Glaucoma and intraocular pressure
Is the intraocular pressure the only cause of glaucoma or can i have glaucoma with normal intraocular pressure.
El glaucoma diagnosis va beyond the value of intraocular pressurealthough this is usually a very relevant indicator when detecting the disease.
Glaucoma and intraocular pressure
Is the intraocular pressure the only cause of glaucoma or can i have glaucoma with normal intraocular pressure.
El glaucoma diagnosis va beyond the value of intraocular pressurealthough this is usually a very relevant indicator when detecting the disease.
What is glaucoma?
We know that glaucoma it is a progressive optic neuropathy whose etiology is multifactorial and where the intraocular pressure value (CHEEP), it is an important factor although the repercussion on the damages that it can generate are very variable in each person. Therefore, rather than analyzing intraocular pressure, what we do is study the consequences of intraocular pressure in the eye, on the nerve fibers of the retina and the optic nerve, true cause of vision loss in glaucoma.
In most glaucoma patients, the main goal of treatment is to lower intraocular pressure, to avoid the optic nerve damage.
Intraocular pressure
We all have one intraocular pressure that moves within some limits: some minimum to give consistency to the eye y, One maxima that above them, compression of the small capillaries inside the eye occurs, especially those of the optic nerve, where the blood does not reach the tissues correctly and ischemia and cell death occur.
The intraocular pressure limits vary in each case and by statistics we know that range between 14 and 20 mm HgBeing 16 mm Hg the most frequent value in the normal population.
Until very recently we only had the value of intraocular pressure to detect those patients with glaucoma (with tissue damage) before they became aware of vision loss or to assess the effect of the treatment given.
Afterwards, the campimetry and helped us establish the diagnosis somewhat earlier and to better understand what was happening in glaucomatous disease.
Intraocular pressure and glaucoma
One of the most relevant aspects was knowing why some patients with treatments that achieved intraocular pressure values within normal they kept progressing, they kept losing vision. It was assumed that they were patients who were more sensitive to pressures, which for the average population were normal, but for them it could act as if it were too high, which is what we know as Normotensional glaucoma.
Another explanation would be those patients who, during the day they could have normal intraocular pressure values y overnight there was a elevation that damaged the optic nerve and that it was not detected because the intraocular pressure was not taken at that time.
When we only had the intraocular pressure value to establish the diagnosis and glaucoma treatmentWe all sighed for a system that could detect these changes in intraocular pressure over 24 hours, the pressure curve. However, now that we have new nerve fiber analysis, is no longer so essential. We can see with great precision the damaged fibers and above all, its evolution with respect to the established treatment.
Tension curve
The analysis system is not simple, it is subject to variations, it has a high cost and it does not provide data that is too relevant.
We think that it is more important to analyze the state of the nerve fibers of the retina and the optic nerve which is where glaucomatous damage occurs, although it is a consequence of intraocular pressure.
Normal intraocular pressure and glaucoma
In a patient with a intraocular pressure value of 17 mm Hgwhat would come in within normalif the alteration of nerve fibers progresses, we know that we have to lower the intraocular pressure even more and look for some other cause of neurological damageas vascular disturbances, diabetes o peaks of low blood pressure.
Beyond the intraocular pressure to diagnose glaucoma
El intraocular pressure value it's interesting to meet him and look for the level optimal for each person, what we call "target value of intraocular pressure"Worse.
The most important thing is to quantify how that intraocular pressure influences the patient more than setting limits on the values and for this we need other technologies like nerve fiber analyzer (GDx) or the tomographs (OCT) of ganglionic fibers in the macula and of the optic nerve head.
Glaucoma specialist center
In our Glaucoma Unit in Área Oftalmológica Avanzada We have long opted for these diagnostic systems and we have verified the referred advantages in specialized literature, early diagnosis of glaucoma and better monitoring of patients, making the tension curve less necessary.
