GLAUCOMA
What is the glaucoma?
Glaucoma is a disease that damages the optic nerve of the eye. Unless it is treated, it can lead to blindness.
This is the head of the the optic nerve. On the left photo it is healthy one. The right one is of a glaucoma patient, it has a big excavation and a hemorrhage at 7 o clock.
The symptoms of the glaucoma
Glaucoma is a very dangerous disease because of the lack of any serious symptoms (like pain or decrease of vision), which could lead the patient to the ophthalmologist. Therefore, the glaucoma progresses and the patient does not even notice it. Only on later stages of the disease the visual field of the patiens deteriorates, from the periphery to the center.
The visual field gradually deteriorates.
The most accurate way to measure the intraocular pressure is the Goldmann Tonometry. On this photo the tension is 33mmHg!
Which examination should be done to every glaucoma patient?
The ophthalmologist should by every glaucoma patient:
a. Measure the intraocular pressure, at least every three months
b. Examinate the visual field (perimetry 30-2, 24-2 or 10-2) at least every six months
c. Test the thickness of the Retinal Nerve Fiber Layer (RNFL) and of the Ganglion Cell Layer (GCL) with the OCT at least once a year.
On this photo we can observe the progression of the glaucoma of one patient over the time, through the visual field examination.
The treatment of glaucoma
What we can do against the glaucoma, is to lower the intraocular pressure, because this is proved to delay/stop the glaucoma progression. We can do it:
Α. With eye drops
There are over five different categories of eye drops, which can be used separatedly or in combination, and lower the pressure of the eye
Β. With special laser
ALT, SLT, YAG iridotomy
C. Surgically
The trabeculectomy is the goldstandard surgery, but Shunts and minimally invasive surgeries can also be used, depending on the pressure and the severity of the disease
the left photo is a normal OCT of a healthy optic nerve
The right one is of a glaucoma patient, with a typical RNFL thinning on the temporal-down area
