Glaucoma is the technical name of a disease characterised by elevated pressure inside the eye. This elevated pressure leads to vanishing of the optic nerve. The nerve-fibers are compressed and lose their ability to lead the impulses from the retina to the brain. Very unfortunately this processes cannot be reversed and first leads to losses inside the visual field.
The pressure must be normalized to avoid a final loss of vision of the eye.
A distinction is made between the so called primary glaucoma, which occurs without detectable reason and so called secondary glaucoma, in which the intraocular pressure is increased by other diseases or violations of the eye.
In the primary and secondary glaucoma there is a mismatch between production and drainage of the fluid in the eye. There, again, are two different states: the open-angle glaucoma and the narrow angle glaucoma. The open-angle glaucoma is the most common. The cause lies in an obsturction of the outflow of aqueous humor directly into the filter layer, i.e. in the trabecular meshwork. aunder the microscope, one can detect changes to the filter layer, based on, for example, pigment deposits.
Both are developments that do not occur suddenly, but develop over time. A narrowing of the outflow is not untipical of the aging process. This makes glaucoma more common from the middle age. The development mostly is a rather slow process that, if not diagnosed and treated, may lead to loss of vision.
The good news on glaucoma treatment is, that about 80% of the diagnosed patients are able to keep their intraocular pressure within normal on standard medication, mostly eye-drops alone.
All those patients can live a normal life and must not be afraid of the severe sequelle of this disease.
All glaucoma operations create a larger out-flow of the fluid produced inside the eye. The names of the operations are Iridectomy, Trabekulectomy, Iridenkleisis, Stents. The operations may be done with the diamond knife or with a femtosecond laser. If the procedure chosen matches the compensation for the over-production of fluid, a life-long normalisation of the pressure may result. Additional eye-drops on the other hand may be indicated in about 40% of the operated cases.
A postoperative survey of at least two weeks should be scheduled.