Glaucoma: Causes, Symptoms, and Prevention

Index of topics

What

Glaucoma is a chronic disease that affects the optic nerve , causing progressive damage. This leads to limited peripheral vision and, in worsening cases, blindness. Glaucoma is caused by increased intraocular pressure. It is the second leading cause of partial or complete vision loss. Officially, it affects 500 people in Italy, but the number of undiagnosed cases is estimated to be just as high. Risk increases after age 60, and glaucoma affects a slightly higher proportion of men.

Cause

The causes of glaucoma are unclear, and debate exists regarding a neurodegenerative or mechanical component. Generally, glaucoma can be due to a poor blood supply or to a congenital factor, meaning it can be present from birth. Among the risk factors, the main one is increased intraocular pressure , especially if accompanied by reduced blood flow to the optic nerve. Advanced age and a family history of glaucoma are predisposing factors. Certain visual impairments ( high myopia and hyperopia) and systemic diseases ( diabetes , high blood pressure, and cardiovascular disease) can contribute to the onset of glaucoma.

Types of glaucoma

The most common types of glaucoma are open-angle and closed-angle. The former is characterized by vision problems, headaches, nausea, and vomiting . In the latter, there is sudden pain in the eyeball.

Symptoms

The most common primary open-angle glaucoma progresses slowly and is often asymptomatic. Narrow-angle glaucoma, which is more aggressive, can lead to acute glaucoma. By the time symptoms appear, the disease is often already advanced, with blurred and restricted vision, loss of peripheral vision, sensitivity to light, dryness, and redness of the eyes.

Diagnosis

An annual eye exam with eye pressure monitoring starting at age 40 (if you have no risk factors) or more frequently if you are at high risk or over 65 is the primary diagnostic tool for detecting the disease in its early stages and designing treatment that slows or halts the progression of optic nerve damage , preserving vision. In addition to the fundus and anterior segment examination, there are more in-depth tests that the ophthalmologist can perform and request. For example:

An Tonometry which measures the pressure inside the eye
An gonioscopy which is used to study the space between the iris and the cornea and allows for the selection of the various types of glaucoma
An pachymetry which measures the thickness of the cornea
Uno study of the visual field to have an assessment of retinal sensitivity
An iridography which studies the vascular circulation of the iris

Therapy

Treatments are personalized based on the type and severity of glaucoma, and can be effective if diagnosed early, rather than when the disease has reached its irreversible stage. Drugs in the form of eye drops are still the most commonly used, but laser treatments or surgery, especially if minimally invasive, may be recommended for more effective and patient-tolerated disease control. Surgery should be undertaken when eye drop or laser treatments are insufficient. Traditional surgery often achieves a permanent result, but its effectiveness must always be monitored over time, and repeat interventions may be necessary. The femtosecond laser, for example, allows for the permanent restoration of normal intraocular pressure. Normal activities, including reading, using a computer, and driving, can be resumed 24-48 hours after surgery. Regular check-ups are performed for a few weeks, followed by a six-monthly follow-up.

Prevention

Due to its sometimes obvious lack of symptoms , glaucoma is also known as "the silent thief of sight." Prevention begins with regular checkups, especially if there is a family history of the disease (in this case, the risk of glaucoma increases by 10-15 percent). The following individuals are also at greater risk and require greater prevention:

Diabetic patients
Subjects with severe myopia
Those who frequently use cortisone drugs
Who has a visual field alteration
Who has a damaged optical disc
About Smokes and those who do not perform regular physical activity

Glaucoma: causes, symptoms, and prevention