Text author: Dr sc. Bojan Kozomara, dr med.
Glaucoma, or the “silent thief of sight,” is one of the most dangerous eye conditions and ranks among the top three causes of blindness worldwide. The term “silent thief of sight” accurately describes this disease because its symptoms are very difficult to notice.
It involves an increase in intraocular pressure above the maximum normal value of 21 mmHg, leading irreversibly to damage to the optic nerve, weakening of vision, and ultimately blindness. Only one form of this disease causes severe pain and sudden vision loss. In all other forms, there is no pain, and there is only a gradual loss of visual acuity.
Cataracts are considered one of the most common conditions in individuals over 70 years old. However, lens opacity can occur at any age, even congenitally.
A comprehensive eye examination, including pupil dilation and examination of the fundus, can indicate the presence of cataracts in one or both eyes.
And this diagnosis is not a reason for discouragement because there is a solution.
As already emphasized, some types of glaucoma occur without symptoms, while certain symptoms such as loss of peripheral vision, blurred vision, nausea, and eye pain require urgent medical attention.
To prevent vision loss, regular ophthalmic examinations are extremely important, especially if you have risk factors for glaucoma:
So far, it has only been proven that some types of glaucoma have a hereditary component. However, the occurrence of glaucoma in the family does not necessarily mean the presence of a hereditary component of the disease, but it is advisable for descendants to undergo regular check-ups after the age of 25.
The diagnosis of glaucoma depends on the stage at which the disease is detected. Until recently, it was believed that the primary parameter for diagnosing glaucoma was high intraocular pressure. However, it has been proven that in some individuals, damage to the optic nerve can occur even if the pressure is normal, i.e., if its values are up to 21 mmHg. Similarly, not every elevation of intraocular pressure above this value necessarily means that the person has glaucoma.
Therefore, several parameters are now analyzed in the diagnosis to help definitively confirm this disease. They are:
If treatment is started in time, it is possible to preserve vision without major damage in most cases.
The treatment of glaucoma is based on controlling intraocular pressure and reducing the risk of optic nerve damage. The first line of treatment involves the use of eye drops aimed at reducing the production of aqueous humor or increasing its drainage from the eye, thus normalizing intraocular pressure by one of these two mechanisms.
However, nowadays, glaucoma surgeries are gaining more prominence in treatment, especially in patients who have been on topical drop therapy for many years or in those for whom instilling drops causes allergic reactions and other undesirable effects.
Laser glaucoma surgery is one form of treatment but with temporary effects. This method “cleanses” the trabecular meshwork through which aqueous humor naturally drains from the eye. However, in most patients, the trabecular meshwork closes again after a certain time, and intraocular pressure rises.
The Ex-Press glaucoma shunt is one of the most modern, efficient, and minimally invasive methods used to permanently correct elevated intraocular pressure in over 80% of patients, freeing them from lifelong instillation of antiglaucoma therapy. The effects of the surgery are seen after 2-3 days, and with a size smaller than the tip of a fingertip, the shunt does not interfere with the normal functioning of the eye.
MIGS (Micro-Invasive Glaucoma Surgery) is a completely new entity in glaucoma treatment that emerged a few years ago. It consists of a set of different procedures that share one common component: to provide intraocular pressure control through surgical means with minimal invasiveness and minimal risk of damaging healthy eye tissue.
