Friday, May 20, 2022

GLAUCOMA: IMPORTANCE OF DIAGNOSIS AND TREATMENT

Glaucoma is the second leading cause of blindness worldwide, especially among the older population. Vision loss caused by this condition can be prevented if the disease is diagnosed early.

Glaucoma is a disease of the optic nerve (neuropathy). It is through the optic nerve that images reach the retina and are then carried to the brain, where they are processed. Glaucoma progressively damages the optic nerve fibers, with the result that blind spots develop in the visual field.

In an early form of glaucoma, absence of symptoms is common. Blind areas are only noticed after there is significant damage to the optic nerve (NO), and its total destruction results in blindness.

Although it is impossible to attribute a single cause, glaucoma has been associated with the most frequent finding of the disease, which is increased intraocular pressure. The eye continuously produces a transparent fluid called the aqueous humor. The aqueous humor assumes important functions in terms of nutrition and maintenance of the eye tissues. Once formed, this fluid circulates through the intraocular tissues and exits the eye through drainage channels. If the drainage area is blocked, the fluid pressure inside the eye increases. There are several types of glaucoma, the most common in Western countries being primary open angle glaucoma (90% of cases).

The key to a correct diagnosis of glaucoma is a consultation with an ophthalmologist and regular eye examinations. In addition to intraocular pressure measurement (tonometry) and evaluation of the optic nerve (fundus), performed during the ophthalmological consultation, other auxiliary tests can be essential in the investigation and follow-up of this disease.

Optic nerve damage caused by glaucoma and the visual loss it causes are usually irreversible. Its treatment is aimed at controlling the disease, in order to prevent the progression of these lesions. The first step in the treatment is the topical use of medication in the form of eye drops, and in some cases, the use of more than one eye drops or an association with oral medication may be necessary. On the other hand, for these drugs to work properly, it is imperative that they are used regularly and continuously. Not infrequently and for various reasons (ineffectiveness, intolerance/allergy), changes in treatment must be considered. In fact, glaucoma treatment requires that the patient use the prescribed medication correctly. One should not stop the eye drops or change substances without first consulting the ophthalmologist.

Other treatments include laser procedures and surgery. Since glaucoma is a chronic and progressive disease, surgery does not cure glaucoma. It may take place when adequate control is not achieved with medication. Prompt diagnosis and treatment are the keys to preventing damage to the optic nerve. Once the disease has been identified, it is up to the ophthalmologist to define how often periodic evaluations and complementary tests should be performed, in order to minimize the impact that advanced disease can mean in terms of limitations in the activities of daily living.

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