Glaucoma
The optic nerve fibers conduct the image formed by the eye to the brain, where one becomes aware of what the eye sees. Glaucoma is an eye disease in which the nerve fibers of the optic nerve are gradually lost. This creates blind spots (visual field defects) in the image and can eventually even lead to blindness.
Cause
The mechanism that leads to optic nerve damage in glaucoma is still not known in full detail. There are many known factors that significantly increase the risk of glaucoma:
- Increased eye pressure: This is by far the most important risk factor. The higher the eye pressure, the greater the risk of glaucoma.
- Glaucoma in the family: If glaucoma occurs in someone’s close (1st and 2nd degree) relatives, the risk of glaucoma is almost 10 times greater than for someone without glaucoma in the family.
- Old age: Glaucoma is much more common in old age (4% of people over the age of 80 have glaucoma).
- High vision near or farsightedness.
- Patients of African or Asian descent have an increased risk of glaucoma.
- Abnormalities of the blood vessels near or in the eye.
Types of glaucoma
Glaucoma is common; 1.5% of Dutch people over the age of 40 have glaucoma. Glaucoma is classified into primary and secondary glaucoma.
Primary glaucoma means that glaucoma is an isolated disease of which the cause is unknown. Secondary glaucoma occurs as a symptom of another (eye) disease or as a result of the use of certain medications or eye drops.
Primary glaucoma is further subdivided into:
- open angle glaucoma
- closed-angle glaucoma and
- congenital (born) glaucoma.
The treatment
Glaucoma is incurable. The part of the visual field that is gone, stays gone. But if it is detected in time, there are treatments that can slow down or even stop the loss.
Traditionally, the treatment of glaucoma almost always starts with the use of eye drops that should lower the eye pressure. The long-term use of drops often leads to (hypersensitivity) complaints. It is also difficult to adhere to the strict drop regime (1 – 3 times a day, one drop every day).
A treatment method that also works very well for approximately 50% of people for an average period of approximately 5 years is performing a laser treatment that increases the drainage of the eye fluid. The eye pressure then becomes lower and is then well regulated. It is then often no longer necessary to use drops.
At the moment, the only proven therapy for glaucoma is lowering the eye pressure.
