As life expectancy increases rapidly, it becomes increasingly difficult to maintain good health, especially healthy eyes. There is an increased risk of cataracts, macular degeneration, retinal degeneration in old age, or autoimmune diseases. The symptoms of some illnesses are apparent, and the treatment is simple enough, but one of them, glaucoma, is particularly insidious.
Glaucoma is an eye disease that belongs to the category of the most complex chronic diseases, characterised by impaired vision, narrowed field of view, increased intraocular pressure and atrophy of the optic nerve. It can be congenital when the eye tissues are not sufficiently developed, primary, which occurs in life, and secondary, which is affected by various traumas or inflammations of the eye.
The First Symptoms are Insignificant
According to Lilija Socevičienė, an ophthalmologist-microsurgeon at the Lirema Eye Clinic, a person does not feel any symptoms at the beginning of the disease – neither pain nor the field of view begins to narrow.
“The main signs of glaucoma are impaired vision and increased intraocular pressure, but the disease can progress even with normal intraocular pressure. Then we are talking about so-called normal intraocular glaucoma, which is particularly difficult to diagnose,” says the doctor.
Diabetes usually develops cataracts – clouding the lens – the lens changes shape, compresses the structure in the eye – the front corner of the chamber – and interferes with the drainage of fluid from the eye. As the intraocular pressure increases, the optic nerve fibres are compressed, and atrophy of the nerve begins, the optic nerve’s concavity deepens. Fluctuations in the amount of sugar in the body can damage small blood vessels, disrupting the fluid flow in the anterior chamber. Interestingly, brown eyes are more likely to develop glaucoma because this type of eye pigment is more likely to interfere with anterior chamber fluid flow.
The blood vessels in the eye are covered, and the lens is held by the dentition between the iris and the choroid. When the iris inflammation begins, adhesions form between the latter and the lens, affecting the pupil’s typical response. Therefore, eye pain should be treated immediately, as early diagnosis can save from complications of the iris and dentition, such as secondary glaucoma due to inflammation.
“There are cases where the patient refers for scaly protein nodules visible on the edge of the pupil – then it is advisable to examine the heart, as this may signal heart valve disorders or exfoliative glaucoma,” the microsurgeon notes.
The most threatening form is malignant glaucoma. The causes of the disease are not always clear, intraocular pressure rises to 40 mmHg and above, and if drug treatment is no longer effective, surgery is necessary.
Prevention is the Best Way to Protect Yourself
It is recommended that everyone over the age of 40 have a preventive eye pressure test once a year. If an increase in the intraocular pressure of more than 20 mmHg is observed, a person should consult an ophthalmologist, and a thorough examination should be performed.
If glaucoma has already been diagnosed, medical or surgical treatment may be prescribed.
“Currently, the patient is given medication drops that perfectly compensate for the pressure in the eye. If your doctor prescribes more than three types of drops, it would be best to see a specialised eye care facility and consider laser therapy. There are cases when after a while, laser therapy becomes ineffective, then the ophthalmologist prescribes antiglaucoma surgical treatment,” says L. Socevičienė.
To successfully combat glaucoma, an ophthalmologist should perform additional optical tomography (OCT) examinations to assess the cornea’s condition, determine the causes of visual impairment, and clearly show the changes in the optic nerve. An ocular fundus image is also required, especially in patients with diabetic retinopathy.
It is important to come for a check-up regularly, especially when undiagnosed glaucoma can become a cause of blindness.