How do we treat glaucoma?
The aim of glaucoma treatment is to reduce the pressure within the eye to a level at which it no longer damages the eyesight. Three types of treatment are used: eye drops, laser, surgery, or combinations of these. The drops are of various compositions and makes, none of which suit all patients. The specialist must often try several until the internal eye pressure is controlled.
Importance of following the prescribed treatment
One concern in the treatment of glaucoma is that patients often fail to follow the treatment prescribed by the ophthalmologist. A study by the John Hopkins University in the U.S. showed that only 56 % of patients continued treatment after being diagnosed with glaucoma. While the causes of this lack of monitoring are varied and often psychological in origin, it is most important that patients understand that treatment dropout poses a serious danger to their vision. This we have unfortunately proven over the years at our Institute.
Surgery as treatment of glaucoma
Surgical treatment, using laser or not, is offered to those patients where the progression of the disease has not been halted by using the prescribed eyedrops. After pre-operative evaluation at our institute, the prospective patient will have a more realistic idea of the possible steps.
Risks of surger
It is known that just as when you ride by car or take a medicine, any operation carries a risk of complications.
However once surgery is necessary, the danger of losing one’s sight if the glaucoma is not operated on becomes far higher than the possible complications.
We answer the most frequent questions people ask about glaucoma:
What is glaucoma?
Glaucoma is a group of diseases that damage the optic nerve, essential to carry vision to the brain so we can see. Seriously affecting the field of vision, if not treated they can lead to blindness. Without treatment the damage is progressive. It starts with a loss of peripheral vision unnoticed by the patient and then progresses toward the centre until it finally closes and completely obscures vision.
Disease progression may halt itself, but the vision already
lost is not recovered. The damage is usually associated with high fluid pressure
inside the eye, although in some cases it occurs even at apparently normal pressures. There are different types of glaucoma but by far the most common is simple chronic glaucoma (also called
primary open-angle glaucoma).
Is glaucoma common?
About two in 100 people over 40 suffer from the disease in Spain.
Approximately half are unaware, so the disease gradually progresses.
Can I go blind if I have glaucoma?
Yes. Glaucoma is the cause of 12 % of blindness in the Western world.
Who is at most risk of developing glaucoma ?
Especially people with direct family members affected by glaucoma, and people with high eye pressure (intraocular pressure is different from the blood pressure measured on the arm). Some with apparently normal eye pressure may also suffer glaucoma even until blindness.
Annual monitoring is therefore important for everyone over 40 years Diabetics are at increased risk.
How is glaucoma detected ?
Screening is of the essence, especially at the start of the disease. The ophthalmologist may find a high pressure in the eyes or the beginnings of damage to the optic nerve, during a routine check. Then, other initial tests are needed to reach a diagnosis. Among these the most important are the measurement of intraocular pressure related to corneal thickness (ORA), the optic nerve scanner (OCT), and examination of the angles where the aqueous humour drains out (Pentacam and gonioscopy).
Subsequently, computerised perimetry or campimetry is of great value in monitoring the disease once established. These are part of the equipment at the Amigó Institute and are employed
routinely for the diagnosis of suspected glaucoma or follow-up of confirmed cases.
What are the symptoms of glaucoma?
One of the main concerns about glaucoma is that there are often no symptoms until the disease is already advanced. These symptoms can then be seen:
How do we treat glaucoma?
The treatment is based on drugs (usually eyedrops), laser or surgery or a combination of the three.
Although all treatments have a certain degree of risk, it is much lower than the probability of vision loss if left without appropriate treatment.
Is there a cure for glaucoma?
No. The lost vision cannot be recovered. However drug treatment and when necessary laser or surgery usually detain progression of impaired vision enough to conserve a useful level of vision.
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