Glaucoma

Glaucoma is a generic term for a group of diseases affecting the optic nerve (responsible for transmitting visual information to the brain).

Glaucoma is a silent disease, showing no symptoms until a very advanced stage of disease. Without noticing any change, the patient may present untreated irreversible loss of vision (from the periphery to the center) until complete blindness is nearly present. According to the World Health Organization (WHO), glaucoma is currently the leading cause of irreversible blindness in Brazil and worldwide.

Fortunately, much has been advanced in the diagnosis and treatment of this disease. New diagnostic equipment (available at the Centro Oftalmológico Paletta Guedes), and new treatments based eye drops or even newer surgical techniques have led to modern and secure a new approach for patients with glaucoma, preventing progression to visual loss.

Prevention

The prevention of glaucoma is essential and consists of the regular annual examination for persons without risk factors for disease, or even at shorter intervals according to the medical indication. The tests which are the most important for glaucoma prevention are intraocular pressure and fundus examination.

Risk Factors

The main risk factor for the onset of glaucoma is increased intraocular pressure.

Other factors related to the onset of glaucoma are: family history of glaucoma, black race, age over 40 years, myopia, ocular trauma, chronic use of corticosteroids, among others.

Diagnosis

The diagnosis of glaucoma depends on the ancillary tests, which will be requested according to need. The main tests are:

  • Evaluation of intraocular pressure: tonometry; diurnal curve, provocative tests.
  • Evaluation of the irido-corneal angle: gonioscopy, anterior segment optical coherence tomography (AS-OCT).
  • Evaluation of optic nerve and nerve fiber layer of the retina: fundus biomicroscopy, digital fundus photography, posterior segment optical coherence tomography.
  • Visual field testing: automated perimetry (several strategies for testing).

Treatment

The treatment of glaucoma must be individualized for each case. There are basically three ways to treat glaucoma:

Medical Treatment: consists of the chronic use of eye drops. Generally it is the initial treatment in most cases of glaucoma.
Laser treatment: indicated for specific cases of glaucoma.

Surgical treatment: suitable for advanced cases of glaucoma and cases where other forms of therapy are not indicated or not successful. Surgical treatment of glaucoma has evolved greatly in recent years. New options for the surgical treatment of glaucoma are:

  • Non-penetrating surgery
  • Express Mini-Shunt

Follow-up

Glaucoma patients under therapy should be followed-up for the rest of their lives.

Medical visits frequency will depend on each specific case, as well as the necessary tests to verify the control of the disease.

Some important tests for this monitoring are:

Evaluation of intraocular pressure: tonometry; diurnal curve, provocative tests.

Evaluation of the irido-corneal angle: gonioscopy, anterior segment optical coherence tomography (AS-OCT).

Evaluation of optic nerve and nerve fiber layer of the retina: fundus biomicroscopy, digital fundus photography, posterior segment optical coherence tomography segment (using the Guided Progression Analysis, or GPA – software responsible for making a detailed analysis of the progression of glaucoma).

Visual field testing: automated perimetry (using the Guided Progression Analysis, or GPA – software responsible for making a detailed analysis of the progression of glaucoma).

Congenital glaucoma

The Centro Oftalmológico Paletta Guedes is a national reference in the treatment of congenital glaucoma, a rare disease that affects babies and infants.

Usually, if not treated in time Congenital Glaucoma can lead to blindness from birth that lasts throughout the life of the individual.
Fortunately, with proper treatment performed in time this situation is controlled and vision restored in most cases.

TheCentro Oftalmológico Paletta Guedes has extensive experience in the diagnosis, monitoring and treatment of this serious eye condition.

The treatment of congenital glaucoma is primarily through surgeries with specific techniques (trabeculotomy or goniotomy).

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