Glaucoma is a condition of the optic nerve whose main risk factor is intraocular pressure. There are different forms of glaucoma, chronic or acute, open-angle or closed-angle, primary or secondary, etc.
The most common form, which is chronic primary open-angle glaucoma, develops slowly, does not have symptoms, and usually gradually damages peripheral vision, which is why it is not noticed by the patient until very advanced stages. The diagnosis is made after an ophthalmological examination and the risk factor that can be controlled to regulate the disease is the intraocular pressure.
The reduction of intraocular pressure is achieved with anti-glaucoma drops, while in cases where the drops are tolerated, other more invasive approaches are followed such as laser, valves or trabeculectomy. The impression that is often held that increased pressure in the eye gives symptoms and the eye hurts is wrong for cases of chronic glaucoma. The patient does not feel pain, his central vision has not been affected, so he cannot realize that he has the disease.
In addition, because there are genes that have been implicated in various forms of glaucoma, relatives of glaucoma patients, especially after the age of 40, should be ophthalmologically examined every year.
However, it would be useful to clarify that there is also a clinical entity, ocular hypertension, which is often confused with glaucoma. In ocular hypertension, the intraocular pressure of the eye is elevated, but there is no damage to the optic nerve. In other words, the eye "can cope with" this increased pressure and does not lose nerve fibers from its optic nerve.
When only the intraocular pressure is elevated and the optic neuropathy that characterizes glaucoma is not present, then depending on the age, the value of the intraocular pressure and the other characteristics of the eye, treatment may not be needed to reduce the eye pressure and the patient just needs to be watched.
Whether the increased intraocular pressure damages the optic nerve is checked with the visual fields machine which records the damage to the function of the optic nerve i.e. the damage to the peripheral vision (and central vision when present) and with the OCT of the optic nerve head which takes tomographs from the optic nerve and measures its nerve fibers so we have the anatomical representation of the lesion.
The clinic has a state-of-the-art optical field device and OCT device, with special software that can combine between the two machines the functional and anatomical imaging of the lesion.