Glaucoma

Glaucoma is a serious disorder which is often caused by a high intraocular pressure damaging the optic nerve. We speak about a high intraocular pressure above 21mmHg (the normal pressure is between 12 and 20mmHg). Nevertheless between 5 and 10% of the glaucoma cases have an intraocular pressure below 21mmHg ( so called low tension glaucoma). Additionally, pressures above 21mm Hg do not necessarily produce damage to the optic nerve (ocular hypertension). Together with the intraocular pressure, other factors such as vascular factors play a role in the pathogenesis of glaucoma.Damage to the optic nerve and loss of visual fibres produce a shrinking of the visual field and in an ultimate stage total visual loss which is irreversible. The first signs are vague and the patient normally does not notice any lack of vision until it is too late. This is the reason why from 40 years on it is important to regularly control the intraocular pressure by your ophthalmologist (every 3 years). This is the only way to detect a possible glaucoma and to start a correct treatment in time.

2% of the overall population above 40 years have glaucoma; above 70 years this incidence rises to 5%; and from 80 years on the incidence can be as much as 10%.
Some types of glaucoma can be hereditary. Therefore it is very important to screen for glaucoma if members in your family have glaucoma. Other risk factors are myopia, diabetes and arterial hypertension or hypotension, migraine or general vascular problems.

Even though glaucoma can be a serious affection, it can always be perfectly treated. The glaucoma treatment consists essentially in avoiding the progression of the disease. Normally the treatment is performed with eye drops. These drops have to be used one or twice a day in usually both eyes, according to the instructions of your ophthalmologist. In certain cases the drop treatment is not sufficient and a laser treatment has to be performed; this is usually done in 2 sessions per eye. Finally, the cases not responding to drops or laser treatment, have to be operated onThis operation is called a trabeculectomy and is usually performed under local anaesthesia.

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