Glaucoma

What is it and how to Recognise it

Glaucoma is an eye disease generally related to the intra ocular pressure being too high. It is the second cause of blindness worldwide after cataract, but it is the leading irreversible condition.

The internal pressure of the eye damages the optic nerve, where all retinal nerve fibres, which send visual information to nerve centres in the brain, converge. The increased pressure irreparably damages the neurons that transport the bioelectric signal.

Chronic open-angle glaucoma is the most frequent form of glaucoma (around 80% of cases). It occurs when an obstacle prevents the aqueous humour from flowing. The majority of outflow is via the trabecular meshwork, an organ responsible for active transport of the aqueous humour. It is found above the iris or more precisely, in the angle between the iris and cornea.

Recent studies have demonstrated how functionality of the trabecular meshwork is fundamental for the progress of this disease.

Glaucoma has been called the “silent thief of sight” because the loss of vision often occurs gradually over a long period of time. The symptoms occur only when the disease is quite advanced. The loss of vision is irreversible.

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Topical therapy is typically first-line treatment for patients with newly diagnosed glaucoma. When the condition is detected early enough, it is possible to arrest the development or slow the progression. Treatment of glaucoma is usually effective only when the patient is aware of the disease and compliant to the medication.

All multidose ophthalmic medications are required to have a preservative to maintain an antimicrobial environment in the bottle, but unfortunately, most preservatives in ophthalmic medications disrupt the ocular surface and even exacerbate any pre-existing ocular surface disease (OSD).

Preservative free glaucoma medications have found that patients experience more comfort and are better compliant. Eyes treated with preservative free medications also appear to have healthier ocular surfaces as determined by the doctors.

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