical conditions such as diabetes, heart disease, high blood pressure
Ocular characteristics, such as thin corneas, high myopia (nearsightedness), or hyperopia (farsightedness)
Age over 40
Eye trauma
Low systemic blood pressure
Long-term cortisone treatment

Prevention

Glaucoma cannot be prevented, but early detection and treatment can prevent vision loss. Typically, patients do not feel that they have elevated intraocular pressure. Sometimes, they coincidentally look with only one eye and only then realize they cannot see with the other. Frequent preventive examinations by an ophthalmologist are crucial for timely detection of elevated intraocular pressure.

Care

If you are diagnosed with glaucoma, it is advisable to follow these recommendations:

Eat a healthy diet, preferably with vegetables, fish, and fruits. Limit fats and sugar.
Stop smoking.
Ensure you get healthy sleep.
Be careful with caffeine – too much caffeine can increase your intraocular pressure.
Use protective eyewear when playing sports or working in the yard.

Frequently Asked Questions

Glaucoma is a serious disease that can lead to complete vision loss. If you are diagnosed with glaucoma, the most important thing is not to neglect your prescribed treatment regimen.
To avoid increasing intraocular pressure, you should avoid consuming coffee and caffeine-containing products, prolonged eye strain, intense physical and mental exertion, drinking large quantities of beer and other alcohol, and prolonged exposure to sun or intense heat.
Neglecting other health conditions, such as hypertension and diabetes, can affect eye health and complicate glaucoma treatment. Poor control of these conditions can lead to higher intraocular pressure and further optic nerve damage. It is essential to effectively manage all health conditions and inform your eye doctor about any changes in your general health. High stress levels and lack of sleep can also negatively impact intraocular pressure.

There are many risk factors for glaucoma, with the most important being elevated intraocular pressure. Normal intraocular pressure is between 10 and 21 mmHg.

Some people show no signs of damage but have higher-than-normal intraocular pressure. These patients are considered “glaucoma suspects” and have a higher risk than normal of developing glaucoma later in life (especially if they have a relative with the disease). They should be monitored and followed over time by an eye doctor.

Glaucoma cannot be completely cured, but early detection and treatment can preserve vision.

Laser or surgical treatment is resorted to when desired intraocular pressure reduction is not achieved with medication and glaucomatous damage progresses.