Glaucoma – in brief
- Glaucoma is a progressive damage to the optic nerve, most often due to excessively high intraocular pressure. Lost visual field cannot be regained, but treatment stops the disease.
- First symptoms usually do not exist: defects begin at the periphery of the visual field and the brain ‘fills them in’; an acute glaucoma attack causes severe pain, blurred vision, and rainbow halos around lights.
- Who is at risk: family history of glaucoma, age over 40, high myopia, diabetes, circulatory disorders, thin cornea, long-term steroids.
- Diagnosis: tonometry with pachymetry, optic nerve OCT and visual field – a package available in glaucoma screening in Warsaw and Krakow.
Imagine someone stealing what you see, piece by piece. Slowly, painlessly, and silently. This is how Glaucoma works, which we, ophthalmologists, call glaucomatous neuropathy. It is an insidious damage to the optic nerve that leads to its irreversible loss. You’re right, it sounds serious. And it is! Look at the statistics: it’s one of the main causes of blindness worldwide. But at Swisslaser – in Warsaw and Krakow – we repeat: don’t panic, act! We will show you why glaucoma is a race against time and how we can win it for you. Your awareness is our greatest ally.
What will you learn from the text below?
- What are the risks of neglecting glaucoma? This disease gradually steals your sight, as it leads to optic nerve atrophy, and millions of people worldwide have permanently lost vision because of it.
- What is the main suspect in the development of glaucoma? Usually, intraocular pressure (IOP) is to blame, but remember that you can have glaucoma even when the pressure seems normal (this is called Normal Tension Glaucoma).
- Does glaucoma only affect your grandparents? Not at all! Although it most often affects adults, we also deal with congenital glaucoma in children and secondary glaucoma, which appears as a result of other health problems (such as diabetes or injuries).
- What type of glaucoma occurs most often? Open-Angle Glaucoma (85-90% of cases) reigns supreme – pressure rises because the aqueous humor drainage system simply clogs.
- How to effectively protect yourself from vision loss? We say clearly: the only chance is very early detection! You must have regular eye exams, especially if someone in your family has already had it or you have other risk factors.
Glaucoma: The Silent Thief of Sight – Causes, Types, and Modern Diagnostics
Glaucoma is an attack on your optic nerve. When it atrophies, you lose the ability to see.
Introduction and Alarming Statistics (Author: Dr. Victor Derhartunian)
Who is at risk and why must we act quickly?
- Definition: Glaucomatous neuropathy and progressive optic nerve atrophy: Glaucoma is nothing more than the gradual death of the fibers of your optic nerve. The worst part is that once lost, vision cannot be regained.
- Scale of the problem: Estimated increase in the number of patients and cases of total blindness: This is a mass disease. We must speak loudly about it, because it is one of the main reasons why people permanently lose their sight.
- Genetic factors: Increased risk in siblings and offspring of patients: Do you have glaucoma in your family? Be careful! The risk increases dramatically: it is 4 times higher for siblings and 2 times higher for your children. Just turn on the orange warning light.
Types of Glaucoma – Classification and Etiology
Did you know that glaucoma can strike at any age?
Congenital and Secondary Glaucoma (Beyond Adulthood)
This is not just a disease of retirees.
- Congenital glaucoma: infantile, childhood, and juvenile: Yes, children also get sick. We have glaucoma that manifests from birth, but also forms that surprise teenagers (up to 35 years of age).
- Primary glaucoma: develops without an identified cause: This is the form that simply appears and we do not associate it with any specific disease.
- Secondary glaucoma: in the course of eye diseases (diabetes, cataracts, injuries): This glaucoma comes ‘in a package’. It develops because you already have another disease – diabetes, cataracts, cancer, or you have suffered a serious eye injury.
Glaucoma and Intraocular Pressure (IOP)
Intraocular pressure is our main target.
- IOP as the main, modifiable risk factor: We can measure it and we can treat it. That is why maintaining proper intraocular pressure is the most important thing we do in therapy.
- Normal pressure can also damage the optic nerve – Normal Tension Glaucoma: And what if your pressure is textbook, but your vision is failing? This is Normal Tension Glaucoma (NTG). Here the problem lies elsewhere – perhaps in poor nerve blood supply.
Classic Classification of Glaucoma Based on the Drainage Angle
The drainage angle – this ‘valve’ determines the course of the disease.
Open-Angle Glaucoma (POAG) – The Most Common Form
Simply put: a blockage in the outflow.
- Mechanism: IOP increase due to obstacles in aqueous humor outflow: Fluid in the eye is constantly produced, but its exit is hindered. It accumulates, pressure rises, and begins to crush nerve fibers. This accounts for 9 out of 10 cases of glaucoma!
- Risk factors: Age > 40 years, elevated IOP, genetics, myopia > 4 D: If you are over 40, have high myopia, thin corneas, and a family history of glaucoma, simply come for examinations more often.
