What should I know about glaucoma?
El glaucoma It is a disease that is the second cause of blindness in the world, even despite having modern analysis systems to prevent its onset and evolution.
The problem is that does not warn, the one who suffers it no discomfort until vision loss begins, phase in which we can't back down anymore.
What should I know about glaucoma?
El glaucoma It is a disease that is the second cause of blindness in the world, even despite having modern analysis systems to prevent its onset and evolution.
The problem is that does not warn, the one who suffers it no discomfort until vision loss begins, phase in which we can't back down anymore.
What is glaucoma?
El glaucoma is a disease which is defined as ischemic optic neuropathythat is one optic nerve involvement (neuropathy) for lack of irrigation (ischemic) causing loss of vision (optics). The optic nerve is in charge of conducting the electrical stimulus that is produced in the retina (by encoding the light that reaches us from the outside), to the brain, so that it is recoded and we have the sensation of seeing.
In glaucoma the optic nerve is damaged, thus the signal that reaches the brain is deficient, generating an altered vision. The optic nerve is very sensitive to oxygen levels, so any disorder that involves a reduced oxygenation, will produce the atrophy of the fibers that comprise it, c is reducedampor peripheral vision. The most frequent cause of glaucoma is high eye strain.
Ocular hypertension and glaucoma
La ocular hypertension and glaucoma It's not exactly the same. The ocular hypertension can appear from multiple causes and stay for variable periods of time. If the eye pressure is high enough or stay a long time, will cause compression of the blood vessels inside the eye and a reduction in the arrival of oxygen. The optic nerve, its beginning, the papilla, is a of the structures most sensitive to this phenomenon. Ischemia at this level causes atrophy of the nerve fibers of the nerve and it is in this phase when we talk about glaucoma.
Based on this, we differentiate between the phase of ocular hypertension, no injury to the optic nerve and the phase with injuriesthen we talk about glaucoma.
Glaucoma and high eye strain
Not all glaucomas are due to high intraocular pressure. There are cases where the intraocular pressure is normal and you have glaucoma.
El 85% of glaucoma cases are due to ocular hypertension, values above 20 mm Hg, but there is a 15% of cases where it occurs death of the optic nerve fibers for other causes, is what is known as normal tension glaucoma.
Most frequent causes of glaucoma
In most cases it is due to a obstruction in the starting area (trabecula), fluid inside the eye, the aqueous humor. Accumulates inside the eye and increases intraocular pressure.
The alteration of the trabecula can occur for different reasons, classifying the different types of glaucoma based on its cause:
- Congenital glaucoma: Present from birth.
- Primary glaucoma: Due to degenerative changes that appear with age.
- secondary glaucoma: Produced as a consequence of other diseases such as Cataracts.
- pigmentary glaucoma: Caused by pigment dispersal syndrome.
- Pseudoexfoliative glaucoma: Present due to pseudoexfoliation syndrome, a genetic disease.
- Closed angle glaucoma: It is due to anatomical alterations of the eye.
- Normotensive glaucoma: Occurs when there is an injury to the optic nerve but the ocular tension values are normal.
- Neovascular glaucoma: Because of the proliferation of blood vessels in the eye.
One of the novelties in this regard is the fact that wrong diet favors the increase of free radicals in the eyes. A deterioration of the aqueous humor exit pathway occurs and aggravates the ischemia of the optic nerve.
Pathogenesis of Glaucoma: The aqueous humor has difficulty exiting the eye through the trabelcular angle (A), it accumulates in the interior and increases pressure, causing compression of the blood vessels and ischemia of the Optic Nerve (B).
Glaucoma symptoms
Except in the cases of acute glaucoma by angle closure, the rest of glaucomas do not usually present symptoms. In the sharp forms a very severe pain in the eye, as if a nail were nailed to it, that is why it is also known as “nail pain”, very intense, which causes the patient to go to the ophthalmologist.
In most glaucomas, the non-acute forms, the disease is uncomfortable and only we become aware of its presence at the time that 60% of the optic nerve fibers have already died, too late. To avoid this situation ophthalmologists insist on the need to make annual reviews, once a year, to detect it before vision loss begins.
How is glaucoma diagnosed?
It is necessary to carry out a review that takes into account the presence of risk factors, which we have previously mentioned, and a series of explorations that basically include taking eye pressure, campor visual and very especially, the study of the retinal nerve fibers and optic nerve (OCT de macula and papilla and GDx).
El study of nerve fibers implies a breakthrough in early diagnosis. When we only had the pressure tap and the campor sight, was detected glaucoma when a major atrophy had already occurred, a 60% deterioration of the fibers, whereas now, with these new systemsis detects when there is a deterioration minimum, of 20%, which it's allows to safeguard vision of these patients very efficiently.
Who is more prone to glaucoma?
The presence of glaucoma increases in people who have a family history glaucoma, especially from the 40 years, and in individuals of black or asian race.
They are also more prone to patients suffering vascular disturbancesas diabetes, arterial hypotension and in the pictures blood vessels, such as the Raynaud's disease o migraine headachesare patients who characteristically they have cold hands and feet. A abnormal diet and Stress, they can also influencing the evolution of glaucoma.
Glaucoma Treatment
El glaucoma treatment is aimed at reducing eye pressure, to improve the exit of the aqueous humor and to protect the fibers of the optic nerve. In most of cases drug treatment is started, generally in the form of eye drops and if this is not enough or the patient is not constant in the administration of the drug, it is recommended alternative treatments, laser or the glaucoma surgery.
Today surgery is performed more and more frequently since it is very effective, safe y prevents pressure fluctuations due to poor compliance in the administration of the drug as well as the tissue alterations that these drops induce, generally the presence of Dry Eye due to deterioration of the ocular surface. The non-perforating deep sclerectomy or new drainage systems that are implemented with minimally invasive surgery, are being imposed in the treatment of glaucoma.
