Can Glaucoma be cured? Check out the facts about the disease
Facts about Glaucoma:
- Glaucoma affects an estimated 78 million people worldwide and is one of the leading causes of irreversible but preventable blindness. The number is estimated to approach 120 million by the year 2040 as society ages.1
- 1 in 200 people aged 40 and over have Glaucoma and 1 in 8 people aged 80 and over.
- Patients aged 65 and over are more likely to have the disease, especially if they are diabetic or high myopic, and also women, ethnic minorities and indigenous people.
- If you have a relative with the disease, you are 10 times more likely to contract the disease.
- In many cases, it is asymptomatic, meaning that you will not have any symptoms until the disease is advanced. This means that 50% of those affected do not know they have the disease.
Questions and Answers:
What is it?
- Glaucoma is characterised by the progressive loss of the visual field, which gradually disappears until there is total loss of vision. Progressive atrophy of the optic nerve develops, due to loss of nerve cells by factors not yet fully identified.
When there are symptoms, what are the most common ones?
- Sensitivity to light or photophobia
- Eye pain (due to high eye pressure)
- Headache
What were the effects of pandemic Covid-19 on Glaucoma patients?
- The pandemic has considerably delayed the follow-up of patients through consultations, eye examinations and procedures that are essential for glaucoma, which represents an increased risk that can lead to irreversible blindness.
- Procedures have accumulated in the national health system, which is currently overloaded. This makes clinics such as the CPO - Private Ophthalmology Clinic an important solution to help the follow-up of these patients.
What do ophthalmologists recommend during the pandemic for patients with the disease?
- If you notice loss of vision, eye pain or eye discharge, especially if you have previously had glaucoma surgery, you should contact your ophthalmologist as soon as possible.
- The most important thing is to maintain the use of all glaucomatous eye drops (hypotensives) - proper eye drops - as recommended by the doctor in the previous consultations and address the issue in the following consultations.
- Keep calm and don't worry too much because the disease progresses very slowly, as long as you keep the recommended treatment (that is well) under control, the postponement or extended wait should not affect your vision.
- If you have an aggressive type of glaucoma, you should not wait too long for your eye appointment.
Why does a glaucoma patient need face-to-face consultations?
- One of the critical components in the identification, diagnosis and follow-up of patients with Glaucoma is the measurement of eye pressure. In addition to other components that can only be performed in a face-to-face consultation.
- If you are unable to come for an appointment, for reasons beyond your control, you can use a teleconsultation at the Ophthalmology Private Clinic or ask to redirect enquiries to your usual ophthalmologist.
- If you experience loss of vision, severe eye pain (or discharge) it is an emergency and should be seen as soon as possible by your ophthalmologist.
Why use lubricating eye drops in glaucoma cases?
- Hypotensive eye drops in some cases cause changes to the ocular surface, with symptoms of severe burning and dryness of the eye.
- They should be used with intervals of at least 5-10 minutes between different medications.
- Contact your ophthalmologist if you experience persistent eye discomfort.
- Make use of teleconsultation to help resolve eye discomfort.
What are the different types of Glaucoma?
- Chronic simple glaucoma is the most frequent and is usual in about 95% of cases.
- The acute or closed angle occurs when there is an abrupt increase in intraocular pressure, by closing the angle of the anterior chamber and due to pupil dilation.
- Secondary happens as a result of other eye diseases e.g. trauma to the eyeball (which eventually causes it). Other types are: Neovascular Glaucoma which results from the formation of new blood vessels in the iris, reaching the trabecular meshwork and preventing the elimination of the aqueous humour; Congenital Glaucoma is a special case, detected at birth, as babies are born with larger than normal eyes.
Can Glaucoma be cured?
- Chronic glaucoma, the most common type, has no cure. Once installed, it will always continue to evolve. The only possibility is to achieve stabilisation of the disease, with medical treatment adjuvated or not with surgery. The aim is to maintain the ocular pressure at values considered to be normal so as not to cause further destruction of the optic nerve, thus halting the evolution of the disease. It is a treatment for life.
- Surgical treatment has the same purpose, to control the ocular pressure when hypotensive drops cannot lower it sufficiently. However, as eye pressure is not the only factor, sometimes, despite good tension control, the disease continues its evolution. Cases of non-pressure glaucoma, that is, in which the eye pressure is normal, are indicative of other unknown factors that we are unable to treat.
- In closed angle glaucoma, a timely intervention at the first crisis, or in advance, by identifying the risk, by observing a closed angle, simple surgical intervention, with YAG laserlaser,resolves the issue definitively by creating a bypass in the iris for the normal outflow of the aqueous humour.
- All cases of secondary glaucoma are difficult to treat and there is little effective treatment.
When are patients indicated for surgery?
- It is not possible to lower the eye pressure to satisfactory values with maximum medical therapy or laser;
- Adherence to medical therapy is low;
- In a patient with marked hypotension;
- Existence of allergy to the eye drops used;
- There is a progression of glaucomatous lesions even when the pressure is apparently controlled despite maximum tolerated medical treatment.
Do patients who have had surgery need to maintain the frequency of follow-up?
- After the immediate post-operative period, the frequency will depend on the outcome of the surgery. If the eye pressure is well controlled the usual six-monthly or annual visit will be sufficient.
Who are the Glaucoma specialists in the Private Eye Clinic?
- O Dr. António Melo and Prof. Dr. Tiago Ferreira are two professionals with wide experience in following patients with the disease and also with vast experience in the surgical field for this pathology.
How to identify?
- From the age of 40, the risk of the disease appearing increases significantly, which makes it essential to have ophthalmology consultations annually to identify possible changes in eye health. The frequency of follow-up, especially when risk factors exist, is important because many cases of glaucoma are asymptomatic. An annual visit will be indicated.
What is the Ophthalmology Private Practice perspective?
- At CPO Glaucoma is treated with great care, seeking early diagnosis, especially in patients at risk.
- Eye pressure measurement and pre-consultation screening are part of the usual consultation.
- This allows our specialists a precise control of the various pathologies and also of glaucoma.
- If the disease is suspected, an examination of the optic nerve and possibly a visual field examination is carried out immediately so that the correct diagnosis can be made. In addition, corneal thickness measurement is another important examination as there are false diagnoses of high eye pressure without signs of glaucoma. Patients with a corneal thickness outside the normal range result in false measurements of elevated eye pressure.
- Our concern for the problem of glaucoma also leads us to constant training of our specialists and diagnostic procedures.