Glaucoma – A very serious occular disease

In one of our previous encounters we talked about the human eye possessing two chambers- the anterior and the posterior.

Today, we will increase this knowledge by stating that the anterior chamber is filled with a transparent liquid called aqueous humor, that is responsible for the eye’s nutrition. There should exist an equilibrium between its production and subsequent evacuation maintaining at the same time a normal intraocular pressure (12-21 mm Hg). {{more}}When this equilibrium is destroyed, there is an increase in the intraocular pressure and irreversible damage is produced to the optic nerve with subsequent loss of vision.

From a practical point of view, the most frequent glaucoma are: congenital (seen in the first years of life with tears; photophobia – intolerance to light – and increased eye size which is treated surgically); secondary (after inflammatory processes, traumas and cataract or retina surgery), acute closed angle glaucoma (presented with intense pain in the affected eye, sudden loss of vision with strong headache and vomiting), and chronic open-angle glaucoma.

This latter glaucoma will be our topic for today as it is the most frequent cause of blindness in the world today with two thirds of the patients being 60 to 70 years old.

As we mentioned before, glaucoma is produced due to a deterioration to the equilibrium system in

the eye with resulting increased intraocular pressure. This deterioration is produced slowly with the patient presenting practically no signs of the same. By the time the patient goes to his ophthalmologist, it is normally in an advanced stage, with complaints in most cases of bumping into objects as the peripheral vision is the first to be lost with conservation of the central vision. Without an adequate and opportune treatment, this disease continues getting worse, leading to blindness.

The patients at highest risk for glaucoma are:

Those with family history of glaucoma;

Myopic patients; Diabetics; Cardiovascular (“heart”) patients and patients with trauma or previous ocular surgery.

The diagnosis is made by the following:

Increased intraocular pressure above 21 mmHg;

Damage to the optic nerve and reduction of the visual field.

The treatment can be local with hypotensive eye-drops (for example Timolol) and/or surgical with laser or conventional surgery.

My dear readers, do not forget that prevention is better than cure, so please have your regular eye-check so that glaucoma can be identified early, thereby retarding the progress to possible blindness.

• Dr. Pedro A.F. Suarez is a Consultant Ophthalmologist at the Milton Cato Memorial Hospital(MCMH).