WHAT IS GLAUCOMA?
Glaucoma, or the “silent killer of sight,” is one of the most dangerous eye conditions, and it is among the top three causes of blindness in the world. The term “silent killer of sight” best describes this disease because its symptoms are very hard to notice. It involves an increase in eye pressure above the maximum normal value of 21 mmHg, which leads to irreversible damage to the optic nerve, vision impairment, and ultimately, blindness. Pain, which could indicate the onset of the disease and the possibility of vision impairment, is extremely rare in glaucoma (except in one form).
How to Detect Glaucoma?
Although some types of glaucoma occur without symptoms, certain signs such as loss of peripheral vision, blurry vision, nausea, and eye pain require immediate medical attention. Regular eye examinations are essential, especially if you have risk factors for glaucoma:
- Age over 45
- Family history of glaucoma
- High myopia
- High blood pressure, hypothyroidism, diabetes
- Frequent and long-term corticosteroid therapy
- Eye injuries
So far, it has only been proven that certain forms of glaucoma have a hereditary component. The occurrence of glaucoma in the family doesn’t necessarily indicate a hereditary component of the disease, but it’s advised for descendants to have regular check-ups after the age of 25.
Glaucoma Diagnosis
The diagnosis of glaucoma depends on the stage of the disease when it is detected. Until recently, it was believed that high eye pressure was the primary parameter for diagnosing glaucoma. However, it has been proven that in some people, damage to the optic nerve can occur even if the pressure is normal, i.e., its values are up to 21 mmHg. Similarly, not every increase in eye pressure above this value automatically means the person has glaucoma. Therefore, several diagnostic parameters are analyzed today to help definitively diagnose this disease. They are:
- Eye pressure values
- Visual field findings
- The appearance of the optic nerve head
- The thickness of the optic nerve fibers (RNFL OCT)
- Pachymetry (corneal thickness of the eye)
If treatment begins in time, it is possible in most cases to retain sight without significant damage.
Glaucoma Treatment
Glaucoma treatment is based on controlling eye pressure and reducing the chances of optic nerve damage. The first line of treatment involves the use of eye drops that aim to reduce the production of aqueous humor or increase its outflow from the eye. However, glaucoma surgeries are becoming increasingly prevalent, especially in patients who have been on local drop therapy for many years, or in whom drop instillation causes allergic reactions.
Laser glaucoma surgery is a temporary solution that “cleans” the trabecular meshwork through which aqueous humor naturally drains from the eye. However, in most patients after a certain time, the trabecular meshwork closes again, and eye pressure rises.
Ex-Press Glaucoma Shunt
The Ex-Press glaucoma shunt is one of the most modern, efficient, and minimally invasive methods used at the “Dr. Kozomara” Eye Hospital in Banja Luka to permanently correct elevated eye pressure in over 80% of patients and free them from the lifetime use of antiglaucoma therapy. The effects of the surgery are seen after 2-3 days, and with its size, which is smaller than the tip of a fingertip, the shunt does not interfere with the normal functioning of the eye.
MIGS
A completely new entity in glaucoma treatment has emerged in recent years called Micro Incision Glaucoma Surgery (MIGS). It’s actually a set of different procedures that have one common component: to ensure control of eye pressure surgically with minimal invasiveness and as little chance of damaging healthy eye tissue as possible.