Normal Tension Glaucoma (NTG) and Secondary Open-Angle Glaucoma
When pressure goes wild or is too low.
- NTG: More common in women > 50 years and associated with thin cornea, migraines, and low blood pressure: NTG is often a vascular problem. It more often affects women who tend to have migraines, cold hands and feet, and low blood pressure.
- Secondary glaucoma: Aggressive course associated with pigment/protein deposits and large IOP fluctuations: Here, various debris – proteins, pigment – accumulate in the drainage system. This significantly raises pressure, and fluctuations are enormous. This can be a truly aggressive form.
Angle-Closure Glaucoma (ACG)
Here’s an emergency scenario – a sudden attack.
- Characteristics: Occurs in 10-15% of patients, sudden closure of outflow: You have a specific eye structure (often hyperopia). A thick iris or lens suddenly blocks fluid outflow. Pressure skyrockets!
- Severity: Acute ACG attack as an emergency and risk of blindness (triggered by stress/pupil dilation): This is an alarm! A sudden increase in pressure, often after significant stress or, for example, after pupil-dilating drops, can lead to blindness in a few hours. You need immediate intervention.
- Risk factors: Hyperopia, eye structure, race: If you are farsighted and have anatomical predispositions, this is your type of glaucoma.
“For me, glaucoma is a game of chess where we have to anticipate the disease’s moves. We must change our approach: treat an annual, full eye examination as an absolute priority after the age of 40. Glaucomatous neuropathy is a process. And we can and must stop this process.” – Dr. Victor Derhartunian.
Prognosis, Symptoms, and Prevention
Early diagnosis is the only way to beat glaucoma.
Symptoms and Pain
Don’t be fooled!
- Chronic form: Insidious and asymptomatic development – Chronic glaucoma doesn’t hurt! This is the most important thing: most glaucoma is painless! When you start feeling pain, it means that, unfortunately, the disease is already very advanced.
- Acute glaucoma attack: Severe eye and head pain (affects 1-2% of patients): Only this rare, acute ACG attack causes excruciating, persistent head and eye pain. If something like this happens to you, rush to the emergency room!
Early Detection and Regular Examinations
Want good eyesight in old age? Get regular check-ups.
FAQ – Frequently Asked Questions about Glaucoma
1. Can glaucoma be completely cured?
Answer: Unfortunately, we cannot reverse it. A damaged nerve will not return to normal. Treatment has one goal: to stop the progression of the disease and maintain intraocular pressure at a safe level.
2. What are the most important tests when glaucoma is suspected?
Answer: The absolute basis is intraocular pressure measurement (tonometry), plus OCT (Tomography) of the optic nerve head – this will tell us how many nerve fibers remain. And, of course, visual field examination.
3. Is glaucoma genetic?
Answer: It is not 100% hereditary, but heredity plays a huge role. If you have affected family members (especially siblings, parents), you must be under constant control – this is your biggest risk group.
4. Does elevated intraocular pressure immediately mean glaucoma?
Answer: No. You can have ocular hypertension (high pressure), but the optic nerve is still healthy. We diagnose glaucoma only when this pressure has already started damaging the nerve.
5. When does a headache mean glaucoma?
Answer: Chronic glaucoma does not cause headaches. Pain, severe and persistent, is a symptom only and exclusively of an acute glaucoma attack (ACG), which is a sight-threatening condition and requires immediate intervention.
6. How to check if you have glaucoma?
Three tests are needed: intraocular pressure measurement (tonometry) considering corneal thickness (pachymetry), evaluation of the optic nerve head and nerve fiber layer with OCT, and visual field examination. Pressure measurement alone is not enough, as some types of glaucoma occur with normal pressure.
7. How do you see with glaucoma?
Normally at first – and this is the most dangerous part. Defects begin at the periphery of the visual field, and the brain ‘fills them in’, so the patient doesn’t notice them. In advanced glaucoma, tunnel vision remains, and an acute glaucoma attack causes severe pain, blurred vision, and rainbow halos around lights.
8. What causes glaucoma?
The main factor is intraocular pressure that is too high for a given nerve, resulting from impaired aqueous humor outflow. Risk factors include: family history of glaucoma, age over 40, high myopia or hyperopia, diabetes, circulatory disorders, thin cornea, and long-term use of steroids.
9. What should you not do with glaucoma?
You should not stop drops on your own or skip check-ups. Avoid pupil-dilating medications without an ophthalmologist’s knowledge (for angle-closure glaucoma), prolonged head-down positions, drinking large amounts of fluids at once, and tight ties. Moderate exercise is recommended.
Glaucoma diagnostics at SwissLaser
Glaucoma develops asymptomatically — early detection is crucial. We perform full diagnostics.
- Glaucoma screening — examination procedure
- Tonometry — intraocular pressure measurement
- OCT examination — evaluation of the optic nerve and retina
- Ophthalmologist in Krakow — consultation and diagnostics
- Diagnostic tests – price list
