GLAUCOMA: TYPES, DIAGNOSIS, THERAPY AND SURGERY
Although glaucoma is an important disease, it can be managed well if recognized and treated in an early stage allowing patients to lead a normal lifestyle. Progressive reduction of eyesight occurs in glaucoma principally because of high intra-ocular pressure.
High intraocular pressure is caused by derangement of the relation between production and outflow of the aqueous humor. The aqueous humor is produced by the ciliary bodies, which are situated behind the iris, and is drained from the eye through the trabecolatum, which is located in front of the iris.
Normal intraocular pressure is between 10-20 millimeters of mercury.
Dr. Abbondanza has been performing medical treatments and innovative surgery for glaucoma for over 30 years, becoming one of the most experienced surgeons in this field.
Types of glaucoma
Glaucoma is classified in primary and secondary types.
Primary glaucoma is caused by alterations in the down-flow system of the trabecolatum. Secondary glaucoma is caused by disorders of the external or internal eye structures excepting those originating from disorders of the trabecolatum. Amongst the various types of glaucoma, the most important are open angled chronic glaucoma and closed angle glaucoma.
Open angled glaucoma produces a slow and constant damage to the optical nerve.
Narrow angled glaucoma can cause an attack of acute glaucoma characterized by very high intraocular pressure and cause rapid reduction of vision associated with intense pain in the orbital region.
Diagnosis
Glaucoma is often a silent disease which often reveals no symptoms until it is already in advanced stage.
To avoid visual damage, the patient should have his ocular pressure measured at each ocular visit, and after age 40, should have his visual field examined with computerized equipment. This should be done twice a year, or more often when there is a case history of glaucoma in a family.
Therapy
There are several possible ways of treating glaucoma.
Medical therapy: Eye drop medications are used to reduce aqueous humor production or increase down-flow. Treatment efficacy can be limited in time and often phenomena of pharmacological tolerance occur making treatment less effective. Follow-up of patients with frequent visits allows us to determine if medical therapy is sufficient or whether it needs to be changed.
Laser therapy: Two types of laser treatment can be used for glaucoma. In yag laser treatment a small hole is made in the iris, allowing aqueous humor an easier passage from behind the iris to the trabecolatum.
Argon laser widens the trabecolatum mesh and facilitates the aqueous down-flow.
Surgical therapy: There are several types of surgery used to restore pressure balance inside the eye. Usually these are used when pharmacological or laser therapy has failed. Since there are so many different surgical methods, an expert surgeon with knowledge of different techniques has the possibility to choose the correct treatment for each case.
.
.
