Glaucoma - progressive optic nerve damage
Glaucoma is often referred to as the "silent thief of sight" because it most often produces no symptoms. Detecting it at an early stage is very important because it can inhibit its development and preserve the patient's vision.
The term "glaucoma" refers to a group of diseases whose common feature is progressive damage to the fibers of the optic nerve. The effects of these injuries are characteristic changes in the optic nerve disc and typical visual field defects. Untreated glaucoma leads, usually asymptomatic, to complete destruction of the optic nerve and irreversible loss of vision.
The largest percentage of people with glaucoma are elderly patients – it is estimated that 2 percent of the population over the age of 45 suffer from glaucoma. - However, glaucoma knows no age and can affect younger patients as well. Contrary to the common perception of glaucoma as a disease of the elderly, cases of the disease in young people are not rare - says Professor Jacek Szaflik, head of the Department of Ophthalmology MUW, director of the Independent Public Clinical Ophthalmology Hospital, President of the Polish Society of Ophthalmology.
Glaucoma is an inherited disease. A family history of glaucoma is associated with a many times higher risk of developing the disease. This is especially true for the first-degree relatives.
The primary risk factors for glaucoma include: age over 40, cardiac disease, family history of glaucoma, peripheral circulation disorders (manifested as "cold feet, cold hands"), myopia, and stress. Regardless of major risk factors, preventive glaucoma testing is recommended for anyone who has not seen an ophthalmologist in a year.
Increased intraocular pressure plays a major role in the development of glaucoma. It depends on the balance between production and outflow of aqueous humor. Continuously produced in the eye to ensure proper functioning of the organ, the aqueous fluid leaves the eye and enters the bloodstream at a point called the iridocorneal angle. If fluid outflow is hindered, intraocular pressure increases, leading to pressure on the optic nerve. The consequence of this process is the loss of nerve fibers, leading to a reduced field of vision and, in the final stage, to blindness.
Glaucoma treatment - pharmacotherapy or surgery?
The only modifiable risk factor for glaucoma progression is intraocular pressure. Treatment of glaucoma is mainly based on the administration of medications - primarily in the form of drops, lowering intraocular pressure and drugs that increase blood flow in the vessels nourishing the optic nerve.
- When conservative treatment is ineffective, and when the patient does not cooperate in taking medication regularly or in advanced stages of the disease, we perform laser or surgical procedures. At the Department we perform even several anti-glaucoma procedures a day. Last year, despite the pandemic, we performed 360 of them - said prof. Jacek Szaflik.
Many new anti-glaucoma treatments have emerged in recent years. They are less and less invasive and we are reaching for them more and more often, also in less advanced stages of the disease. Among the available innovative methods of eye pressure equalization, the following are performed at the Department of Ophthalmology MUW: Preserflo implantation, fistular procedures, seton procedures (Ex-press implants) and canaloplasty.
The therapy is selected individually for each patient. It depends on the type and severity of glaucoma, as well as age, the presence of chronic systemic and ophthalmic diseases.
-Glaucoma treatment must be started early to be effective. This is the only way to stop the disease - concludes Professor Szaflik.
Regular diagnostic testing - the only way to prevent vision loss due to glaucoma
Glaucoma screening involves measuring intraocular pressure, examining the fundus, and testing corneal thickness. These procedures are not painful or unpleasant for patients, and can save the sight. Follow-up visits should occur once every 2 to 3 years, and every 6 to 12 months for those at higher risk. Only with regular visits to the ophthalmologist can the disease be diagnosed early and appropriate treatment initiated.
„Polish Ophthalmologists Against Glaucoma” campaign website: https://www.tydzienjaskry.pl/