Medical information gathered by Dr. Marco Abbondanza on experience with ocular surgery


GLAUCOMA


Although glaucoma is a serious pathology, if recognized and cured at an early stage it can be kept under control so that a normal life can be led.
Constant weakening of eyesight is brought on by glaucoma especially because of an increase in intra-ocular pressure.
This high ocular pressure is caused by aqueous humour. Aqueous humour is produced by ciliar bodies, situated behind the iris and is eliminated by the trabecolatum in front of the iris. High pressure and consequent damage is caused by the imbalance between liquid produced and that which is eliminated through the trabecolatum.
Normal endo-ocular pressure is between 10-20 millimeters of mercury.


Types of glaucoma
There are primary and secondary types of glaucoma.
Primary glaucoma is caused by alterations in the down-flow system: trabecolatumSecondary glaucoma is caused by external or internal eye factors differing from trabecolatum.
There are many different types of glaucoma but the most important are open angled chronic glaucoma and closed angle glaucoma.
Open angled glaucoma produces slow and constant damage to the optical nerve.
Narrow angled glaucoma can cause an attack of acute glaucoma characterized by a rapid decrease in vision associated with much pain in the orbital region.


Diagnosis
Glaucoma is a deceiving illness which oftentimes reveals no symptoms until it is too late.
The patient should have his ocular pressure measured during each visit, and after turning 40, should have his visual field examined through computerized equipment. This should be done twice a year, or more often where there is a case history of glaucoma in a family.


Therapy
There are several possible ways of curing glaucoma.
Medical therapy: Eyedrops is used to reduce aqueous humour or increase down-flow.Eyedrops efficiency can be limited in time and often phenomena of addiction can occur making eyedrops therapy less valid. Check-ups tell us whether medical therapy can continue or whether this needs to be changed.
Laser therapy: Two types of laser treatment can be used for glaucoma. In yag laser a small hole is made in the iris giving aqueous humour an easier passage from behind the iris to the trabecolatum.
Argon laser widens the trabecolatum mesh and eases 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 pharmacologic or laser therapy has failed. Since there are so many different surgical methods, an expert surgeon with knowledge of different techniques can choose the right kind for each case.