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Glaucoma

Glaucoma is a disease of the optic nerve that transmits visual stimuli to the brain that affect the retina. Glaucoma is a disease caused, generally, by increased intraocular pressure (tone) to the above normal values (20-21 mmHg).

Gradually the pressure causes an excavation of the papilla, the part of the fundus which emits and form the optic nerve, which is subject to constant suffering from the affected intraocular tone.

The result of all this is a loss which corresponds to the loss of some of the nerve fibers when, through the optic disc, protrude from the eyeball to form the optic nerve.

 

Foto concessione: Dott. C. Benedetti

There are several different glaucoma types divided into:

  • open-angle glaucoma
  • narrow-angle glaucoma
  • at normal pressure glaucoma
  • congenital glaucoma (present at birth)
  • secondary glaucoma

All of these forms, as different from each other, have as a common end result the progressive and irreversible damage to the optic nerve.

 

Foto concessione: Dott. C. Benedetti

The effect of glaucoma is a progressive reduction of the visual field, which starts from the more peripheral areas up to hear, in the most advanced phase, the central part of the visual field itself.

  

Foto concessione: Dott. C. Benedetti

The scotoma (blind areas) are perceived by the patient only in late stage when the damage to the optic nerve is already advanced. For this reason glaucoma is also said: “The silent thief of sight.” This is why it is essential that all patients over the age of 40 to undergo in the eye pressure checks at least every two years. Glaucoma is also affected by hereditary aspects, for this reason it is advisable to make an earlier monitoring and more frequent in family members of people with glaucoma.

The ocular pressure is determined by the liquid that fills the eye: aqueous humor. The aqueous humor also allows the eye to maintain a more or less spherical shape. This is continually being produced but at the same time must also be eliminated. An imbalance of this dynamic can lead to the increase of intra ocular fluids and at the same time the increase of pressure.

For the measurement of the tone there are several such tools tonometer. The most common methods require the use of an anesthetic eye drops as they have to go in contact with the eye even if for a few moments.

The so-called tonometer “also exists in breath” that does not require the use of drugs.

Both the first and in the second case it comes to a quick examination and absolutely painless and non-traumatic, to which you may bring with it peacefully.

In the case of open-angle glaucoma is the poor efficacy of the aqueous humor outflow system, said meshwork, to determine a pressure increase. In rare cases there may be an excessive production.

In the closed-angle glaucoma it is the eye’s internal structure to determine an anatomical alteration of the outflow system which is to shrink, thereby reducing the passage of the aqueous humor to delete.

In the case of glaucoma at normal pressure, a consideration must be made: not all are sensitive in the same way to changes in pressure. Most likely the patients with normal-tension glaucoma are so sensitive to intraocular pressure from manifesting typical signs of glaucoma although to a measurement of the tone that is normal. Conversely, there are people who while manifesting a tone above the norm for years, never develop glaucoma.

The damage to the optic nerve caused by glaucoma is irreversible. What you can do is to plan your eye doctor planned measurements of intraocular pressure and keep the pressure control thanks to several eye drops capable of lowering ocular pressure within the normal. If, as sometimes happens, the drugs are insufficient you can resort to laser treatments or surgical useful to improve the outflow of aqueous humor.