The term glaucoma brings together several quite different diseases which have a problem with eye pressure in common.
The most common type of glaucoma is a chronic disease called chronic open-angle glaucoma (GCAO), characterized by an increase in intraocular pressure (IOP), or more precisely, by an IOP level higher than what the optic nerve can bear. Indeed, the structure that suffers in the event of inadequate IOP is the optic nerve, and more precisely, the head of the optic nerve, whose vascularization depends on vessels that are, in a way, “crushed” by an excessively high IOP.
By understanding that glaucoma is a chronic disease of the optic nerve head, we understand that the threshold level of IOP above which the optic nerve begins to suffer is not the same for all individuals.
Thus, if it is most often observed that the intraocular pressure is high in an individual with glaucoma, there are also so-called “normal pressure” glaucoma in which the IOP is normal, i.e., less than 20 mm Hg, with, however, authentic suffering of the optic nerve whose “threshold” is then lower.
If the diagnosis of glaucoma can be suspected when a high IOP is measured during a routine consultation, it is the analysis of the optic nerve that will make it possible to confirm or rule out the diagnosis. The suffering of the optic nerve can be visualized on the fundus in the form of an excessive digging of the head of the optic nerve, which, even isolated, with a normal IOP, should evoke the diagnosis.
This will be confirmed by functional examinations, the first of which is a simple realization examination: the visual field. This indeed shows, in proven glaucoma, deficits in specific topography, which make it possible to confirm the diagnosis and also make it possible to follow the evolution of the disease under treatment.
In recent years, many imaging techniques have also been developed to quantify and monitor the widening of the optic nerve over time, which is very characteristic of glaucomatous disease.
The treatment with discover vision for example is, above all, medical, based on eye drops belonging to different molecular families, and intended to lower intraocular pressure. These eye drops can be combined when monotherapy proves to be insufficient. When the evolution of glaucoma makes medical treatment insufficient, a surgical sanction can be proposed, replaced, or preceded in certain cases by laser treatment.
In any case, it should be remembered that this form of glaucoma develops slowly, that its diagnosis is based above all on systematic screening in consultation, in particular during consultations for presbyopia around the age of 50 and that the treatment is mainly medical, surgery having its place in the inadequacies of medical treatment.
Finally, it is a hereditary disease, and family cases strongly encourage earlier and more frequent screening.
Acute angle closure glaucoma is a different pathology, characterized by the sudden onset, most often in middle-aged subjects, of a picture associating acute pain and a significant drop in vision. The examination then shows a significant rise in intraocular pressure exceeding 40 mm Hg, and surgical or laser treatment is urgently required. This glaucoma results from a sudden blockage of the intraocular circulation of aqueous humor and is often triggered by taking medications that have the side effects of inducing pupil dilation. A large number of drugs include in their instruction contraindications or precautions for use in the event of glaucoma, and only subjects predisposed to angle closure glaucoma are concerned.
Once the crisis has been suppressed in the eye concerned, preventive laser treatment with glaucoma doctor near me will be systematically carried out on the other eye, which is also exposed to the risk of acute glaucoma.