We call glaucoma to the disease that causes an increase in intraocular pressure, this pressure directly affects the structures of the optic nerve, which is the responsible for transmitting what we see to our brain. The consequence is a progressive loss of vision that, if not treated, leads to irreversible blindness.
The first thing we need to know is that the eye is an organ in which there is a constant circulation of fluid called aqueous humor. In this circulation, the fluid passes through a draining mesh -trabecular meshwork- that is sometimes obstructed, making it difficult for the fluid to pass and causing an increase in intraocular pressure (it is worth pointing out that this intraocular pressure has no relationship with blood pressure). This increase in pressure affect directly to the back of the eye, where the optic nerve is, breaking the fibers that make it up. Each of these fibers that breaks is unrecoverable and causes a decrease in our visual field.
The main problem with this disease is that it is asymptomatic until the moment we begin to notice a loss of vision. Glaucoma does not produce any pain -except for a very specific type of glaucoma that does produce a pricking sensation in the eye- , this is why it is known as 'silent blindness' and is the main cause of blindness in the Western world.
The only way to diagnose it is by performing continuous controls with the ophthalmologist, which assesses if there is a higher than usual intraocular pressure and possible damage to the structures of the eye, particularly on the optic nerve.
There are three types of treatments: medical treatment with eye drops, laser treatment and different surgical treatments. The purpose of everyone of them is to reduce intraocular pressure.
The drops prescribed for the treatment of glaucoma are intended either to reduce the production of intraocular fluids or to increase the capacity of the draining mesh so that the liquid circulates more fluidly.
It is a technique called Selective Laser Trabeculoplasty. It consists in treating the area where the fluid is filtering with a laser that produces a little inflammation. This causes a remodeling of the tissues that favors the increase in its filtering capacity. The great advantage of this technique over previous ones is that tissue is not irreversibly destroyed. It may be necessary several sessions to achieve the desired effect.
There are multiple surgical treatments that use different physical devices that act as a filtering valve, favoring the flow of aqueous humor and, therefore, that significantly reduce intraocular pressure. The choice of one type of treatment or another will depend on the needs of each patient and especially the stage in which the disease is found.
